Abstract: This material comprises an annuloplasty member (12) able to be introduced using a catheter (2) through minimally invasive vascular access, then to be delivered by said catheter and fixed to the valve annulus (104).

Abstract: An apparatus for delivering bioabsorbable fasteners of the type having two cannulated legs to secure the two sides of an incision in tissue comprises a housing containing a magazine with one or more fasteners positioned on a reciprocally movable fastener support. Needle guide tubes and the legs of the front-most fastener are in slidable contact with at least one alignment surface configured to axially align them. An actuator is operated by a user to move two needles within the needle guide tubes to insert each needle into a cannulated leg. A timing lever acts on the fastener support in concert with the actuator movement to remove support of the front-most fastener after the needles are inserted. The needle guide tubes transfer force to the fastener, to push it out of the magazine and along a path through the center of a bifurcated foot, to insert it into the tissue.

Abstract: A surgical instrument comprising a handle assembly, and actuation member, an elongated body portion, and a locking mechanism is disclosed. The locking mechanism is disposed in mechanical cooperation with the actuation member, and is configured to substantially prevent at least a partial movement of the actuation member when the elongated body portion is not engaged with a loading unit. The locking mechanism comprises a link, a bushing, and a connecting member. The link is configured for mechanical engagement with a portion of a loading unit. At least a portion of the busing is disposed proximally of at least a portion of the link. At least a portion of the connecting member is disposed proximally of at least a portion of the bushing. Engagement between a loading unit and the elongated body portion causes proximal movement of the link, the bushing, and the connecting member.

Abstract: In various embodiments, a surgical stapling head is provided that may comprise a staple cartridge for supporting one or more staples, a core movable relative to the staple cartridge, at least one staple driver extending from the core, and a casing configured to at least partially hold the staple cartridge and movably receive the core and the staple driver(s). The casing may further comprise at least one retention member that is configured to move from a first position to a second position when sufficient external force is applied to the retention member, such as that provided by a shaft of a surgical stapler during insertion of the stapling head assembly into the shaft. When the retention member(s) are at the second position, the staple driver(s) may be prevented from driving staples from the staple cartridge, thereby providing a firing lockout feature to the stapling head assembly during insertion into at least a portion of a surgical stapler.

Abstract: A device to maintain temporary engagement with a bone plate and a bone, the device comprising a first biased appendage positioned opposite a second biased appendage, the first and second biased appendages including an arcuate vertical profile that partially defines an interior region; a platform concurrently coupled to the first and second biased appendages, the platform also partially defining the interior region, the platform including a through hole open to the interior region; a first tab extending from at least one of the first biased appendage, the second biased appendage, and the platform, the first tab extending into the interior region and adapted to engage a bone plate; a first arcuate flange mounted to a distal portion of the platform; and a second arcuate flange mounted to a proximal portion of the platform.

Abstract: Devices and methods for treatment of prolapsed hemorrhoidal arteries is disclosed. The devices can identify the hemorrhoid and ligate the artery without causing significant pain or distension of the rectum. The artery can be identified with ultrasound. The ligation can be performed using energy and/or mechanical structures, such as clips or rubber bands.

Abstract: Catheters such as guide catheters can be configured to provide distal occlusion, while still providing sufficient interior lumen space for device delivery. Such catheters can also provide a desired level of flexibility, yet can include sufficient column support. A catheter can include an elongate shaft having a distal region, a proximal region and a lumen extending therebetween. A distal occlusion member can be disposed over a portion of the distal region of the elongate shaft and an occlusion activating member can be disposed over the elongate shaft.

Abstract: A saw for pivoting a blade in a sagittal plane. The saw includes a drive assembly with at least one drive member. The drive assembly is configured to both reciprocate the blade in the sagittal plane and to simultaneously pivot the blade around an axis that extends through the sagittal plane. The drive assembly is configured to reciprocate and pivot the blade at different frequencies. Consequently the teeth (186) of the blade travel in a loop pattern that crosses itself.

Abstract: A number of orthopaedic surgical instruments for use in a surgical procedure to prepare a patient's femur to receive an orthopedic prosthesis. The tools include guide tools, cutting tools, surgical blocks, and other orthopaedic surgical instruments configured to plan and guide the preparation of the patient's femur. A method of using the orthopaedic surgical instruments is also disclosed.

