Abstract: A method for controlling appetite by means of a satiation device is disclosed. The device, which includes a flexible webbing defining proximal and distal openings and a biasing structure, is attached to the patient's stomach with the proximal opening positioned adjacent and below the patient's gastro-esophageal junction. The biasing structure imparts pressure against the wall of the patient's stomach adjacent the gastro-esophageal junction.

Abstract: The present application describes a retention device for anchoring a medical device within the vasculature. The device may include expandable member coupled to an intravascular medical device and proportioned for receipt within a vessel. At least a portion of the expandable member is expandable to radially engage a vessel wall and to thereby retain the medical device within the vessel. The system is suitable for a variety of intravascular devices, including but not limited to ICD's, pacemakers, and intravascular drug delivery systems.

Abstract: An intravascular electrode device for use in neuromodulation includes an anchor expandable from a radially compressed position to a radially expanded position. A lead extends from the anchor and has at least one conductor extending through it. A flex circuit is coupled to the anchor and comprises a flexible insulative substrate, a plurality of electrodes carried by the substrate, and a plurality of conductive traces carried by the substrate, each trace electrically coupled to an electrode and a conductor. Expansion of the anchor within a blood vessel biases the electrodes into contact with the surrounding blood vessel wall. An exemplary anchor includes a first portion having expansion forces sufficient to bias the electrodes against the vessel wall for mapping and chronic stimulation, and a second portion having greater radial expansion forces sufficient to chronically engage the vessel wall once an optimal electrode location has been selected.

Abstract: A system for performing multi-tool minimally invasive medical procedures through a single instrument port into a body cavity includes a rigid tube carried by a mount. Cannulas having instrument channels and steerable distal ends extend distally from the rigid tube. During a procedure using the system, the mount is supported by an operating room fixture, and instruments are advanced through the steerable instrument channels. Manipulation of the instrument handles engages actuators positioned on the mount, which steer the distal ends of the cannulas through the action of pull cables. The distal ends of the instruments may thus be steered within the body by the distal ends of the steerable cannulas.

Abstract: A satiation device is described which includes a sheath or liner extending from the proximal or middle stomach to the distal antrum. Food ingested by the patient passes through the sheath or liner, thereby minimizing contact between the ingested food and the stomach. It is believed that over time, reduced contact between food and the stomach will result in decreased Ghrelin production by the patient and a consequent decrease in appetite. In some embodiments, the satiation device may also include a proximal pouch and/or a distal bypass tube.

Abstract: Methods of manufacturing polymeric intraluminal prostheses include annealing the polymeric material to selectively modify the crystallinity thereof. Annealing may be utilized to selectively modify various properties of the polymeric material of an intraluminal prosthesis, including: selectively increasing the modulus of the polymeric material; selectively increasing the hoop strength of the intraluminal prosthesis; selectively modifying the elution rate (increase or decrease) of a pharmacological agent subsequently disposed on or within the annealed polymeric material; selectively increasing/decreasing stress in the intraluminal prosthesis; and selectively modifying the polymeric material such that it erodes at a different rate.

Abstract: The present application describes a retention device for anchoring a medical device within the vasculature. The device may include expandable member coupled to an intravascular medical device and proportioned for receipt within a vessel. At least a portion of the expandable member is expandable to radially engage a vessel wall and to thereby retain the medical device within the vessel. The system is suitable for a variety of intravascular devices, including but not limited to ICD's, pacemakers, and intravascular drug delivery systems.

Abstract: A satiation device is described which includes a sheath or liner extending from the proximal or middle stomach to the distal antrum. Food ingested by the patient passes through the sheath or liner, thereby minimizing contact between the ingested food and the stomach. It is believed that over time, reduced contact between food and the stomach will result in decreased Ghrelin production by the patient and a consequent decrease in appetite. In some embodiments, the satiation device may also include a proximal pouch and/or a distal bypass tube.

Abstract: Disclosed are a system and method for performing a medical procedure using direct percutaneous access of an aorta. A main sheath is introduced through an incision formed in proximity to the sternum, and positioned along (and preferable against) a posterior portion of the sternum. Instruments passed through the main sheath are used to form a purse-string suture in an exterior wall of the aorta. An opening is formed in the wall of the aorta in a region encircled by the purse-string suture, and a distal end of an introducer sheath is advanced through the opening into the aorta. A medical procedure, which may be a transcatheter aortic valve replacement, is performed using instruments passed through the introducer sheath into the aorta. After the medical procedure, the introducer sheath is withdrawn from the aorta and, as the introducer sheath is withdrawn, the purse-string suture is tightened to close the opening.

Abstract: An intravascular electrode device for use in neuromodulation includes an anchor expandable from a radially compressed position to a radially expanded position. A lead extends from the anchor and has at least one conductor extending through it. A flex circuit is coupled to the anchor and comprises a flexible insulative substrate, a plurality of electrodes carried by the substrate, and a plurality of conductive traces carried by the substrate, each trace electrically coupled to an electrode and a conductor. Expansion of the anchor within a blood vessel biases the electrodes into contact with the surrounding blood vessel wall.

