Abstract: A radial closure device has a compression element to place compression force against the radial access site. The invention further comprises an occlusion element that places an occlusion force against the ulnar artery to reduce blood pressure at the arteriotomy site and increase blood flow in the radial artery thereby reducing radial artery occlusion and reducing the time and compression force to achieve hemostasis. A radial restriction element can also be placed upstream of the access site to further reduce radial blood pressure at the arteriotomy site.

Abstract: A wheel assembly for a wheel chair allows the occupant to transfer laterally without encountering obstruction from a fixed mobilization or transfer wheel. In one embodiment the wheel is slid rearward and locked to allow the occupant to transfer laterally in front of the slidable wheel. In another embodiment a chordal portion of the wheel is temporarily removed to allow transfer over the remaining portion of the wheel. Another embodiment enables the chair occupant to mobilize vertically to allow lateral transfer over a standard fixed mobilization wheel; alternately, a further embodiment allows the occupant to mobilize forward to allow lateral transfer in front of a standard fixed mobilization wheel.

Abstract: A system for accessing a desired location in the heart or other target areas has an alignment catheter which directs a directional element towards a target area. A second directional element can be directed towards a target tissue, using the known location of the first directional element as a basis to easily locate other tissues and targets. One or more stabilization elements can help to stabilize the distal portion of the apparatus near the target area. The system can be used for transvenous access to the transatrial septum for transatrial access to the mitral valve, for example, and can use a stabilization basket near the right atrium. The system can be used for coronary sinus access or access to other targets. Various configurations are disclosed, as are various stabilization elements, directional elements, combinations, and methods.

Abstract: Transcatheter mitral valve replacement is provided which includes a stabilizing stent portion for placement at a mitral annulus, with a narrowed waist portion to avoid significantly dilating the annulus, and expanded bulb portions at the atrial and ventricular ends to secure the device in position. A housing is attached to the stabilizing stent and reduces in diameter to a smaller tract portion where replacement valve leaflets are secured. The resulting smaller replacement mitral valve offers benefits including a lower introduction profile, yet fits and secures to the native annulus by the securing stent and housing. Expansion limiting elements can limit expansion of portions of self-expanding stent if desired, avoiding excessive mitral annulus dilation or providing a fixed diameter in other portions of the stent or housing. Two-step implantation can be accomplished by making the housing functional as a temporary valve.

Abstract: A low profile stent device consisting of a stent plus an optional covering is placed percutaneously into a blood vessel to provide vascular closure to a nearby large diameter arteriotomy site. A self-expanding stent device is mounted onto a balloon for postdilitation and is held in a small diameter configuration by an outer case. A balloon expandable stent device has hinge and strut features that provide it with crush resistance. The cone and sheath of the deliver catheter serves as a dilator and introducer sheath to assist in delivery. An attachable guidewire reduces profile by eliminating a guidewire lumen. A locator balloon placed through the large diameter arteriotomy introducer sheath assists positioning.

Abstract: A balloon catheter for dilation of stenotic tissue within a tubular member of the body such as a blood vessel provides fluid flow such as blood flow through the balloon while it is being inflated and after it has been inflated. For valvuloplasty applications or for predilitation prior to a TAVI procedure the balloon is placed across the stenotic aortic valve leaflets and inflated to push the leaflets aside to create a greater blood flow area or allow improved subsequent passage of the large TAVI catheter across the stenotic aortic valve leaflets. As the balloon is inflated in diameter, it is required to reduce in length; this length reduction causes a braided inner tubing to also reduce in length. The braided inner tube is thereby required it to increase in diameter during the balloon inflation and create a suitably large blood flow path through the inner tubing.

