Abstract: Forming a proximal anastomosis on an aortic wall includes method and instrumentation and apparatus for forming an aortic puncture and inserting into the vessel through the puncture a fluid-impervious sealing element with a protruding retainer. An anastomosis of a graft vessel over the puncture is partially completed with the retainer of the sealing element protruding through the partial anastomosis. The retainer facilitates removal of the sealing element from the partial anastomosis prior to completion of the procedure.

Abstract: Disclosed herein are various systems and methods for facilitating control of a tool or tools. The systems can allow a user to control multiple degrees of freedom. One such system allows a user to control multiple degrees of freedom of two tools simultaneously. Another such system allows a user to control multiple degrees of freedom with a single hand. Frames and rails for supporting and/or constraining movement of a tool or tools are also described herein.

Abstract: The present invention provides a compression and distraction shaft assembly used to apply compression and distraction to bones including vertebrae. Shaft A assembly and shaft B assembly are attached together via a polyaxial fulcrum. The polyaxial fulcrum allows all rotational degrees of freedom between shaft A assembly and shaft B assembly. Such fulcrum, during compression and distraction, does not impart ancillary stresses or motion to vertebrae. An hourglass-shaped bore for engaging pliers is formed in approximately middle of both the shaft A assembly and the shaft B assembly. Distraction pliers having cylindrical tips are used to apply distraction to vertebrae. Once handles are pressed to impart an appropriate amount of distraction to the vertebrae, they are locked in this position. Compression pliers having cylindrical tips are used to apply compression to vertebrae. Once handles are pressed to impart an appropriate amount of compression to the vertebrae, they are locked in this position.

Abstract: Described herein are devices and methods for fusion of adjacent vertebral bones using distractor platforms for exposure and resection of at least a portion of the facet joint, such as in performance of a TLiF procedure. In one embodiment, the distractor platform contains at least a first receptacle and/or extension adapted to couple to the implanted screw/bone marker and the method includes advancing a threaded segment of a bone fastener assembly into the identified first pedicle of the first vertebral bone, the first bone fastener assembly further comprises a second segment adapted to couple with a distraction platform adapted to concurrently attach onto at least one tissue retention blade and adapted to retain the tissue retention blade in the displaced position. Stabilization of a spinal segment is also provided by advancing a substantially concave orthopedic implant through an opening made in a posterior aspect of a disc space.

Abstract: A system for repairing separated body tissues includes a tensioning device having a movable housing, a pair of stationary tensioning tips distal to and attached to the movable housing, and suture tensioning jaws on a proximal end of the movable housing. The tensioning jaws are pivotable between open and closed orientations. A buckle is provided for securing and tensioning suture and the like, having a first plate, a second plate spaced from the first plate so that there is a gap between the first and second plates, and a lock bar within the gap and movable between a first position wherein suture may be freely passed through the gap as tensioning of the suture proceeds, and a second locking position wherein the suture is clamped in place within the gap. A tension tab is provided for securing the lock bar in its first position until tension on the suture exceeds a predetermined level.

Abstract: A suture thread having: a thread-shaped main body with spikes and a stopper cylinder having a diameter enlarged with respect to the main body is described.

Abstract: The present disclosure relates to an anchor assembly. The anchor assembly includes an anchor defining a cavity and an opening to the cavity and an insertion member configured for arrangement within the anchor cavity. The insertion member includes a body having a proximal end portion and a flat distal end portion, and a head coupled to the proximal end portion of the body. A method of tissue repair and other anchor assemblies are also disclosed.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose with first and second noose limbs connected, preferably slidably connected, to the filament engagement feature of the anchor. The first and second noose limbs emerge from the anchor as first and second free filament limbs which are capable of being passed through tissue to be repaired and then passable through the noose. The noose, such as one or more half-hitches, is capable of receiving the free filament limbs and strangulating them when tension is applied to at least one of the free filament limbs and the noose to enable incremental tensioning of the tissue after the anchor is fixated. Preferably, the snare assembly further includes a flexible sleeve joining at least some portion of the first and second free filament limbs to facilitate passing of the free filament limbs at least through the tissue as a single unit.

Abstract: The present invention is a new technology that addresses some of the deficiencies of current fracture fixation technology used in surgical procedures. It involves the use of a polymeric cored braided suture held in place by anchors implanted on each side of a fracture. The anchors must be secured into the bone while yet maintaining very high tensions in the suture during the deployment process. The polymeric cored braided suture is tensioned so as to compress the fracture and hold it in place, functioning as though it has sewn the bone fragment back together. This provides the rigid fixation of the fracture that is essential for primary healing to occur. Simultaneously, the tension preload provides compression which maintains fixation in the face of tensile and shear loads applied to the bone as a result of movement and weight bearing.