Abstract: A method for aligning a bone cutting guide on a tibia may involve coupling a cutting guide alignment device and an attached cutting guide with a tibia, adjusting the alignment device in a varus/valgus orientation, adjusting the alignment device in an anterior/posterior orientation, attaching the cutting guide to the tibia, and removing the alignment device from the cutting guide, leaving the cutting guide attached to the tibia. The adjustments to the alignment device may be made according to vertically and horizontally oriented laser lights emitted from the alignment device. As the alignment device is adjusted, the bone cutting guide attached to the alignment device changes position relative to the tibia.

Abstract: A surgical dissection tool for cutting bone and other tissue includes a cutting head having an outer surface having non-paired or an odd number of flutes formed therein. Each flute includes a rake surface intersecting with the outer surface to form a cutting edge, and a relief surface opposite the rake surface. The relief surface and the rake surface form a first angle. Each flute also includes a leading angled surface extending from the relief surface to a distal end portion of the cutting head, the leading angled surface and the rake surface forming a second angle substantially the same as the first angle.

Abstract: A cutting tool for bone, cartilage, and disk removal includes a body with a first radial array of helical flutes formed along the body with a continuous radius in a first helical direction. The body has a second radial array of helical flutes formed along the body with a continuous radius in a second helical direction opposed to the first helical direction and intersecting the first array of helical flutes. Each helical flute forms a pair of spaced apart rake surfaces, which collectively perform a first and second cutting operations along a side of the body such that the intersecting rakes balance the cutting operation thereby minimizing axial loading of the cutting tool to permit bidirectional cutting while minimizing g inadvertent axial translation of the tool.

Abstract: In a first embodiment, the present invention includes an instrumentation system for preparing a bone for soft tissue repair, the instrumentation system including a flexible drill pin capable of bending along a curved path; an aimer capable of engaging the flexible pin to bend the flexible pin; and a flexible reamer having a flexible portion along at least a portion of its length, the flexible portion comprising a plurality of laser cuts.

Abstract: Surgical procedures, tools and implants are disclosed for both conventional and reverse shoulder implant surgeries. The improved procedures, tools and implants relate to humeral head resurfacing, humeral head resection for standard implants, humeral head resection for reverse shoulder implants, glenoid resurfacing for standard shoulder implants and glenoid resurfacing for reverse shoulder implants. 3D scans and x-rays are used to develop virtual models of the patient anatomy, identify patient specific landmarks for anchoring guide wire installation blocks, templates and drill guides. 3D scans are also used to design patient specific tools and implants for the shoulder implant procedures and to pre-operatively determine the appropriate inclination and retroversion angles.

Abstract: A system for removing a kidney stone from a ureter may include: an elongate, flexible, outer shaft having a distal end configured to be advanced into the ureter and a proximal end; an elongate, flexible, inner shaft extending through at least part of the outer shaft; an expandable stone retention member extending through at least part of the inner shaft and moveable along the longitudinal axis relative to the inner shaft; an elongate, flexible camera positioned coaxially within the retention member shaft, such that a distal end of the camera is located at or near a distal end of the inner shaft; and a handle coupled with the proximal end of the outer shaft, a proximal end of the inner shaft, and a proximal end of the retention member shaft.

Abstract: A curved bur with an inner flexible member that is rotatably positioned within an outer tube. The curved bur has a design that constrains the flexible inner coil within the outer tube as the curved bur is rotated (without permitting the coil to stretch and to allow the bur tip to come out of the distal end of the outer tube). To ensure containment of the flexible coil within the outer tube, the outer tube is provided with a constraining neck feature at its distal end to allow the flexible inner assembly to be constrained within the outer tube, and to prevent bur extrusion. The constraining neck feature also centers the bur tip and prevents bur wobble. The curved bur may have a convex or concave bend configuration.

Abstract: A surgical instrument including a reusable and sterilizable hub assembly and a releasably connectable disposable blade assembly allows multiple reuse of the hub assembly in conjunction with single use disposable blade assemblies.

Abstract: Prostate treatment using fluid stream to resect prostate tissue, thereby relieving symptoms of conditions such as BPH, prostatitis, and prostatic carcinoma. A device having a fluid delivery element is positioned within a lumen of the urethra within the prostate. A fluid stream is directed outwardly from the fluid delivery element toward a wall of the urethral lumen. The fluid delivery element is moved to scan the fluid stream over the wall to remove a volume of tissue surrounding the lumen. The fluid may be combined with therapeutically active substances or with substances that increase resection efficiency. Fluid force may be adjusted to provide selective tissue resection such that soft tissue is removed while harder tissue is left undamaged. In order to gain a working space within the urethra, another fluid may be introduced to insufflate the urethra in the region of treatment.