Abstract: A woven tubular endoprosthesis comprising means for locking the endoprosthesis in a deployed configuration is disclosed. The means for locking the endoprosthesis may comprise locking protrusions, notches, a chemical bond, a curable bond, or other mechanism. The woven fibers comprising the endoprosthesis may be hollow and comprise circumferentially oriented polymeric chains, and may be filled with a curable material. A method of treatment using an endoprosthesis according to the invention is also disclosed.

Abstract: A device for facilitating use of instruments disposed through an aortic arch includes an embolic deflector having a first surface positionable in contact with a wall of an aortic arch such that a porous barrier portion of the embolic deflector covers ostia of at least the brachiocephalic and left common carotid arteries. A second surface is disposed on an opposite face from the first surface. A lubricious guide track is disposed on the second surface and extends longitudinally on the embolic deflector. The deflector and/or guide track is supported by a shaft that is extendable through a femoral artery and descending aorta to position the guide within the aortic arch. During use, the device is percutaneously introduced via the femoral artery and advanced into the aorta. The porous barrier portion of the deflector is positioned over the target ostia, and the guide track thus faces into the aortic arch.

Abstract: An intravascular electrode system includes an expandable anchor and a flexible substrate which carries at least one electrode. The anchor is positioned in a blood vessel and expanded to an expanded position to bias the electrode in contact with the vessel wall. The flexible substrate may be longitudinally withdrawn from its position between the anchor and the vessel wall without removing the anchor from the blood vessel. A second flexible substrate may be longitudinally inserted into position between the anchor and vessel wall as replacement for the first substrate.

Abstract: A satiation device is described which includes a sheath or liner extending from the proximal or middle stomach to the distal antrum. Food ingested by the patient passes through the sheath or liner, thereby minimizing contact between the ingested food and the stomach. It is believed that over time, reduced contact between food and the stomach will result in decreased Ghrelin production by the patient and a consequent decrease in appetite. In some embodiments, the satiation device may also include a proximal pouch and/or a distal bypass tube.

Abstract: A device temporarily positionable within an aortic arch for deflecting embolic particles released during a therapeutic or diagnostic procedure comprises a resilient frame defining an opening and a barrier disposed in the opening. The barrier has a plurality of openings, which may be pores, proportioned to allow passage of blood therethrough but to prevent passage of embolic particles. The barrier has a concave shape having a convex surface positionable in contact with a wall of an aorta to cover at least a brachiocephalic ostium. The frame may include an upstream end including a pair of lobes and an apex between the lobes, and has a generally tapered downstream end.

Abstract: A satiation device is described which includes a sheath or liner extending from the proximal or middle stomach to the distal antrum. Food ingested by the patient passes through the sheath or liner, thereby minimizing contact between the ingested food and the stomach. It is believed that over time, reduced contact between food and the stomach will result in decreased Ghrelin production by the patient and a consequent decrease in appetite. In some embodiments, the satiation device may also include a proximal pouch and/or a distal bypass tube.

Abstract: A system for performing multi-tool minimally invasive medical procedures through a single instrument port into a body cavity includes an expandable frame that carries a pair of tool cannulas, each of which has a lumen for receiving a tool useable to perform a procedure in the body cavity. The frame is expandable to orient the tool cannulas such that they allow the tools to be used in concert to carry out a procedure at a common location in the body cavity.

Abstract: A neuromodulation system for treating epilepsy provides therapeutic elements for modulating nerve activity to prevent or diminish (e.g. through reduced intensity or shortened duration) epileptic seizures. The therapeutic elements may be positioned in the vasculature of the patient and are energized to modulate nerve fibers positioned outside the vascular walls. Electrode positions may include the maxillary vein, inferior alveolar vein, lingual vein, retromandibular or facial vein, or the emissary vein of the foramen ovale. Target nerves include the mandibular branch (V3) of the trigeminal nerve, or a branch of the mandibular branch (e.g. the inferior alveolar nerve).

Abstract: An embolic deflection device includes an anchor engageable with a lumen of a branch vessel extending from an aortic arch and a deflection device, the deflection device having a first end coupled to the anchor and an elongate member extending from the deflection device. A method of deflecting embolic material away from a branch vessel extending from an aortic arch includes providing a deflection device comprising a anchor and an elongate member extending from the anchor. The anchor is engaged with a lumen of the branch vessel and positioned such that the elongate member extends within the aortic arch in proximity to ostia of at least two branch vessels. Embolic material flowing from the ascending aorta to the aortic arch is diverted by the elongate member away from the branch vessels and into the descending aorta.

Abstract: A transvascular electrode system includes an expandable electrode-carrying anchor. The anchor is intravascularly advanced in a compressed position to a first site in a blood vessel. A first portion of the anchor expands to position an electrode against the vessel wall, while a second portion remains is compressed. Mapping is performed by delivering stimulation energy from the electrode and measuring the response (e.g. blood pressure, heart rate, and/or related parameters). The first portion is at least partially collapsed and the electrode system is moved to a second site. The first portion is expanded to position the electrode into against the vessel wall, while the second portion remains compressed. Additional mapping is performed. The process is repeated until the anchor electrode position is optimized, at which point the second portion of the anchor is expanded to chronically retain the electrode in the vessel.