Abstract: Apparatus and methods are provided, including a plurality of anchoring elements, each of the anchoring elements being an elongate element that is curved to define an opening. A housing holds each of the anchoring elements. A mandrel is reversibly disposable through the openings defined by the anchoring elements. The anchoring elements are configured such that, in response to removal of the mandrel from the openings, ends of the anchoring elements automatically move outwardly, and diameters of the openings decrease, due to elastic loading of the anchoring elements. Other embodiments are also described.

Abstract: Methods and constructs for soft tissue to bone repairs employing tensionable knotless anchors, without knot tying. The tensionable knotless anchors may be used by themselves or in combination with additional constructs (which may have a similar or different configuration, i.e., modified according to the specific repair) and with the flexible strands provided through tissue, around tissue, or through and around tissue to be repaired or fixated.

Abstract: In a general aspect, a medical device includes a receiving arm configured to be coupled to at least a portion of an implant, and a clamping arm having a proximal end coupled to the receiving arm and having a track at a distal end of the clamping arm. The medical device also includes a sliding component including a needle and configured to slidably move along the track of the clamping arm.

Abstract: Various embodiments of sling or implant systems are provided. The sling or implant systems can be employed to treat incontinence, prolapse, and like conditions. A needle delivery device can be included, wherein the delivery device includes a needle and a rotatable sheath. The rotatable sheath can rotate upon actuation relative to the needle to selectively deploy or disengage an implant anchor from the distal end of the needle.

Abstract: A needle removal device is provided for removing needles from suturing systems. In an embodiment, the needle removal device may include a base member configured to be selectively positioned substantially adjacent a proximal portion of a suturing system. The proximal portion of the suturing system may include a plurality of needle lumens. The needle removal device may also include a plurality of needle receptacles at least partially defined by the base member. The needle receptacles may be positioned and configured to generally correspond to the needle lumens of the suturing system. The needle receptacles may be further configured to selectively receive and grasp onto one or more needles extending proximally from the needle lumens of the suturing system.

Abstract: A needle removal device is provided for removing needles from suturing devices and/or systems. In an embodiment, the needle removal device may be intended for use with a suturing device having one or more needle lumens. The needle removal device may include a first member having a first plurality of needle receptacles extending therethrough. The first needle receptacles may be configured and positioned to correspond to one or more of the one or more needle lumens of the suturing device. The needle removal device may also include a second member having a second plurality of needle receptacles extending therethrough. At least one of the first member or the second member may be moveable between a first position, wherein the first needle receptacles and the second needle receptacles are substantially aligned, and a second position, wherein the first needle receptacles and the second needle receptacles substantially unaligned.

Abstract: The present embodiments provide apparatus and methods suitable for coupling a graft member to tissue, closing a bodily opening, and the like. In one embodiment, a tacking device comprises a wire having first and second ends, and further having delivery and deployed states. In the contracted state, the wire comprises an elongated configuration that is substantially parallel to a central longitudinal axis. In the expanded state, the wire comprises a head region and a body region, the head region comprising at least one full turn having a first diameter, and the body region comprising at least two full turns having a second diameter, wherein the first diameter is greater than the second diameter. One or more of the tacking devices may be delivered using a laparoscopic, endoscopic or percutaneous approach.

Abstract: A staple cartridge assembly for use with a surgical stapler. The assembly has a cartridge body having a support portion with a plurality of staple cavities with openings. There is also a plurality of staples, wherein at least a portion of each the staple is removably stored within the staple cavity. Each the staple is movable between an unfired position and a fired position, and is deformable between an unfired configuration and a fired configuration. The assembly also includes a compressible tissue thickness compensator configured to be captured within the staples. The compressible tissue thickness compensator at least partially covers the staple cavity openings. The compressed tissue thickness compensator is configured to assume different compressed heights within different the staples. The compressible tissue thickness compensator comprising a lyophilized foam having a hemostatic agent embedded therein.

Abstract: An exemplary surgical method of treating tissue within the body of a patient, may include providing an endocutter having a knife, a staple holder along which the knife is slidable, feeder belts located on each side of the knife, staples having a first size, those staples integral with and breakable from at least one feeder belt, and staples having a second size different from the first size, those staples integral with and breakable from at least one feeder belt; engaging tissue of the patient with the staple holder; deploying at least two staples having a first size; disengaging tissue of the patient from the staple holder; once again engaging tissue of the patient with the same staple holder; and deploying at least two staples having a second size.