Abstract: Prostate treatment using fluid stream to resect prostate tissue, thereby relieving symptoms of conditions such as BPH, prostatitis, and prostatic carcinoma. A device having a fluid delivery element is positioned within a lumen of the urethra within the prostate. A fluid stream is directed outwardly from the fluid delivery element toward a wall of the urethral lumen. The fluid delivery element is moved to scan the fluid stream over the wall to remove a volume of tissue surrounding the lumen. The fluid may be combined with therapeutically active substances or with substances that increase resection efficiency. Fluid force may be adjusted to provide selective tissue resection such that soft tissue is removed while harder tissue is left undamaged. In order to gain a working space within the urethra, another fluid may be introduced to insufflate the urethra in the region of treatment.

Abstract: Over-the-wire self-sizing, self-centering valvulotomes sufficiently designed to cut valves through a wide range of vein diameters and adjust to the internal diameter of a vein as the valvulotome is being drawn through the vessel, and methods of use thereof during certain medical procedures that involve splitting valves, are disclosed herein. In an embodiment, an over-the-wire valvulotome includes a catheter having a proximal end, a distal end, and a longitudinal axis therebetween, wherein a first portion of a plurality of cutting tools engage the catheter at the distal end, and wherein an actuation mechanism engages the catheter at the proximal end; a retainer for temporarily shielding a second portion of the plurality of cutting tools, wherein the second portion includes cutting blades; and a sheath slidably movable over the plurality of cutting blades, wherein the catheter and the retainer have internal diameters configured for passing over a guidewire.

Abstract: Medical devices, systems and methods are disclosed that serve to guide one or more medical devices through a port formed in bodily tissue to access a bodily cavity. One embodiment of the medical device includes a connection member, a rail, and a carrier. The connection member is structured for attachment to the port. The rail is attached to the connection member, and has a first portion extending distally through the port opening, and a second portion extending at an angle relative to the first portion. The carrier is structured to selectively connect to the first portion of the rail, and is slidable along the first and second portions of the rail.

Abstract: A trocar comprises a retention cannula comprising an inverted or incised retention pattern disposed thereon. Embodiments of the incised cannula exhibit reduced tissue trauma compared with screw-threaded cannula, improved fixation and/or retention compared with an unthreaded cannula, and good sealing between the cannula and the incision.

Abstract: A connection element (1) for stabilizing vertebral bodies that has a variable stiffness along its longitudinal axis in that particularly the cross-section of the connecting element varies along its longitudinal axis and extends over a plurality of bone screws (6). In spite of the varying cross-section (h1, h2), in a preferred embodiment, the same bone screws (6) may be used in all locations by inserting clamping elements (9, 10) of different lengths.

Abstract: A coupling assembly that is configured to couple a surgical screw to another coupling assembly and another surgical screw is disclosed. The coupling assembly comprises a body that includes a receptacle configured to receive a head portion of the surgical screw and hold the head portion through an interference fit. The body further includes either a female member, a male member, or both, the female member and the male member configured to mate with a female member and a male member of the another coupling assembly and thereby join the coupling assembly to the another coupling assembly. Embodiments of the coupling assembly provide for adjustment of the distance between the coupling assemblies, as well as misalignment of various axes of the coupling assembly relative to the surgical screw and the male member. Exemplary embodiments provide fewer parts, greater flexibility during the surgical implantation, and a smaller profile than previous coupling mechanisms.

Abstract: An adjustable articulating spinal rod system including a first elongated element secured to a first bone, a second elongated element secured to the spine, and an articulating joint connecting the first and second elongated elements. The articulating joint including a first movable joint, a second movable joint, and at least one locking mechanism. The first movable joint is coupled to the first elongated element and the second movable joint which is also coupled the second elongate element. The first and second movable joints are configured to allow polyaxial movement and rotation of the first elongated element with respect to the second elongated element. The at least one locking mechanism immobilizes the first and second movable joints in the locked position to secure the first elongate element in a position relative to the second elongate element and allow movement and rotation in an unlocked position.

