Abstract: A protective sleeve for use with an endoscopic surgical instrument is provided. The protective sleeve includes a flexible tube having an opening at each end of the tube and a length to cover a desired portion of the surgical instrument. At one end of the tube may be an elastic band that allows the sleeve to be positioned over the instrument or to be retracted to reveal the instrument for use. Additionally, the tube may also include a second band that may be fixed or movable. The tube also may have a perforation running along the length of the tube to allow for the sleeve to be easily removed from the instrument. A circumferential perforation may also be provided. A method for using the protective sleeve is also provided.

Abstract: A low profile emboli capture device is provided for use in angioplasty and other intravascular procedures. A standard guidewire is utilized having a reduced cross-sectional area formed near its distal end. A filter and self-expanding stent are packaged on the reduced cross-sectional area of the guidewire. A movable sleeve extends over the guidewire and holds the self-expanding stent and filter in their retracted positions while the device is being positioned in the artery. The sheath is moved relative to the self-expanding stent and filter, whereupon the self-expanding stent and filter become deployed.

Abstract: A step up transformer has an inert core, primary windings concentrically surrounding the inert core, and secondary windings concentrically surrounding the primary windings, the ratio of secondary windings to primary windings of up to 1,000,000:1. The step-up transformer is particularly useful in an x-ray catheter having an x-ray source in a vacuum tube and a power source. The power source can deliver a lower voltage which is stepped up at by the transformer to produce a voltage sufficient to stimulate production of x-rays by the x-ray emitter source. Methods for preparing the step-up transformer and x-ray catheter and methods of administering x-rays to subjects with the x-ray catheter of the invention are also disclosed.

Abstract: A step up transformer has an inert core, primary windings concentrically surrounding the inert core, and secondary windings concentrically surrounding the primary windings, the ratio of secondary windings to primary windings of up to 1,000,000:1. The step-up transformer is particularly useful in an x-ray catheter having an x-ray source in a vacuum tube and a power source. The power source can deliver a lower voltage which is stepped up at by the transformer to produce a voltage sufficient to stimulate production of x-rays by the x-ray emitter source. Methods for preparing the step-up transformer and x-ray catheter and methods of administering x-rays to subjects with the x-ray catheter of the invention are also disclosed.

Abstract: The present invention relates to methodology of and apparatus for accurately positioning devices for performing endoscopic cannulation, papillotomy and sphincterotomy and similar procedures. The sphincterotome with a steerable or adjustable distal segment of the present invention allows the physician to control the position of the distal tip of the device independently of the endoscope and adjust for inconsistencies in the device and the anatomy. According to one embodiment of the present invention, a threaded portion of a cable assembly cooperates with a torque transmission element and a cog to enable the operator to rotate a cutting wire into a desired position relative to the catheter. Alternate embodiments allow the operator to fix the depth of a needle knife while allowing, if desired, accurate rotational positioning of the associated catheter. Threaded stabilizing elements, pivot elements and a steering wire may be used together or individually to accomplish these features.

Abstract: A medical closure device for providing a passage into or out of the body. A resilient member at least partially defines the passage, and a two-part body is disposed to permit relative rotation its parts about the passage axis. The first body portion compresses and supports the resilient member. Cam surfaces on the second body control a compression member which is disposed in a radially extending aperture of the first body portion and biased radially outwardly by the resilient member to maintain contact with the cam surface. Relative rotation of the body portions about the axis moves the cam surface relative to the compression member, causing radial displacement of the compression member from a first position (in which the passage is relatively uncompressed and open) to a second position (in which the passage is restricted).

Abstract: A method and apparatus for managing polyps by which an elongated tubular member is generally positionable within the working channel of an endoscopic device. The tubular member carries a selectively extendable severing device and capturing device at its distal end. Control apparatus at the proximal end of the tubular member enables a physician to extend and retract the severing and capturing devices. The physician retracts the capturing device to grasp the portion of the polyp to be severed and retracts the severing device to sever the polyp. The capturing device retains the severed portion of the polyp for removal with the tubular member. In one embodiment, the capturing device includes an injection needle.