Abstract: A surgical stapling apparatus is provided including a cartridge assembly defining a tissue contacting surface; an anvil assembly defining a tissue contacting surface; and a surgical buttress releasably secured to at least one of the tissue contacting surface of the cartridge assembly and the tissue contacting surface of the anvil assembly by at least one anchor. A loading unit is provided including a surgical buttress releasably secured to an anvil assembly and/or a staple cartridge secured thereto by at least one anchor, and a drive assembly including a knife blade, wherein movement of the drive assembly from a proximal position to a distal position results in the knife blade cutting the at least one anchor and freeing each surgical buttress from the anvil assembly and/or cartridge assembly.

Abstract: A surgical kit is disclosed. The kit comprises a surgical instrument, a loading unit, and a plurality of cartridge members. The surgical instrument includes a handle assembly, and an elongated portion extending distally from the handle assembly and defining a longitudinal axis. The loading unit is configured for selective engagement with a distal portion of the elongated portion. The loading unit including an anvil assembly and a cartridge channel. Each cartridge member includes a plurality of retention slots with at least some of the slots including fasteners therein. Each cartridge member is configured for selective mechanical engagement with the cartridge channel, and includes a longitudinal length and a working length. The working length is the longitudinal distance along retention slots having fasteners therein. The longitudinal length of each cartridge member is substantially the same, and the working length of at least two of the plurality of cartridge members is different.

Abstract: In various embodiments, a surgical end effector is disclosed. The surgical end effector comprises a staple cartridge comprising a proximal end and a distal end. The staple cartridge is configured to be used to staple tissue within an optimal tissue thickness range. An anvil is movably coupled relative to the staple cartridge. A tissue thickness sensing module is located adjacent to the distal end of the staple cartridge. The tissue thickness sensing module comprises a sensor and a controller. The sensor is configured to generate a tissue thickness signal indicative of a thickness of the tissue located between the anvil and the staple cartridge. The controller is in signal communication with the sensor. The controller comprises means for identifying a staple cartridge type. The staple cartridge type and the thickness measurement are used to determine if the thickness of the tissue is within the optimal tissue thickness range.

Abstract: A surgical stapling device and method for joining tissue portions are provided including a handle assembly, an elongate body extending from the handle assembly, a cartridge assembly supported on a distal end of the elongate body, and an anvil assembly at a distal end of the surgical stapling device. The anvil assembly includes a shaft for removably coupling the anvil assembly to the cartridge assembly and a head pivotally mounted to a distal end of the shaft. A sleeve member is slidably disposed about the shaft of the anvil assembly and is transitionable between a first position, where the sleeve member engages the head of the anvil assembly to secure the head in an un-tilted condition, and a second position, where the sleeve member is disengaged from the head of the anvil assembly to allow the head to tilt.

Abstract: A strap tie assembly includes a first strap tie and a second strap tie. The first strap tie includes a first base, a first body including a first opening and a first engagement member disposed within the first opening, and a first strap extending from the first body. The first strap includes a plurality of movement restriction members disposed along a surface of the first strap. The second strap tie includes a second base, a second body including a second opening and a second engagement member disposed within the second opening, and a second strap extending from the second body. The first strap tie is configured to receive the second strap and prevent translation of the second strap away from the first body. The second strap tie is configured to receive the first strap and prevent translation of the first strap away from the second body.

Abstract: A tool is described for deploying a sutureless vascular anastomosis connection, including a body, a sheath configured to house a connector, the connector being configured to couple a graft vessel to a main vessel, the sheath being removably coupled to a distal end of the body, a dial disposed on a proximal end of the body, a spring disposed within the body and coupled to the dial, a shaft extending from the distal end of the body into the sheath, the shaft having a shaft cannula, a plunger having a plunger head configured to be coupled with the spring at one end, the plunger coupled to the shaft at an opposite end, and a retractable needle coupled to the dial using a retraction mechanism, the retractable needle configured to fit within the shaft cannula, the retractable needle having a sharp end.