Abstract: A dynamic fixation device is provided that allows the vertebrae to which it is attached to move in flexion within the normal physiological limits of motion, while also providing structural support that limits the amount of translation motion beyond normal physiological limits. The present invention includes a flexible portion and two ends that are adapted for connection to pedicle screws. In at least one embodiment of the present invention, the normal axis of rotation of the vertebrae is substantially duplicated by the dynamic fixation device. The flexible portion of the dynamic fixation device can include a geometric shape and/or a hinge portion.

Abstract: A spinal pedicle rod comprising an internally reinforced polymeric core that is at least partially encased within at least one polymeric coating. A dynamic stabilization device for bones in which flexible rods are combined with a pair of dynamic anchoring devices comprising i) a shank for anchoring into a bone or a vertebra, ii) a head connected to the shank, iii) a receiving part for the head and iv) a mobile element acting on the head.

Abstract: A multi-axial screw assembly comprises a receiver, a base member, and a crown. The receiver comprises a channel for receiving a rod and an aperture extending from a bottom portion of the receiver. The base member comprises an aperture extending through the base member and an opening on a bottom portion of the base member. The base member is configured to couple to the receiver such that the aperture of the receiver is generally aligned with the aperture of the base member. The base member is rotatable relative to the receiver. The crown is received in the receiver and configured to mate to the base member. The crown has a mating feature configured to couple to the base member such that the crown rotates the base member when the crown is rotated.

Abstract: A femur fixation device including an elongated nail configured for insertion into the medullary canal of the femur and a buttress element extending from the elongated nail. The buttress element is configured to reinforce the lesser trochanter region of the femur and assist in stabilizing the head portion of the femur.

Abstract: A cement-directing structure for use in cement-injection bone therapy includes a collapsible, self-restoring braided structure with regions of differential permeability to the bone cement. The regions of differential permeability may be provided by areas where the braided mesh density is greater or lesser than surrounding areas and/or by means of a baffle. After the structure is placed in a void within a bony structure, cement is injected into the interior of the structure then oozes out in preferred directions according to the locations of the regions of differential permeability.

Abstract: A grasping treatment device includes a probe including a first electrode portion in its distal portion, and a jaw configured to open or close relative to the first electrode portion and including a second electrode portion. The grasping treatment device includes a grasping force converting unit converting a grasping force so that a second grasping force between the distal portion of the probe and the jaw in a second treatment mode in which high-frequency current alone is transmitted to the first electrode portion and the second electrode portion is greater than a first grasping force between the distal portion of the probe and the jaw in a first treatment mode in which at least an ultrasonic vibration is transmitted to the distal portion of the probe.

Abstract: A bipolar snare including an elongated tubular electrically insulating sheath, a pair of elongated flexible electrically conductive wires disposed within the sheath, and an electrically insulating connector disposed at the distal ends of the wires mechanically connecting the distal ends of the wires to form a loop projecting from the distal end of the sheath. The wires are provided with electrical insulation covering all but a selected portion of each of the wires. The device also includes a guide member located within the sheath and forming compartments for each of the electrically conductive wires, the guide member being rotatable within the sheath. The guide member is also set back from the distal end of the sheath to an extent such that the whole of the loop including at least part of the connector is capable of being received within the sheath.

Abstract: An endoscopic bipolar forceps includes a housing, a shaft affixed to the housing, and a pair of jaw members attached to a distal end of the shaft. The forceps also includes a drive assembly for moving one of the jaw members relative to the other jaw member from a first position to a second position for manipulating tissue. A movable handle is included which is rotatable about a pivot to force a drive flange of the movable handle into mechanical cooperation with the drive assembly to move the jaw members from the first position to the second position. The forceps is connected to a source of electrosurgical energy connected to each jaw member such that the jaw members are capable of conducting bipolar energy through tissue held therebetween.

Abstract: A steerable laser probe may include an actuation structure, a nosecone fixed to the actuation structure by one or more links and one or more link pins, a housing tube having a first housing tube portion with a first stiffness and a second housing tube portion with a second stiffness, and an optic fiber disposed in the housing tube and the actuation structure. A compression of the actuation structure may be configured to gradually curve the housing tube and the optic fiber. A decompression of the actuation structure may be configured to gradually straighten the housing tube and the optic fiber.

