Abstract: An endothelial scaffold may used to form a graft with an endothelial lining or endothelium. The scaffold allows a natural vessel or other endothelial lumen to line a channel of the scaffold to provide an endothelial layer which enhances blood flow through the channel. The channel may have a narrowed section to provide a stenosis. One or more conduits may extend from an exterior portion of the scaffold to an inner surface of the channel. Air may be withdrawn from between the natural vessel and inner surface of the channel via the conduits to cause the endothelial lumen to conform to the inner surface of the channel. A valve may be used to prevent air from reentering the conduits. The graft, including the endothelial lumen, may be implanted into a patient.

Abstract: An improved vascular graft having increased patency is disclosed herein. The graft may comprise a central or other stenosis. In addition, in some embodiments, the graft may comprise an internal reservoir and a collapsible portion configured to self-adjust the stenosis based on blood flow pressure. The graft may comprise an endothelial lining, one or more drug eluting materials, or both to increase patency by respectively reducing clots and preventing unwanted cellular or fibrin growth. The endothelial lining may be formed from one or more endothelial cells artificially grown or harvested from a patient's vascular system.

Abstract: The present invention provides an apparatus and method for optimizing flow in an A-V dialysis graft having a selectable constricted section. Electronic pressure and flow sensors in the arterial and venous ends of the graft are electronically coupled to a monitor to detect the arterial and venous environments and change the degree of stenosis to optimize flow. The stenosis or narrowing within the graft creates resistance for the purpose of decreasing the flow rate and pressure at the outflow end. The selectable restricted section may be provided by a balloon or a thin “slit” type valve with flexible leaves to provide the required resistance. The “slit” valve allows access to wires or catheters for the purpose of any type of graft maintenance.

Abstract: A self adjusting venous equalizing graft (SAVE graft) which provides a self regulating stenosis is provided herein. The SAVE graft responds to increases or decreases in blood pressure which allows a higher pressure at the graft's arterial end and a lower pressure at the graft's venous end. This is ideal in that it mimics the natural pressure of a patient's circulatory system. A dialysis machine may draw blood at the arterial end, dialyze the blood, and return the blood to the patient at the graft's venous end. The lower pressure at the venous end prevents damage to the patient's vein. The SAVE graft may comprise a deformable stenosis control diaphragm or a venous controlled pressure nozzle which may expand or contract in response to blood pressure to self regulate the stenosis provided by the SAVE graft.

Abstract: An improvement to an A-V dialysis graft construction that includes an elongated length of polymer tubing having an inlet end and an outlet end adapted to be attached to access needles. The improvement comprises a normally reduced diameter intermediate portion, providing a pressure drop from the inlet end of the length of polymer tubing to the outlet end for the purpose of improving flow to the extremity, not utilizing excess cardiac output and minimizing venous stenosis. A first embodiment comprises a gradual converging portion of the lumen followed by a gradual diverging portion. A second embodiment comprises an inflatable, annular stenosis balloon, providing a variable stenosis.

Abstract: A vascular filter system and method of removing the same is disclosed. In one embodiment, the filter system comprises a filter housing having a plurality of hollow support struts connected to a support ring, and a filter element having a plurality of primary filter limbs. Securing barbs extend from the distal ends of the primary filter limbs. The primary filter limbs are slidably held within the hollow support struts of the filter housing to form the filter system. The hollow support struts hold the filter element away from a vascular wall to allow only the securing barbs to contact the wall. The filter system may be removed by advancing a snaring catheter and wire to the filter system and drawing the system into the catheter thereby causing the securing barbs to retract into the hollow support struts releasing the system from the vein.

Abstract: A catheter removal device having a handle, a shaft extending from the handle, a cutting tip, and a longitudinal groove extending through the cutting tip and at least a portion of the shaft is disclosed. The cutting tip has a leading edge, a cutting edge, and delivery threads. The leading edge and the cutting edge are sharpened, and the delivery threads may be on the interior or the exterior of the cutting tip. A catheter is removed by attaching the device to an external portion of the catheter and advancing the device's cutting tip along the catheter. The leading edge and cutting edge allow the device to cut tissues attached to the catheter while the delivery threads help pull the device into the patient along the catheter. Once the connecting tissues or scar tissues are cut away the device and the catheter may be removed together.