Abstract: A prosthesis delivery system having a balloon catheter with an inflatable balloon on its exterior. The balloon is inflatable by injection of fluid through a lumen in the catheter and the balloon is initially partially constrained against inflation by a constraint. A tubular prosthesis is disposed on the catheter over at least a portion of the balloon and a portion of the constraint. The tubular prosthesis has a contracted condition and an expanded condition. The tubular prosthesis is initially disposed on the catheter in the contracted condition. Further, a balloon catheter includes a constraint so that the balloon may be sequentially,inflated for dilatation purposes such as in a valvuloplasty operation.

Abstract: A system for treating an aneurysm in a vessel includes a delivery device having a delivery portion suitable for delivery of embolic material. The delivery device is placed in a neck of the aneurysm and an expandable member is placed proximate the neck. The expandable member is expanded to overlie substantially the entire neck. Embolic material is delivered to the aneurysm with a delivery device. The expandable member is held over the neck to inhibit movement of the embolic material out of the aneurysm. Blood is allowed to flow out of the aneurysm, past the neck of the aneurysm, and through the vessel while the expandable member is held over the neck of the aneurysm.

Abstract: A system for treating an aneurysm in a vessel includes a delivery device having a delivery portion suitable for delivery of embolic material. The delivery device is placed in a neck of the aneurysm and an expandable member is placed proximate the neck. The expandable member is expanded to overlie substantially the entire neck. Embolic material is delivered to the aneurysm with a delivery device. The expandable member is held over the neck to inhibit movement of the embolic material out of the aneurysm. Blood is allowed to flow out of the aneurysm, past the neck of the aneurysm, and through the vessel while the expandable member is held over the neck of the aneurysm.

Abstract: A medical instrument converts linear movement of a shaft at a proximal end of the instrument to a rotational movement of an end effector of the instrument. According to one embodiment, the medical instrument includes an end effector formed of a snare loop connected to a shaft that is located within a sleeve. Once the sleeve is located near a desired location within a patient, the snare loop may be rotationally positioned with linear movement of the shaft by the operator. The shaft is formed with a threaded portion that matches threads formed in a torque transmitter element fixed within the sleeve. Linear movement of the shaft through the torque transmitter element causes the shaft to rotate. The medical instrument may also include a pivot connector for reducing torque build-up of the shaft and/or a clutch assembly for restricting controlled rotation of the snare loop to only one direction.

Abstract: A system for severing lesions within a living body includes a housing defining an interior tissue receiving chamber is coupled to the distal end of an endoscope. At least one snare extends around the ligating band supporting surface so that, when at least one ligating band is received around the ligating band supporting surface, drawing the at least one snare off the ligating band supporting surface releases a corresponding ligating band from the ligating band supporting surface. In addition, a method for severing tissue comprises the steps of introducing into the body an endoscope to which a housing defining an interior tissue receiving chamber is coupled, wherein at least one snare and at least one ligating band extend around the ligating band supporting surface and advancing the distal end of the endoscope into the body until the housing is located adjacent to a first portion of tissue to be severed.

Abstract: A prosthesis delivery system having a balloon catheter with an inflatable balloon on its exterior. The balloon is inflatable by injection of fluid through a lumen in the catheter and the balloon is initially partially constrained against inflation by a constraint. A tubular prosthesis is disposed on the catheter over at least a portion of the balloon and a portion of the constraint. The tubular prosthesis has a contracted condition and an expanded condition. The tubular prosthesis is initially disposed on the catheter in the contracted condition. Further, a balloon catheter includes a constraint so that the balloon may be sequentially inflated for dilatation purposes such as in a valvuloplasty operation.