Abstract: An implantable flow connector for fluidically coupling a source tissue-enclosed body space with a destination element, comprising: a conduit having a lumen terminating at an orifice at a first end of the conduit implantable in the source body space through an opening formed in a tissue wall of the source body space, and a second end of the conduit implantable in the destination element through an opening in a surface of the destination element; and a circumferential flange, radially extending from the conduit proximate the conduit first end, configured to be implanted in the source body space adjacent an opening in the tissue wall of the source body space such that the conduit extends through the opening, the flange comprising one or more circumferentially adjacent sections at least one of which has a rigidity that decreases in a radially-increasing direction.

Abstract: A hollow fibrous conduit for promoting regeneration of a severed nerve, comprising a first end for coapting the conduit to a first end of a severed nerve and second end for coapting the conduit to a second end of the severed nerve, the hollow fibrous conduit comprising chitosan-poly(caprolactone) fibers. Methods for making the conduit and methods for using the conduit for nerve regeneration.

Abstract: Disclosed is a drilling device and a method for the drilling of human or animal bone tissue. The method comprises the following steps; (a) providing a drill having an electrically conductive bone cutter and an electrically conducting nosepiece assembly spaced apart from the electrically conductive bone cutter and acting as a counter electrode; (b) placing the electrically conductive bone cutter and nosepiece assembly into contact with the bone tissue to be drilled; (c) measuring the electrical impedance between the bone cutter tip and the nosepiece or the current through the cutter motor; (d) commencing drilling and moving the bone cutter toward the bone surface; (e) starting a step counter when the impedance reduces or the cutter motor current increases; (f) incrementing the step counter with every step of the vertical drive motor until the step count reaches the prespecified value thereby controlling the depth of the hole drilled.

Abstract: A method of cutting tissue between a first bone and a second bone. An aperture is formed through the first bone. The aperture has a radius. An undercutting system is provided. The undercutting system includes a cutter. The undercutting system is extended into the aperture. The cutter is moved with respect to the undercutting system to an extended configuration where at least a portion of the cutter extends from the undercutting system. The cutter is used to cut tissue between the first bone and the second bone that is beyond the radius of the aperture. The undercutting system is removed from the aperture.

Abstract: A reaming device comprising a shaft with a mounting portion, the mounting portion having an outer surface; a carbon fiber layer located on the mounting portion outer surface; an injection molded interface element for mechanical coupling of an external device molded on the carbon fiber layer, the interface element having a mounting portion; wherein the carbon fiber layer extends over the outer surface of the shaft mounting portion and having an outer surface, wherein the carbon fiber layer outer surface has a non-smooth surface structure; wherein the injection molded interface element mounting portion is injection molded over the carbon fiber layer surface structure The method according to claim 12, further comprising preparing of shaft mounting portion before wrapping a carbon fiber layer for establishing a reliable connection between the shaft and the carbon fiber layer.

Abstract: A surgical power tool has an actuation assembly for the actuation-force-dependent control of the tool. The actuation assembly includes a force sensor configured to sense the actuation force and a carrier component for the force sensor which is arranged upstream of the force sensor in a direction of force application and is coupled thereto in a force-transmitting manner. A mechanical damping member is arranged upstream of the carrier component in the direction of force application. The damping member protects the carrier component and the force sensor, for example, from impacts and shocks and the accompanying plastic deformations.

Abstract: Methods and devices are described for modifying tissue in a spine of a patient to treat or alleviate spinal stenosis. In one embodiment, a method may include: advancing at least a distal portion of an elongate tissue modification device into an epidural space and between target tissue and non-target tissue in the spine; positioning the tissue modification device so that at least one abrasive surface of the device faces target tissue and at least one non-abrasive surface faces non-target tissue; applying tensioning force at or near separate distal and proximal portions of the tissue modification device; and translating the tissue modification device back and forth while maintaining at least some tensioning force to abrade at least a portion of the target tissue with the at least one abrasive surface. Unwanted damage to the non-target tissue may be prevented via the at least one non-abrasive surface.

Abstract: A measurement system for measuring a parameter of the muscular-skeletal system is disclosed. The measurement system comprises a capacitor, a signal generator, a digital counter, counter register, a digital clock, a digital timer, and a data register. The sensor of the measurement system is the capacitor. The measurement system generates a repeating signal having a measurement cycle that corresponds to the capacitance of the capacitor. The capacitor comprises more than one capacitor mechanically in series. Electrically, the capacitor comprises more than one capacitor in parallel. In one embodiment, the capacitor includes a dielectric layer comprising polyimide. A force, pressure, or load is applied to the capacitor that elastically compresses the device. The capacitor is shielded from parasitic coupling and parasitic capacitance.