Abstract: A magnetic drape comprises a drape body made of a flexible material. The drape body has a panel portion having an undersurface adapted to be laid on an uneven body and a top surface, and a given thickness between the undersurface and the top surface. A plurality of magnet units are within the flexible material of the drape body, with each said magnet unit comprising a shielding material in the shape of a cup oriented to have a bottom wall facing toward the undersurface of the drape body, and a magnet received at least partially in the cup. The magnet comprises two or more sections arranged to expose opposite polarity on a top surface of the magnetic drape, with each said section having opposite polarities oriented vertically.

Abstract: An instrument guiding device featuring a base having an aperture for a catheter; one or more legs disposed on the base; a first plate and a second plate each extending upwardly from the base perpendicularly to each other, the second plate is pivotally attached to the base; a guide component having an inner channel adapted to receive the catheter, the first end of the guide component is pivotally attached to the second plate, the guide component can be pivoted toward sides of the second plate; a first scale disposed on the first plate, a second scale disposed on the second plate; reference markers on the second plate and on the guide component; and a temporary attachment means for holding the second plate in place with respect to the first plate and for holding the guide component in place with respect to the second plate.

Abstract: A surgical system includes an instrument driver having a distal end positionable in a body cavity and a user input device. The instrument driver and user input device are positioned to removably receive distal and proximal portions, respectively, of a surgical instrument. The user input device is configured to generate movement signals in response to manual manipulation of the proximal portion of the surgical instrument. At least one motor operable to actuate the instrument driver in response to the movement signals and to thereby change position of the distal portion of the surgical instrument within the body cavity.

Abstract: A surgical tool is disclosed. The surgical tool has a tool mounting portion having a tool mounting housing, a tool mounting plate, and a coupler to couple a shaft assembly with an articulation section to the tool mounting portion. An articulation mechanism is located within the tool mounting portion and is configured to receive a proximal end of the shaft assembly to articulate the articulation section of the shaft assembly. An interface mechanically and electrically couples the tool mounting portion to a manipulator.

Abstract: An operation input device that has multi jointed arms includes: a holding unit that holds proximal ends of the multi-jointed arms in a state in which a relative positional relationship between the proximal ends is fixed; a detection unit that detects a joint movement amount that represents a movement of a joint by a rotation angle or a translational displacement from an unknown initial joint value; engagement units that are provided in distal ends of the multi jointed arms; a data acquisition unit that acquires a plurality of sets of joint movement amounts detected by the detection unit in a time series when engaging and moving the distal ends; and an initial value calculation unit that calculates the unknown initial joint value under a condition that a relative positional relationship between the distal ends is fixed via the engagement units.

Abstract: A surgical holder is provided, including a base unit, a first positioning unit, a second positioning unit, a connecting unit, a first orientating unit, and a second orientating unit. The first elastic element, the second elastic element, the plurality of third elastic elements and the plurality of the fourth elastic elements balance the surgical holder statically. Further, the connecting unit, the first and second orientating units are designed to have RCM points which restrict lateral displacement of the surgical holder on the surgical incision to increase safety in laparoscopic operations.

Abstract: A system for orientation assistance and display of an instrument that is inserted or present in the natural or artificially produced hollow cavity (human, animal, object), and that is equipped with one or more sensor units. Multiple measurements of the 3D position of the instrument equipped with one or more sensor units are performed by positioning a measuring system, so that a precise orientation and positioning of the instrument in the body can be computed. The 3D position data are used to compute a virtual image of the instrument synchronously. The virtual images are then either projected directly in exact position onto the body surface of a person or combined in a body surface image (real video camera image of the patient) onto a monitor or superimposed (virtual or augmented reality). The system is especially appropriate for displaying for a user a medical instrument, such as a catheter or a rigid or flexible endoscope, in the body of a person in real time, extracorporeally and in correct position.

Abstract: A method is disclosed for determining an illumination beam dose in surgical field illumination. Said method comprises the following steps: at least one actual illumination-relevant value is sensed; and an illumination beam dose is calculated from said sensed actual value. Sensing of the actual illumination-relevant value includes sensing of a value of at least one adjustable parameter of an illumination device. Furthermore, simulated dose characteristics associated with the adjustable parameter are selected, at least one simulated dose value is calculated taking into account the value of the adjustable parameter and the associated simulated dose characteristics, and the illumination beam dose is calculated taking into account the at least one simulated dose value. Also disclosed are an apparatus, a computer program product, and a surgical microscope for carrying out said method.

