Abstract: A steering tool includes an internal tube disposed inside an external tube. The internal and external tubes are arranged for longitudinal axial movement relative to one another. A distal end of the internal tube is fixedly joined to a distal end of the external tube. At least one of the internal and external tubes is slotted near the distal end thereof, and the longitudinal axial movement causes bending of the distal ends of the tubes.

Abstract: A first part of an annuloplasty structure is anchored to an annulus of a valve of a heart by using a driver to screw a tissue-coupling element of a first anchor into a first site of the annulus, such that the tissue-coupling element enters cardiac tissue in a direction parallel to a central longitudinal axis of the driver through the distal end of the anchor driver. The same is subsequently done for second and third parts of the annuloplasty structure using second and third anchors at second and third sites of the annulus, mutatis mutandis. Between anchors, the driver is retracted out of the heart. Subsequently, the valve is treated by reducing a distance between the first site and the second site, and a distance between the second site and the third site, by tightening a flexible and elongate contracting member of the annuloplasty structure.

Abstract: An add-on for a self-injector is described. The add-on includes an adaptor having at a rigid and a bent fluid path. The adaptor is sized and fitted to sterilely couple the bent fluid path to a tip of a fluid reservoir. The add-on also includes a fastener sized and fitted to couple a body of the fluid reservoir to the self-injector. The internal diameter of the fastener is adjustable. The adaptor and the fastener couple to the self-injector to at least one of a plurality of reservoirs having different sizes and tip types. The self-injector can include a support plate with a plurality of attachment points. The fastener can be sized and fitted to couple to the body of the fluid reservoir and to at least one of the attachment points. A retention cantilever can releasably couple the at least one fastener to the support plate.

Abstract: Anchor deployment systems and tools are provided. An anchor deployment tool can include a flexible tube including a distal anchor manipulation portion. The tool can also include a deployment element, which is positionable within the flexible tube, and is configured to, while the distal anchor manipulation portion is proximate an implantable device, (i) engage the anchors in the flexible tube, (ii) advance each of the anchors in a distal direction to the distal anchor manipulation portion, and (iii) anchor the implantable device to tissue of a subject by deploying each of the tissue anchors through the implantable device and into the tissue.

Abstract: Systems and apparatuses herein include a longitudinal member having opposite first and second end portions, a tension of the longitudinal member being adjustable to repair an atrioventricular valve of the patient. A delivery tool can be configured to couple the first end portion of the longitudinal member to a first portion of heart tissue, couple the second end portion of the longitudinal member to the leaflet, adjust tension of the longitudinal member, assume a first diameter at a portion of the delivery tool that passes between the leaflets of the atrioventricular valve, during coupling of the first end portion of the longitudinal member to the first portion of heart tissue, and assume a second diameter that is smaller than the first diameter, at the portion of the delivery tool that passes between the leaflets of the atrioventricular valve, during adjusting of the tension of the longitudinal member.

Abstract: An add-on for a self-injector including an adaptor and a bent fluid path is provided. The adaptor includes at least one coupling sized and shaped to couple the adaptor to a fluid reservoir. The bent fluid path is configured at a first end to penetrate tissue and coupled at a second end to the adaptor. The add-on coupled to the fluid reservoir forms an integral self-injector cartridge unit configured to be sterilized and filled with an injectable. The adaptor is configured to couple to a self-injector at least one of a plurality of reservoirs having different sizes and tip types.

Abstract: An injector including at least one fluid reservoir having a needle, a surface attached to skin and coupled to the fluid reservoir by at least a first joint and a second joint at least a portion of one of the joints being slidable or having interlocking arms. At least a portion of a path of translation of a slidable portion of the first joint and a portion of a path of translation of the second joint are angled in respect to each another.

Abstract: A tube and a set of anchors, are transluminally advanced toward a heart of a subject. Tabs are distributed axially along an anchor storage area of the tube, each of the tabs protruding medially from a circumferential wall of the tube. The anchors are disposed in the anchor storage area, a first anchor engaged and restrained by a first tab at a first axial location of the tube, and a second anchor engaged and restrained by a second tab at a second axial location of the tube proximal from the first axial location. The first anchor is engaged by the driver at the first axial location, advanced to a distal end of the tube, and anchored to tissue of the heart. Subsequently, the second anchor is engaged by the driver at the second axial location, advanced to the distal end of the tube, and anchored to the tissue.

Abstract: A system and method are provided for preventing a sharp stick hazard from a needle tip of an automatic injector device. In some embodiments, a skin contact surface of the device is attached to an injection site, for example by an adhesive. Optionally a locking mechanism holds a needle extended into an injection site. A body of the device is optionally movably attached to the skin contact surface. Pulling the body away from the injection site optionally moves the body with respect to the skin contact surface. Movement of the body with respect to the skin contact surface optionally moves interlinked parts of the locking mechanism, releasing the locking mechanism.

Abstract: A method of changing a catheter into a distal steering tool catheter includes adding to an existing catheter a tube assembly that passes through the catheter, the tube assembly including an internal tube and an external tube whose distal ends are coupled to each other and which are arranged for longitudinal axial movement relative to one another, and providing a tube manipulator coupled to the tube assembly, which is operative to cause relative axial movement of the internal and external tubes and bending of a distal portion of at least one of the internal and external tubes.