Abstract: A vascular filter system and method for implanting the same are disclosed. The filter system generally includes a filter housing and a filter element where the element is suspended within the housing by a plurality of filter holding members. The housing is held in place in a vein by a plurality of securing barbs which generally extend outward from the housing. The housing and its holding members may be bioabsorbable. In these embodiments, the filter element may include at least one filter barb to secure the element after the housing has been bioabsorbed. The filter system may be implanted by accessing a vein and inserting a deployment sheath containing the filter system. The deployment sheath is advanced to the proper location and a deployment member is used to release the filter system as the sheath is retracted. The deployment member and sheath may be removed.

Abstract: A vascular filter system and method are disclosed. In one embodiment, the filter system comprises a dispensing needle releasably attached to a filter dispenser which stores a length of filter wire. The filter wire dispenser has a guide tube which guides the filter wire into the needle and then into a vein during surgical implantation. The filter wire is configured to coil into a predetermined shape as it is deployed from the needle. The shape of the filter wire captures blood clots in the blood stream. Once the filter wire is deployed, the needle may be removed and a portion of the filter wire may be left protruding from the patient's skin surface to allow the filter wire to be secured by a fixation device. A syringe may be used to draw blood to confirm that the needle is properly positioned within a vein before the filter wire is deployed.

Abstract: A vascular bypass graft having a primary member and a secondary member is disclosed. The secondary member extends from a distal second end of the primary member and has a common fluid pathway there between. The secondary member may have a flared or diffused proximal first end that facilitates low pressure fluid return and may be integrally formed with the primary member. An adjustable or fixed stenosis is provided in the secondary member which allows the fluid flow through the vascular bypass graft to be modified. The stenosis may be adjusted either manually or by way of a controller. The primary member is surgically connected to a patient's vascular system to provide an alternate route for blood flow around a vascular occlusion. The secondary member is surgically connected to another point in the vascular system to allow continuous circulation of blood through the graft thereby preventing clotting and graft failure.

Abstract: A redirectional catheter apparatus 10 for inserting a conventional catheter 80 into a desired vascular access 201 wherein the redirectional catheter apparatus 10 includes a redirectional catheter member 20 having an elongated hollow stem 21 which includes a slightly tapered distal end 24, an enlarged proximal end 23, and a deflection flap 26 disposed proximate to, but spaced from, the distal end of the hollow stem 21 wherein the deflection flap 26 forms an aperture 25 in the sidewall 27 of the hollow stem 21 for directing a secondary guide wire 101 into the desired vascular access 201 so that the secondary guide wire 101 will eventually guide the conventional catheter 80 into the desired vascular access 201 and the method employed to accomplish that result.

Abstract: An intragraft dialysis catheter apparatus (10) for installation in a pre-existing A-V dialysis shunt for prolonging the useful life of the A-V dialysis shunt for providing blood flow to the inlet and outlet ports of a conventional dialysis machine to cleanse a patient's blood supply in a well recognized manner. The apparatus includes a pair of generally thin walled reservoir members (30), (30′) each having a generally stiff backing plate member (40), (40′) covering at least the bottom portion of the respective reservoir members (30), (30′) and wherein each reservoir member (30), (30′) is in open fluid communication with one of a pair of elongated hollow catheter members (20), (20′).

Abstract: A catheter stripping apparatus (10) for removing a fibrin sheath (80) from the outlet end (101) of an indwelling access catheter (100) disposed in a patient's vascular system wherein the apparatus (10) includes: a stripping catheter unit (11) comprising an elongated hollow tubular housing member (20) having a rearwardly curved distal end (23) dimensioned to be received within the access catheter and further provided with an elongated soft pliably guide tip element (25); a wire noose unit (12) including an elongated strand of wire (30) dimensioned to be slidably received within the hollow tubular housing member (20) and having a distal end (31) provided with a wire noose element (32); and a retractor unit (13) for extending and retracting the wire noose element (32) relative to both the distal end of the hollow tubular housing member (20) and the outlet end (101) of the access catheter (100).

Abstract: An exercise apparatus (10) comprising a housing unit (11) having relatively moveable upper (17) and lower (18) housing members containing a spring element (12) which surrounds a force transmitting unit (13) and is disposed intermediate an adjustable spring tensioning means (16); wherein, a force imparting lever unit (15) is pivotally connected to the housing unit (11) and further operatively connected to the force transmitting unit (13) via a toggle linkage (14).