Abstract: A balloon or self expandable endoprosthesis formed of a single or multiple joined stent sections. Each section has a node and strut structure extending throughout in order to uncouple expansion forces of the stent to hold a blood vessel outward from crush forces that resist the formation of an oval shape during crush deformation. The hinge can bend in the direction of a uniformly curved surface of the stent but not in the radial direction. The strut can bend in the radial direction but not in the uniformly curved surface of the stent. The widths, lengths, and radial dimensions of the hinges and struts provide a balloon-expandable hinge stent that is non-crushable. For a self-expanding stent the hinge and strut dimensions provide expansion forces that are controlled independently from crush forces. Expansion properties are determined by the hinge dimensions and crush properties are determined independently by strut dimensions.

Abstract: A catheter for delivery of sclerosant to a tubular member or vein of the body to cause ablation. The catheter has one or more balloons located near the distal end to enhance effectiveness of the sclerosant and prevent its delivery to the deep venous system. The catheter has an orifice located near the distal end of the catheter to direct the sclerosant into the vessel and one or more effluent openings to provide for removal of the sclerosant fluid. A heating member such as an electrical resistance element, a Laser probe, or an RF electrode located within the catheter lumen or on the outside of the catheter shaft heats the sclerosant fluid to improve its ablation effectiveness.

Abstract: A catheter for provides protection to the brachiocephalic and left common carotid arteries against embolic delivery associated with transcatheter aortic valve implantation (TAVI). A catheter having two lumens is introduced into the radial artery and the distal end is delivered to the aorta and an intermediate end is delivered to the brachiocephalic artery. Blood is taken from the aorta and is delivered to the intermediate end via a pump. Fluid flow out of the brachiocephalic artery prevents embolic debris from entering the brachiocephalic artery; streamlines of blood flow into the aorta prevent embolic debris from entering the neighboring left common carotid artery.

Abstract: An oval valve for use in transcutaneous aortic (TAVI) or mitral valve implantation or for direct access valve implantation. The oval leaflet frame or stent provides a better seal with the oval native annulus to reduce perivalvular leaks. The valve leaflets are a bileaflet configuration to provide improved leaflet coaptation independent of the amount of ovality of the native valve annulus. The bileaflet configuration is less dependent upon the diameter and perimeter of the native valve annulus and provides leaflet coaptation without intravalvular leakage.

Abstract: A vascular closure device for closing vessels of the body following percutaneous access via an introducer sheath that is similar in size to the vessel lumen. The vascular closure device has an anchor that is inflated using a polymerizable polymer. The anchor is attached to a plug that also can be inflated with a polymer. The anchor and plug can be introduced into the body via a positionable introducer sheath that is also used for the therapeutic procedure. A weep hole in the introducer sheath is positionable adjacent the arteriotomy site.

Abstract: A low profile occlusion device for percutaneous or direct transcutaneous placement into a vein or other tubular vessel of the body. Two wires form one or more loops having a thin cover disposed between them. The loop forms a beveled angle within the blood vessel and the cover prevents blood flow through the vessel. An additional loop can be present to prevent device embolization or device migration. The occlusion device is delivered to a vein such as an incompetent perforator vein or other incompetent vein through a small flexible sheath. Ultrasound guidance is used to position the occlusion device which can be repositioned within the vessel if necessary.

Abstract: A low profile stent device consisting of a stent plus an optional covering is placed percutaneously into a blood vessel to provide vascular closure to a nearby large diameter arteriotomy site. A self-expanding stent device is mounted onto a balloon for postdilitation and is held in a small diameter configuration by an outer case. A balloon expandable stent device has hinge and strut features that provide it with crush resistance. The cone and sheath of the deliver catheter serves as a dilator and introducer sheath to assist in delivery. An attachable guidewire reduces profile by eliminating a guidewire lumen. A locator balloon placed through the large diameter arteriotomy introducer sheath assists positioning.

Abstract: A balloon or self expandable endoprosthesis formed of a single or multiple joined stent sections. Each section has a node and strut structure extending throughout in order to uncouple expansion forces of the stent to hold a blood vessel outward from crush forces that resist the formation of an oval shape during crush deformation. The hinge can bend in the direction of a uniformly curved surface of the stent but not in the radial direction. The strut can bend in the radial direction but not in the uniformly curved surface of the stent. The widths, lengths, and radial dimensions of the hinges and struts provide a balloon-expandable hinge stent that is non-crushable. For a self-expanding stent the hinge and strut dimensions provide expansion forces that are controlled independently from crush forces. Expansion properties are determined by the hinge dimensions and crush properties are determined independently by strut dimensions.