Abstract: An endoscopic assembly, utilizing a braided mesh material as an expandable sheath, is disclosed. The mesh sheath is adapted to receive an endoscope for viewing the interior of a body cavity or lumen and one or more channels for performing medical procedures within the patient. The mesh sheath expands laterally as it is compressed longitudinally, which allows it to come into contact with the interior of the body cavity. By doing so, it can anchor the assembly, take samples from the body cavity, or dilate a stricture in the body cavity. Additional dilation procedures can be performed by removing the endoscope and inserting other instruments without removing the entire assembly from the patient. The body cavity can be hermetically sealed to reduce the risk of contamination of the endoscope and channels.

Abstract: A ligating band dispenser comprises a substantially cylindrical first support surface capable of holding a plurality of first ligating bands. The first support surface has a first channel extending substantially axially therethrough and a plurality of first slots extending away from a distal end thereof through at least a portion of the first support surface. A plurality of increased diameter abutting portions define a plurality of segments of a pull line extending through the slots with each of the abutting portions being retained within the channel by contact with a corresponding one of the slots. Each of the segments loops around a corresponding one of the ligating bands to releasably couple the pull line to the ligating bands.

Abstract: A ligating band dispenser comprises a substantially cylindrical first support surface capable of holding a plurality of first ligating bands. The first support surface has a first channel extending substantially axially therethrough and a plurality of first slots extending away from a distal end thereof through at least a portion of the first support surface. A plurality of increased diameter abutting portions define a plurality of segments of a pull line extending through the slots with each of the abutting portions being retained within the channel by contact with a corresponding one of the slots. Each of the segments loops around a corresponding one of the ligating bands to releasably couple the pull line to the ligating bands.

Abstract: A method and apparatus for managing polyps by which an elongated tubular member generally positionable within the working channel of an endoscopic device. The tubular member carries a selectively extendable severing device and capturing device at its distal end. Control apparatus at the proximal end of the tubular member enables a physician to extend and retract the severing and capturing devices. The physician retracts the capturing device to grasp the portion of the polyp to be severed and retracts the severing device to sever the polyp. The capturing device retains the severed portion of the polyp for removal with the tubular member. In one embodiment the capturing device includes an injection needle.

Abstract: A device for treating a lesion comprises a sheath extending from a proximal end which, in an operative position, is located outside the body, to a distal end which, in the operative position is located within the body. A needle extending through the sheath has a tissue piercing distal tip and a central lumen extending through the needle from a proximal port to a distal opening formed in the distal tip and a needle actuator is provided for moving the needle between a retracted position in which the distal tip is received within the sheath to an injection position in which the distal tip extends distally beyond a distal end of the sheath. A snare extends within the lumen to a loop formed in a distal end of the snare and a snare actuator is provided for moving the snare between a covered position in which the loop is received within the lumen and an extended position in which the loop extends distally from the lumen beyond the distal tip.

Abstract: A method and apparatus for managing polyps by which an elongated tubular member generally positionable within the working channel of an endoscopic device. The tubular member carries a selectively extendable severing device and capturing device at its distal end. Control apparatus at the proximal end of the tubular member enables a physician to extend and retract the severing and capturing devices. The physician retracts the capturing device to grasp the portion of the polyp to be severed and retracts the severing device to sever the polyp. The capturing device retains the severed portion of the polyp for removal with the tubular member. In one embodiment the capturing device includes an injection needle.

Abstract: A ligating band dispenser for dispensing a plurality of ligating bands individually during a sequence of operations for a ligating instrument. Interfitted housing and piston segments support a plurality of ligating bands at axially spaced locations. Retraction of the piston segment dispenses one ligating band and shifts the remaining ligating bands distally and axially. After retraction, the piston is biased forward so a next retraction dispenses another ligating band. A sclerotherapy needle mounts in a sheath that connects to the piston segment. A physician retracts the sheath to retract the piston. In addition the physician can advance the sclerotherapy needle through the sheath to administer a sclerotherapy agent as an alternative to ligating a lesion.