Abstract: Various embodiments of an endovascular sheath include a shaft portion with an interior lumen and an exit opening. The sheath may be introduced into a blood vessel along a guidewire that has already been placed within the vessel (typically via a Seldinger needle technique). Along the shaft is an opening that permits exit of a second guidewire introduced into the sheath lumen. The sheath may include, within the lumen, one or more features that encourage exit of the second guidewire through the opening at an optimal angle. A secondary lumen carries a stiffening wire for procedures involving tortuous vascular anatomy.

Abstract: A surgical valvulotome has a detachable hub. The hub has a hub body and a removable cap. A seal disposed between the hub body and the cap holds an end of a catheter. Tapering side walls squeeze the seal when the hub body and cap are tightened. Loosening the cap allows the seal to return to its original shape, releasing the catheter.

Abstract: An anchoring device can be used to secure a vascular rivet to the wall of a blood vessel. The anchoring device has a catheter with a rivet chamber that can be positioned at a desired location within a blood vessel. The rivet can be driven through a graft and the wall of the blood vessel by either a mechanical pusher or a blast of fluid, such as carbon dioxide gas. The rivet has an optional leg with a thermal memory that curls to secure the rivet in place when it warms to body temperature. An optional elastic rivet disk holds the graft tightly to the wall of the blood vessel during the geometric changes that occur during cardiac cycles.

Abstract: An improved valve cutter for in-situ incision of valve leaflets which safely, efficiently, and consistently renders venous valves incompetent while minimizing frictional forces on the endothelium of the vessel and preventing inadvertent contact between cutting surfaces and the intima of the vein wall. The valve cutter includes a plurality of proximally directed prongs presenting sharp edges, where the prongs are separated by slots similarly presenting sharp edges to pierce the valve leaflets so that the cutting head is provided with a continuous cutting surface in multiple planes running along the entire forward edge of the cutting head. Fiber optics provided for viewing the valves as they are penetrated by the sharp cutting edges.

Abstract: A specimen-receiving receptacle apparatus for use in minimally invasive surgical procedures can be remotely opened and closed from a proximal end of the apparatus, outside of the patient. The apparatus includes a belt having substantial longitudinal rigidity so that the belt can be forced longitudinally into the surgical site to open the specimen-retrieval receptacle from a remote end of the apparatus. The belt can be longitudinally pulled out of the surgical site to close the specimen-retrieval receptacle from outside of the patient. The belt is relatively flexible or easily deformable along an open end of the receptacle without deforming substantially out of the plane of the open receptacle end. This is achieved by aligning the belt with respect to the open end such that a large dimension of the belt is aligned transverse to the plane of the open receptacle end. In a preferred embodiment, the belt is extruded from nylon and has an elliptical cross-sectional shape.

Abstract: A surgical retractor having a plurality of widenable and narrowable blades of substantial width, having tissue-contacting surfaces that are not significantly narrower, in a collapsed position, than a guide tube for guiding the retractor blades through a surgical access port to a surgical site during a minimally invasive surgical procedure. Each retractor blade includes a relatively large, preferably planar, tissue-contacting surface for displacing or repositioning internal body tissue, such as an internal organ, for temporary displacement away from the surgical site. After insertion through a surgical access port one or more of the retractor blades can be widened laterally to substantially space distal ends of the retractor blades apart for maximum contact against and over a substantial area of the tissue to be displaced during the surgical procedure.