Abstract: Guidewire exchange systems, devices and methods, for positioning and actuating surgical devices in a desired position between two tissues in a patient's body are described. A guidewire may be coupled to a surgical device for positioning and actuating (e.g., urging against a target tissue). The guidewire may be exchanged between different surgical devices during the same procedure, and the guidewire and surgical devices may be releaseably or permanently coupled. The surgical device generally includes one or more guidewire coupling members. A system may include a guidewire and a surgical device having a guidewire coupling member. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures.

Abstract: A device for modifying tissue in a patient may include: an elongate body having a rigid proximal portion and a flexible distal portion having first and second major surfaces; a proximal handle coupled with the proximal portion of the body; one or more tissue modifying members disposed along the first major surface of the distal portion of the body; a guidewire coupled with and extending from the distal portion of the body; and a distal handle removably coupleable with the guidewire outside the patient.

Abstract: A method and system for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body involves coupling a guidewire to the device and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues. The surgical device generally includes one or more guidewire coupling members and may comprise a tissue access device. A system may include a guidewire and a surgical device. In some embodiments, a guidewire, a tissue access device, and one or more additional devices to use with the access device may be provided. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures, in various embodiments.

Abstract: A method and system for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body involves coupling a guidewire to the device and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues. The surgical device generally includes one or more guidewire coupling members and may comprise a tissue access device. A system may include a guidewire and a surgical device. In some embodiments, a guidewire, a tissue access device, and one or more additional devices to use with the access device may be provided. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures, in various embodiments.

Abstract: A device for cutting tissue in a human body may include an elongate, hollow shaft having a proximal portion and a distal portion, a bundle of flexible wires slidably disposed within at least a portion of the shaft and having a proximal end and a distal end, and an actuator coupled with the proximal portion of the shaft and the proximal end of the bundle of wires. The distal end of the bundle may be configured to facilitate cutting of tissue, and the wires of the bundle may be at least partially free to move, relative to one another, to allow a cross-sectional shape of the bundle to differ along a length from the proximal to the distal end. The actuator may be configured to move the wires back and forth through the hollow shaft to cause the distal ends of the wires to cut tissue.

Abstract: A device for cutting tissue in a human body may include an elongate shaft having a proximal portion and a distal portion, at least one translatable blade disposed along one side of the distal portion of the shaft, and at least one actuator coupled with the at least one translatable blade and extending to the proximal portion of the shaft, wherein the actuator is configured to translate the blade to cut tissue. In various embodiments, various components of the device may have dimensions that facilitate passing a portion of the device into or through a small space and also facilitate and/or enhance the device's tissue cutting abilies.

Abstract: An apparatus for providing hemostasis within a puncture through tissue includes an elongate member having a lumen extending between proximal and distal ends thereof, an expandable member carried on the distal end and a housing on the proximal end, the housing including an interior communicating with the lumen, and further including a valve assembly with a one-way valve allowing access into the housing interior upon application of a pressure differential across the valve, and a movable plunger for overriding and opening the valve.

Abstract: A device for modifying tissue in a patient may include: an elongate body having a rigid proximal portion and a flexible distal portion having first and second major surfaces; a proximal handle coupled with the proximal portion of the body; one or more tissue modifying members disposed along the first major surface of the distal portion of the body; a guidewire coupled with and extending from the distal portion of the body; and a distal handle removably couplable with the guidewire outside the patient.

Abstract: A device for modifying tissue in a patient may include: an elongate body having a rigid proximal portion and a flexible distal portion having first and second major surfaces; a proximal handle coupled with the proximal portion of the body; one or more tissue modifying members disposed along the first major surface of the distal portion of the body; a guidewire coupled with and extending from the distal portion of the body; and a distal handle removably couplable with the guidewire outside the patient.

Abstract: A device for modifying one or more tissues in a patient's spine may include: an elongate, at least partially flexible body having a proximal portion and a distal portion, wherein at least the distal portion has dimensions that allow it to be passed into an epidural space and between target and non-target tissues of the spine; at least one movable blade disposed along one side of the elongate body; at least one actuator coupled with the at least one blade and disposed at or near the proximal or distal portion of the body for moving the blade(s) to modify one or more target tissues, wherein the at least one actuator is configured to move the blade(s) without significantly translating the elongate body proximally or distally; and means at or near the proximal and distal portions of the elongate body for facilitating application of at least one of anchoring force and tensioning force to the body to urge the at least one blade against the target tissue.