Abstract: Apparatus is provided, including an implant including a tissue-adjusting member including a longitudinal member, and a tissue anchor coupled to the tissue-adjusting member and configured to be anchored into the tissue of the patient. A tissue-coupling element is coupled to the longitudinal member. A delivery tool is reversibly couplable to the implant and is configured to deliver the implant to the tissue of the patient. The delivery tool includes an elongate shaft, a tissue-coupling-element holder coupled to a portion of the elongate shaft, the tissue-coupling-element holder being configured to hold the tissue-coupling element during delivery of the implant to the tissue of the patient, and an actuating element configured to rotate the tissue anchor so as to facilitate anchoring of the tissue anchor into the tissue of the patient while not rotating the tissue-coupling-element holder with respect to the shaft.

Abstract: Embodiments of the invention provide solid controlled-release penetrating member for exposure to the intestinal lumen environment and delivery of an active agent across or within the small intestine lumen wall and having a tissue penetrating tip, especially advantageous for active agents typically administered by injection. Optionally, the penetrating members include a tip coat or water insoluble extension of the controlled release formulation and/or an intestine environment protective component. Methods of using the penetrating members and arrays thereof are also provided.

Abstract: Apparatus is described for administering a substance to a subject. A vial contains the substance and a stopper is disposed within the vial and is slidably coupled to the vial. A first threaded element is (a) rotatable with respect to the vial and (b) substantially immobile proximally with respect to the vial during rotation of the first threaded element. A second threaded element is threadedly coupled to the first threaded element. At least a distal end of the second threaded element is substantially non-rotatable with respect to the vial, and the distal end of the second threaded element defines a coupling portion that couples the second threaded element to the stopper. The first threaded element, by rotating, linearly advances the stopper and at least the distal end of the second threaded element toward a distal end of the vial. Other embodiments are also described.

Abstract: A syringe cartridge including a reservoir part and an extension extending from the reservoir part. The extension defining a fluid path and including a molding and a first needle extending from the molding. The extension turning to a finite angle with respect to an axis of the reservoir part and at least part of the first needle is likewise at the finite angle. At least some of the part of the first needle at the finite angle being enclosed within the molding of the fluid path. A drug delivery device may be used with the cartridge and includes a skin-contacting surface. In use the longitudinal axis of the interior of the cartridge may be disposed substantially parallel to the skin-contacting surface.

Abstract: Apparatus is described for administering a substance to a subject. A vial contains the substance and a stopper is disposed within the vial and is slidably coupled to the vial. A first threaded element is (a) rotatable with respect to the vial and (b) substantially immobile proximally with respect to the vial during rotation of the first threaded element. A second threaded element is threadedly coupled to the first threaded element. At least a distal end of the second threaded element is substantially non-rotatable with respect to the vial, and the distal end of the second threaded element defines a coupling portion that couples the second threaded element to the stopper. The first threaded element, by rotating, linearly advances the stopper and at least the distal end of the second threaded element toward a distal end of the vial. Other embodiments are also described.

Abstract: A method of manufacturing a cartridge is described. An injection needle is inserted into a mold that forms a barrel. The barrel defines an open proximal end, an opposing distal end, an internal reservoir therebetween, and an arm projecting distally from the distal end of the barrel and having a portion bent at a fixed angle. The injection needle is positioned within a portion of the mold configured to form the arm of the barrel, and a terminal needle tip is oriented such that a beveled opening of the needle tip is distally facing. The injection needle is stabilized against movement with a gripping device. The mold is filled with resin to form the barrel around the injection needle. The gripping device is separated from the injection needle upon hardening of the resin.

Abstract: A method of connecting a cartridge having a connection feature to an automatic injector is described. The cartridge, while mechanically coupled with a plunger driver, is arranged into a receiving frame of the automatic injector. The cartridge is slid until reaching a distal stop. The connection feature is linked to an interference element of the receiving frame. The connection feature is slid, such that disconnection of the cartridge is inhibited. Forces generated by the plunger driver on the cartridge through the receiving frame are contained, thereby immobilizing the cartridge with respect to the automatic injector.

Abstract: A system for medicament delivery includes a cartridge containing a medicament and in fluid communication with a needle, where the needle is enveloped by a needle cap, a housing for containing the cartridge and having an orifice for allowing access to said needle cap and its associated needle, and a needle cap remover device.

Abstract: An automatic injector for delivering a pharmaceutical substance from a reservoir of a cartridge, the cartridge interconnected to a needle at its distal end and mechanically coupled to a plunger driver at its proximal end, the injector comprising a connecting feature on the cartridge a contact surface for contacting an injection site a frame connected to the contact surface, the frame having an interference element with a distal stop, the interference element sized to slidably link to the connecting feature and allow the cartridge to slide up to the distal stop, a snap element allowing the interference element to receive the connection feature, but inhibiting disconnection of the cartridge; the frame further comprising a driver mount, for fixedly containing a plunger driver, the driver for driving a plunger to empty the reservoir of the cartridge through the needle to inject fluid from the reservoir into the injection subject.

Abstract: Within a delivery passage of a catheter, an elongated and flexible annuloplasty structure is transluminally advanced toward a heart of a subject while the annuloplasty structure is in a substantially linear configuration in which a distal end of the annuloplasty structure is closer than a proximal end of the annuloplasty structure to a distal opening of the catheter. Subsequently, the distal end of the annuloplasty structure is advanced, followed by the proximal end of the annuloplasty structure, out of the catheter and into an atrium of the heart. Within the atrium, the annuloplasty structure is transitioned toward a ring form by the distal end of the annuloplasty structure being brought towards the proximal end of the annuloplasty structure. While the annuloplasty structure remains in the ring form, the annuloplasty structure is placed against tissue of the annulus and is anchored to the tissue.