Abstract: A balloon catheter for dilation of stenotic tissue within a tubular member of the body such as a blood vessel provides fluid flow such as blood flow through the balloon while it is being inflated and after it has been inflated. For valvuloplasty applications or for predilitation prior to a TAVI procedure the balloon is placed across the stenotic aortic valve leaflets and inflated to push the leaflets aside to create a greater blood flow area or allow improved subsequent passage of the large TAVI catheter across the stenotic aortic valve leaflets. As the balloon is inflated in diameter, it is required to reduce in length; this length reduction causes a braided inner tubing to also reduce in length. The braided inner tube is thereby required it to increase in diameter during the balloon inflation and create a suitably large blood flow path through the inner tubing.

Abstract: The Access guide catheter provides passage for therapeutic and diagnostic devices through vessels or conduits that return substantially in a direction from which they originated. One application is for delivery of therapeutic catheters to the carotid or cerebral arteries via access from the radial or brachial artery. The guide catheter enters the aorta from one of the great vessels, forms a closed loop in the aorta, and is directed back into a great vessel in an opposed direction. The distal portion of the guide catheter is advanced into the great vessel for support. Further support is attained by providing tension to the proximal shaft of the guide catheter. Flexibility of the guide catheter allows diagnostic angiograms to be performed prior to delivery of a therapeutic catheter or device.

Abstract: A thin-walled sheath is placed over a balloon having an antirestenotic drug placed on the balloon of a balloon dilatation catheter. The sheath protects the drug from dissolution into the blood and allows improved delivery to the lesion site. A rolling action of the sheath prevents the drug from loss due to shearing motion. The sheath can also provide a protected surface for carrying the drug and providing exposure to the lesion site for delivery of the drug. The sheath can also serve as a delivery sheath for providing delivery of a stent via a single catheter introduction for drug delivery and stent delivery.

Abstract: An expandable introducer sheath can actively be induced to reduce in diameter or enlarge in diameter due to a braided internal structure that has axial strands connected to its distal end. The introducer sheath is delivered to the blood vessel or other tubular member of the body in a smaller diameter configuration with the axial strands in compression. The catheter is flexible and can be delivered to eccentrically shaped and tortuous vessels. Once the catheter is in position, the axial strands are placed into tension to cause the introducer sheath to assume a larger diameter configuration that will help straighten out tortuous vessels. The access site into the blood vessel is expanded via a radial expansion that is less traumatic. Passage of a larger interventional catheter can proceed through the larger diameter sheath configuration.

Abstract: A peripheral stent with individual segments reduces the occurrence of fatigue fracture failure seen in vessels and tubes having bending and twisting movement. Segments can be attached via connecting fibers that biodegrade and offer the segments freedom of movement. The segments are balloon-expandable but will not be crushed by external forces placed upon the stent. Hinges and struts provide the stent with a plastic deformation during expansion and remain elastic if exposed to an oval shape. The segments overlap each other to provide improved scaffolding of the vessel wall and a greater flexibility during delivery. A composite stent having both balloon-expandable and self-expanding character has application in the venous system.

Abstract: The Access guide catheter provides passage for therapeutic and diagnostic devices through vessels or conduits that return substantially in a direction from which they originated. One application is for delivery of therapeutic catheters to the carotid or cerebral arteries via access from the radial or brachial artery. The guide catheter enters the aorta from one of the great vessels, forms a closed loop in the aorta, and is directed back into a great vessel in an opposed direction. The distal portion of the guide catheter is advanced into the great vessel for support. Further support is attained by providing tension to the proximal shaft of the guide catheter. Flexibility of the guide catheter allows diagnostic angiograms to be performed prior to delivery of a therapeutic catheter or device.