Abstract: Disclosed herein is a low profile catheter valve comprising a movable sealer portion positioned within the inflation lumen of a catheter. The sealer portion forms a fluid tight seal with the inflation lumen by firmly contacting the entire circumference of a section of the inflation lumen. The sealer portion may be positioned proximally of a side-access inflation port on the catheter, to establish an unrestricted fluid pathway between the inflation port and an inflatable balloon on the distal end of the catheter. As desired, the clinician may move the sealer portion to a position distal of the inflation port, thereby preventing any fluid from being introduced into or withdrawn from the balloon via the inflation port. Also disclosed herein is an inflation adaptor for moving the sealer portion within the catheter to establish or close the fluid pathway between the inflation port and the inflatable balloon.

Abstract: Disclosed herein is a low profile catheter valve comprising a movable sealer portion positioned within the inflation lumen of a catheter. The sealer portion forms a fluid tight seal with the inflation lumen by firmly contacting the entire circumference of a section of the inflation lumen. The sealer portion may be positioned proximally of a side-access inflation port on the catheter, to establish an unrestricted fluid pathway between the inflation port and an inflatable balloon on the distal end of the catheter. As desired, the clinician may move the sealer portion to a position distal of the inflation port, thereby preventing any fluid from being introduced into or withdrawn from the balloon via the inflation port. Also disclosed herein is an inflation adaptor for moving the sealer portion within the catheter to establish or close the fluid pathway between the inflation port and the inflatable balloon.

Abstract: Several improvements are provided in the design of a catheter shaft to reduce costs and improve performance. In one aspect, a small notch is fabricated into a catheter tube by a nonlaser process such as electric discharge machining (EDM) or mechanical grinding. This notch in the catheter tube is necessary for fluid communication between the catheter lumen and a balloon or other element in communication with the tube. Use of a nonlaser process reduces the costs of fabrication while ensuring a high degree of structure integrity. In another aspect, a method is provided to produce a nonuniform polymer coating on a catheter shaft to reduce friction and to maintain a catheter with a low profile. In another aspect, the catheter is provided with a radiopaque marker which is more visible and is more effective at identifying the location of a balloon. The marker is moved closer to a distal balloon by placing it within an adhesive taper adjacent the balloon.

Abstract: An integrated inflation/deflation device provides easy, precise delivery of a small amount of fluid for proper inflation of a low volume surgical balloon and similarly provides easy and fast deflation of the balloon. A preferred embodiment includes a low volume syringe and large syringe mounted together within a housing. A port in the low volume syringe is in communication with the large syringe barrel. The low volume syringe plunger is controlled by a knob disposed on the housing. The large syringe is used to prime the surgical balloon system, including a catheter, and the low volume syringe delivers a precise, predetermined volume of fluid to inflate the balloon. The low volume syringe is also used to deflate the balloon. Preferably, indicia on the housing adjacent the knob direct the required rotation of the knob to deliver the correct volume of fluid to be injected to match a balloon of a given size and shape so that the balloon is properly inflated.

Abstract: Several improvements are provided in the design of a catheter shaft to reduce costs and improve performance. In one aspect, a small notch is fabricated into a catheter tube by a nonlaser process such as electric discharge machining (EDM) or mechanical grinding. This notch in the catheter tube is necessary for fluid communication between the catheter lumen and a balloon or other element in communication with the tube. Use of a nonlaser process reduces the costs of fabrication while ensuring a high degree of structure integrity. In another aspect, a method is provided to produce a nonuniform polymer coating on a catheter shaft to reduce friction and to maintain a catheter with a low profile. In another aspect, the catheter is provided with a radiopaque marker which is more visible and is more effective at identifying the location of a balloon. The marker is moved closer to a distal balloon by placing it within an adhesive taper adjacent the balloon.

Abstract: Disclosed herein is a low profile catheter valve comprising a movable sealer portion positioned within the inflation lumen of a catheter. The sealer portion forms a fluid tight seal with the inflation lumen by firmly contacting the entire circumference of a section of the inflation lumen. The sealer portion may be positioned proximally of a side-access inflation port on the catheter, to establish an unrestricted fluid pathway between the inflation port and an inflatable balloon on the distal end of the catheter. As desired, the clinician may move the sealer portion to a position distal of the inflation port, thereby preventing any fluid from being introduced into or withdrawn from the balloon via the inflation port. Also disclosed herein is an inflation adaptor for moving the sealer portion within the catheter to establish or close the fluid pathway between the inflation port and the inflatable balloon.