Abstract: Systems and methods for performing robotically-assisted surgical procedures on a patient enable an image display device to provide an operator with auxiliary information related to the surgical procedure, in addition to providing an image of the surgical site itself. The systems and methods allow an operator to selectively access and reference auxiliary information on the image display device during the performance of a surgical procedure.

Abstract: An instrument tracking device for cooperating with an instrument during a surgical procedure where the instrument has an elongated body extending along a first longitudinal axis and including a working member at a distal tip includes a body having a distal end and a proximal end. An opening can be formed through the body along a second longitudinal axis. The opening can define a passthrough in the body from the distal end to the proximal end. A first tracking coil can be disposed in the body and can define a first tracking coil axis that is substantially coaxial with the second longitudinal axis of the body. A connection mechanism cooperates between the elongated housing and the body that secures the body to the elongated housing of the instrument upon passing at least a portion of the elongated housing through the passthrough of the body in an assembled position.

Abstract: Devices and methods for ultrasonic dental treatment are described, wherein the devices and methods can comprise a flexible array of cooperative ultrasound transducers. The array can contain individual ultrasonic transducers that can perform both functions of emitting and sensing. The transducers can have the ability to interchange their functions from emitting to sensing. The transducers can cooperate in providing an ultrasound treatment and each transducer can be independently controlled by an external source controller. An ultrasound system is provided comprising: an ultrasound transducer sensor array operable to emit or sense ultrasound, wherein the timing and intensity of emission may be controlled by an electronic controller based on a feedback signal from the sensors. In addition the ultrasound system can also have the ability to sense coupling to a treatment tissue. This ability to sense proper coupling can improve the efficacy of the treatment.

Abstract: An apparatus for use with an image-guided system to calibrate a handpiece having a tip that is difficult to calibrate comprises a tip extension having an attachment end and a round end, the attachment end configured to fixedly attach to the tip of the handpiece. The attachment end may include a female component that mates with a correspondingly shaped male component of the tip of the handpiece. The tip extension may have a neck configured to allow rotation of the round end when the round end is in a round recess. A method of using an image-guided system to calibrate a handpiece having a tip may comprise fixedly attaching to the tip an attachment end of a tip extension, the tip extension also having a round end separate from the attachment end; and calibrating a center of the round end by contacting the round end to a calibration device.

Abstract: An orthodontic bracket having a slot formed by arm parts facing each other in the vertical direction, and an inner part, inserted into the slot, having a socket for holding a wire is disclosed. The shape of the socket is designed for applying desired forces to a tooth through the wire when the bracket is attached to the tooth. Forces can be changed simply by changing the inner part; replacing the bracket attached to the tooth. When the inner part is inserted into the slot, the inner part closes the slot and it is held in the position by the arm parts; enabling the wire to be securely held in its position.

Abstract: Lithium silicate glass ceramics and glasses containing specific oxides of divalent elements are described which crystallize at low temperatures and are suitable in particular as dental materials.

Abstract: A skin gripping means for use with an injector (200) is disclosed. In one embodiment the skin gripping means is a needle guard (100). An exterior surface (7) of the skin gripping means (100) is provided with a plurality of fingers (6) adapted to engage a subject's skin (9) when in use. A method of performing a subcutaneous injection is also disclosed with includes the steps of bringing a skin gripping means (100) of an injector (200) into contact with the skin (9) of a subject, moving the skin gripping means (100) substantially parallel to the skin (9) to thereby form a fold (10) in the skin, moving a needle (11) of the injector (200) into the fold (10) to a suitable position for a subcutaneous injection and injecting a substance through the needle (11).

Abstract: An apparatus for retrieving an implanted device from a body vessel includes a distal hub with an elongated, bendable distal tip and with a first marker visible through body tissue with at least one imaging method; a proximal hub with a central longitudinal channel therethrough, arranged proximal from the distal hub, and bearing a second marker. A stylet wire extends from the distal hub through the central longitudinal channel of the proximal hub to a proximal stylet wire end. A flexible, radially expandable interlocking arrangement extends from the distal hub to the proximal hub. An elongated positioning device extending proximally from the proximal hub to a proximal device end. The positioning device and the stylet wire may be configured to perform a longitudinal relative movement between proximal hub and the distal hub, and the interlocking arrangement expands radially when the proximal and distal hubs approach each other.