Abstract: The present disclosure is for a device, tooling, methods of use and kits containing the cranial plates and bur hole covers used for resecuring a cranial flap after a craniotomy. The cranial repair system is meant to reduce the profile of cranial plates or bur hole covers on the external surface of the cranium after a craniotomy is performed. The embodied devices of present disclosure are designed to reside substantially within the kerf or bur holes and thus minimize the surface area of devices resides on the external surface of the cranium. Additional embodiments include kits, tooling and methods to further reduce and/or eliminate the external profile of the cranial plate on the external cranial surface.

Abstract: An orthopedic tool includes a handle having an exterior profile defined by a first three-dimensional shape having an exterior surface of revolution about a first axis of rotation, and a second three-dimensional shape having an exterior surface of revolution about a second axis of rotation. The second axis of rotation is offset from the first axis of rotation, whereby the first three-dimensional shape and the second three-dimensional shape intersect to define a volume of intersection. The exterior profile is defined only by the volume of intersection. A shaft extends from the handle.

Abstract: Systems and methods provide patient-specific cutting blocks that allow for bone resurfacing procedures, such as milling or burring, with simplified devices. A computer assisted surgical cutting block is produced having a surface region that matches with the surface region of a patient's bone to be altered. A cutting tool may be provided having a contoured bone mating surface and a contoured and patient-specific shaped cutting guide surface, which is located in a plane above the bone mating surface. One or more channels are provided in the cutting block, and as the surgeon moves the cutting tool (a milling or burring, for example) in the channels the tool cuts the bone both laterally along the surface of the bone and vertically into the bone according to the cutting guide surface and other preselected surface features of the cutting block.

Abstract: An improved olecranon fracture repair device and system. The device includes standoffs to minimize compression of a patient's triceps muscle and tendon. A buttress plate curved to approximate the olecranon process radius accepts a plurality of fixation screws is sized such that the distal end of the plate extends forward of the triceps tendon fibro-osseous junction. The system includes an installation tool having a positioning plate with a moveable member. The positioning plate serves as a stabilizing device, a medullary cavity penetration drill template, and a fixture for guiding the intramedullary rods into the cavities. The moveable member allows for removal of the tool following partial insertion of the repair device intramedullary rods.

Abstract: The jig is formed based on a three-dimensional reconstruction of the bone elements of the joint from tomodensitometric data; the marking of points on the humerus being used as a basis for the positioning of the considered prosthetic element. The jig includes: a support base cooperating with the humeral head according to a single position, one portion of the base cooperating with the intertubercular sulcus or bicipital groove; a gripping portion; and a breakable area temporarily receiving a cutting block to allow its fixation to the humeral bone before enabling to perform the humeral resection.

Abstract: Some embodiments provide a system for external manipulation of magnetic nanoparticles in vasculature using a remotely placed magnetic field-generating stator. In one aspect, the systems and methods relate to the control of magnetic nanoparticles in a fluid medium using permanent magnet-based or electromagnetic field-generating stator sources. Such a system can be useful for increasing the diffusion of therapeutic agents in a fluid medium, such as a human circulatory system, which can result in substantial clearance of fluid obstructions, such as vascular occlusions, in a circulatory system resulting in increased blood flow.

Abstract: A catheter is provided for retrieving an embolus or foreign body from a body lumen. The catheter can have a distal segment which is movable from a reduced outside diameter for positioning at a target site. Further, the catheter can have an enlarged outside diameter suitable for thrombectomy or foreign body retrieval.

Abstract: A manually actuated function hose instrument has a hose-shaped function part and a wire-shaped function part extending in the latter, wherein the two function parts are axially movable relative to each other in order to exert a useful function at a distal section remote from a proximal end section. An associated operating device, which has two operating parts, is arranged at the proximal end section of the function parts. A fixing part is provided which serves for the external fixing of the operating device and with which the second operating part is coupled in an axially relatively movable manner, and/or the second operating part is connected non-releasably to the proximal end section of the hose-shaped function part and contains an operating ring with a circumferential finger recess as operating area.

Abstract: There is described an endoluminal filter having an end cap having a lumen sized to receive there through a guidewire used in the positioning of the filter within the vasculature. There is a first support member with a pre-formed counter clockwise spiral shape and a second support member with a pre-formed clockwise spiral shape positioned adjacent to one another to form a proximal support frame, a distal support frame with a crossover between the proximal support frame and the distal support frame with a proximal portion of the first and the second spiral support members being attached to the end cap. A material capture structure having a rim and an apex with the rim attached to the proximal support frame and the apex extending distally through without attaching to the distal support frame.

