Abstract: An emboli filtration apparatus is provided comprising a guide wire having a filter element captured thereon, so that the guide wire is free to rotate or translate while the filter element remains stationary. The apparatus allows for movement and rotation of the guide wire as devices are advanced over it to treat occlusive disease, substantially without dislodging the filter element.

Abstract: Methods and apparatus for removing emboli during an endarterectomy procedure are provided. The present invention provides a proximal catheter disposed proximal to a stenosis and a distal catheter disposed distal to the stenosis. Each catheter may selectively communicate with a venous return catheter via a manifold having a setting controlled by a physician. Blood flows into an aspiration lumen of the distal catheter and is reperfused into a remote vein via the venous return catheter. Additionally, emboli generated during the procedure are removed via an aspiration lumen of the proximal catheter, and filtered blood then is reperfused into the remote vein.

Abstract: Methods and apparatus are provided for improved brachytherapy treatment of prostate disease. The apparatus provides for angular reorientation of a needle template with respect to an ultrasound probe during brachytherapy administration. Angular reorientation is expected to beneficially overcome anatomical constraints, such as skeletal structures, that may limit a medical practitioner's ability to deliver radioactive brachytherapy seeds into a prostate in proper alignment.

Abstract: A prosthesis is provided for treating aneurysms, occlusive disease of vessels and body organs, and arterio-venous fistulas, occurring in single and bifurcated lumens. The prosthesis comprises an expandable coiled sheet portion having a biocompatible graft, either a sheet or tube, affixed thereto along part or all of the circumference of the coiled sheet portion. The prosthesis has a small delivery profile, making it suitable for use in a variety of body vessels. Methods of making and deploying the prosthesis in single and bifurcated lumens are also provided.

Abstract: Methods and apparatus are provided for removing emboli generated during a surgical procedure comprising a catheter having proximal and distal ends, a lumen extending therethrough, an occlusive member affixed to the distal end, and at least one blood intake port disposed in a lateral surface of the catheter. The occlusive member preferably is disposed in a treatment vessel, and the blood intake port, when uncovered, permits a portion of the antegrade flow from a host vessel to be diverted into the lumen of the catheter. A pressure differential caused by the blood intake from the host vessel establishes a venturi-effect suitable for manipulating flow in the treatment vessel. The flow characteristics may be manipulated via the intake port to direct emboli into the lumen of the catheter for subsequent removal.

Abstract: A stent including a helical mesh coil is provided having a substantially rectangular cross-section and a band width equal to at least one-quarter to one-third of the maximum expanded circumference of the stent. The helical mesh has a multiplicity of openings forming a lattice that preferably provides about 60% open space or more. Alternative embodiments of the stent include free ends that preferentially overlap neighboring turns of the coil, and integrally formed barbs that enhance resistance to localized compressive forces. Methods of deploying the helical mesh coil stent also provided.

Abstract: A perfusion-occlusion catheter provides an occluded region in a vessel to facilitate, for example, an anastomosis in the region, while providing a path for perfusing fluid (blood) through the path for delivery in the vessel downstream from the occluded region. According to one aspect of the invention, at least a portion of the catheter that effects vessel occlusion comprises a shield that when exposed to suture needles or like piercing instruments deflects or resists perforation.

Abstract: A surgical cutting instrument adapted for percutaneous insertion into a body cavity to facilitate a minimally invasive surgical procedure. The surgical cutting instrument includes a shaft having a proximal end, an open distal end, and an axial lumen therebetween. An inlet opening may be fluidly coupled to the lumen at a proximal end of the shaft, for connection to a vacuum source for creating a suction force sufficient to retain the distal end of the shaft adjacent to a surface of a body structure within the body cavity. A cutting element is disposed within the lumen of the shaft near the distal end of the shaft, and is operable to cut the body structure without removing any substantial portion of the body structure when the shaft is held adjacent to the surface of the body structure.

Abstract: Apparatus for occluding a vessel and enhancing blood flow within a catheter are provided, wherein a catheter comprises a multi-section self-expanding wire weave forming a radially expandable body and an occlusive distal section, covered with an elastomeric polymeric coating, and disposed within an outer sheath. Methods of using the apparatus of the present invention to remove emboli also are provided.

Abstract: Methods and apparatus are provided for brachytherapy treatment of prostate disease for use in conjunction with needles containing a plurality of radioactive seeds. The apparatus comprises a housing and plunger assembly operable by a single clinician. The plunger is coupled to the housing, so that when the apparatus is actuated the needle is retracted against the plunger and the plurality of radioactive seeds is ejected.

Abstract: An emboli filtration apparatus is provided comprising a guide wire having a filter element captured thereon, so that the guide wire is free to rotate or translate while the filter element remains stationary. The apparatus allows for movement and rotation of the guide wire as devices are advanced over it to treat occlusive disease, substantially without dislodging the filter element.