Abstract: Stomach tissue is manipulated to form, for example, a restored flap of a gastroesophageal flap valve. The manipulation includes gripping stomach tissue from within the stomach while the stomach is inflated to promote visualization and stabilization of the gripped stomach tissue. Once the stomach tissue is gripped, the stomach is deflated and pulled into a mold. The molded tissue is then fastened with at least one fastener. The stomach is inflated to a first pressure during visualization and then to a second higher pressure during the stomach tissue gripping.

Abstract: A medical manipulator has a distal-end working unit including an end effector. The distal-end working unit has a rotor having a hollow tube rotatable in unison with the end effector and a rotational support tube having a posture variable with respect to the shaft. The rotor is rotatably supported by an inner circumferential surface of the rotational support tube. Engaging members that are disposed in side holes formed in the rotational support tube have inner ends inserted in an annular groove.

Abstract: A surgical tool with an electric motor. The motor rotor includes a bore in which a number of magnets are disposed. Each magnet has an outer surface and two inner surfaces that extend inwardly towards a corner. One pole of each magnet is along the outer surface; the opposed pole is at the corner. The magnets are disposed in the rotor bore so that the corners of arcuately adjacent magnets have opposed magnetic polarities.

Abstract: An ultrasonic transmitting unit includes a first vibrating section and second vibrating section vibrating at the same predetermined frequency with respect to each other. The ultrasonic transmitting unit includes a relay portion transmitting the ultrasonic vibration toward a first transmitting direction from the first vibrating section to the second vibrating section and positioned at a position corresponding to one of an antinode position of the vibration in the first vibrating section and different from an antinode position and a node position of the vibration in the second vibrating section, and a non-contact vibrating portion extending in a second vibrating section from the relay portion toward a second transmitting direction without contact with the first vibrating section.

Abstract: An ultrasonic surgical instrument includes a transducer assembly having a distal engagement member and configured to supply ultrasonic energy. A waveguide defines a longitudinal axis and has a proximal engagement member configured to threadingly engage the distal engagement member. The waveguide is configured to transmit the ultrasonic energy therealong to a distal end thereof for treating tissue. A torque member is coupled to the transducer assembly and is disposed about the longitudinal axis. The torque member is selectively rotatable about the longitudinal axis and relative to the waveguide to threadingly engage the transducer assembly and the waveguide to one another. The torque member includes a plurality of fingers pivotably coupled thereto and movable between a closed position and an open position. In the open position, each finger extends substantially perpendicularly from the longitudinal axis to define a moment arm that facilitates the engagement of the transducer assembly and the waveguide.

Abstract: A prostate therapy system is provided that may include any of a number of features. One feature of the prostate therapy system is that it can access a prostate lobe from the urethra. Another feature of the prostate therapy system is that it can deliver condensable vapor into the prostate to ablate the prostate tissue. Another feature of the prostate therapy system is that it can aspirate tissue from the prostate. Yet another feature of the prostate therapy system is that it can rotate during delivery of vapor and aspiration of tissue. Methods associated with use of the prostate therapy system are also covered.

Abstract: This disclosure discusses various methods and devices for capturing plaque that is to be removed from a blood vessel after the plaque has been separated from the blood vessel or remaining plaque.

Abstract: Devices and methods are disclosed for widening a channel in a treatment site, the channel containing a guide-wire. The channel is widened by advancing an elongated dilation device, which is configured to fit tightly over the guide-wire at the distal tip of the dilation device and to provide a distal dilating surface, over the guide-wire and at least partially through the treatment site. The dilation device comprises a tubular metallic shaft, typically a metal inner tube, for providing sufficient stiffness and column strength for the dilator to be advanced at least partially through the channel, and a flexible sleeve providing a tapered distal tip. The distal end of the dilator defines a leading surface that is shaped to force away portions of a lesion surrounding the guide-wire away from the guide-wire as the distal end is advanced over the guide-wire through the lesion, whereby a channel through the lesion is at least partially dilated.

Abstract: Described herein are atherectomy catheters, systems and methods that include longitudinally displaceable drive shafts that drive actuation of one or more cutters at the distal end of the catheter. The catheters described herein may include one or more imaging sensors for imaging before, during or after cutting tissue. In some variations the imaging sensor may be rotated around the perimeter of the catheter independently of the rotation of the cutter. Also describe herein are imaging catheters that may be used without cutters.