Abstract: Methods and apparatus are provided for temporarily excluding an aneurysm or an arterio-venous fistula from a flow path by transluminally disposing a hollow balloon catheter structure within the aneurysm so that its proximal and distal ends extend past the aneurysm while maintaining continuity of the flow path, and then injecting a synthetic molding material or a biological hardening agent into the aneurysm cavity to cause solidification of the volume within the cavity. Once the material within the excluded aneurysm has solidified, the balloon catheter structure is deflated and removed, so that the hardened mass forms a new lining for the organ or vessel, and relieves the weakened tissue of the aneurysm or fistula from further flow-induced stress.

Abstract: A perfusion-occlusion catheter provides an occluded region in a vessel to facilitate, for example, an anastomosis in the region, while providing a path for perfusing fluid (blood) through the path for delivery in the vessel downstream from the occluded region. According to one aspect of the invention, at least a portion of the catheter that effects vessel occlusion comprises a shield that when exposed to suture needles or like piercing instruments deflects or resists perforation.

Abstract: A surgical cutting instrument adapted for percutaneous insertion into a body cavity to facilitate a minimally invasive surgical procedure. The surgical cutting instrument includes a shaft having a proximal end, an open distal end, and an axial lumen therebetween. An inlet opening may be fluidly coupled to the lumen at a proximal end of the shaft, for connection to a vacuum source for creating a suction force sufficient to retain the distal end of the shaft adjacent to a surface of a body structure within the body cavity. A cutting element is disposed within the lumen of the shaft near the distal end of the shaft, and is operable to cut the body structure without removing any substantial portion of the body structure when the shaft is held adjacent to the surface of the body structure.

Abstract: A prosthesis is provided for treating aneurysms, occlusive disease of vessels and body organs, and arterio-venous fistulas, occurring in single and bifurcated lumens. The prosthesis comprises an expandable coiled sheet portion having a biocompatible graft, either a sheet or tube, affixed thereto along part or all of the circumference of the coiled sheet portion. The prosthesis has a small delivery profile, making it suitable for use in a variety of body vessels. Methods of making and deploying the prosthesis in single and bifurcated lumens are also provided.

Abstract: Hand-held surgical assembly for use in performing a laparoscopic medical procedure, comprising a housing. An actuator tube having a bore therein is slidably mounted in the housing. A handle operated mechanism is carried by the housing for causing reciprocatory movement of the actuator tube assembly within the housing.

Abstract: A stent comprising a helical mesh coil is provided having a substantially rectangular cross-section and a band width equal to at least one-quarter to one-third of the maximum expanded circumference of the stent. The helical mesh has a multiplicity of openings forming a lattice which preferably provides about 60% open space or more. Alternative embodiments of the helical mesh may include specially designed free ends that preferentially overlap neighboring turns of the coil, to ensure that the free ends of the stent do not project into the body lumen, and integrally formed barbs that induce a ratcheting effect that ensures that the stent resists localized compressive forces. Methods of deploying the helical mesh coil stent also provided.

Abstract: A prosthesis is provided for treatment of aneurysms, occlusive disease of vessels and body organs, and arterio-venous fistulas, comprising an expandable coiled sheet portion having a biocompatible graft affixed thereto. The graft material, preferably a polytetrafluoroethylene ("PTFE") or polyesther material, is affixed to the coiled sheet portion by sintering, suturing, or bonding using a biocompatible adhesive. The coiled sheet portion comprises a lattice formed from a biocompatible material, and may include one or more rows of locking teeth adjacent one edge of the coiled sheet that interengage openings in an opposing edge of the coiled sheet portion to retain the prosthesis at a desired expanded diameter. The prosthesis has a small delivery profile, making it suitable for use in a variety of body vessels. Methods of making and deploying the prosthesis are also provided.

Abstract: An endoprosthesis is provided having at least first and second resilient coiled sheet portions, and an intermediate region comprising a helical articulation. The coiled sheet portions may be of the same or different diameters so as to accommodate a taper in the body lumen, while the helical articulation comprises a mesh portion that provides both flexibility and high radial strength, and which contracts to its delivery profile with relatively few turns. The coiled sheet portions also may be of the same or different lengths, and for very long devices, may be interspersed between a plurality of helical articulation portions. The pitch of the helical articulation may be varied to create a partial telescoping of the helical articulation within one of the first and second coiled sheet portions when in a contracted state. The prosthesis may also be used for treating bifurcated vessels.

Abstract: Methods and apparatus are provided for temporarily excluding an aneurysm or an arterio-venous fistula from a flow path by transluminally disposing a hollow balloon catheter structure within the aneurysm so that its proximal and distal ends extend past the aneurysm while maintaining continuity of the flow path, and then injecting a synthetic molding material or a biological hardening agent into the aneurysm cavity to cause solidification of the volume within the cavity. Once the material within the excluded aneurysm has solidified, the balloon catheter structure is deflated and removed, so that the hardened mass forms a new lining for the organ or vessel, and relieves the weakened tissue of the aneurysm or fistula from further flow-induced stress.