Abstract: A balloon guiding sheath may include an elongated sheath comprising a proximal end, a distal end, an inner tube, an outer tube surrounding the inner tube, an access port, a distal port, and a working lumen extending through an interior portion of the elongated sheath between the access port and the distal port. The balloon guiding sheath may also include an inflatable balloon located on an outer surface of the elongated sheath adjacent the distal end. The balloon guiding sheath may include a plurality of inflation holes extending through a side wall of the elongated sheath. The elongated sheath may be sized and configured to enable direct insertion into a patient's vasculature through an arteriotomy in at least one of a femoral artery and vertebral artery to position the inflatable balloon at a target site.

Abstract: A medical instrument may include a tube, a sheath provided around and coaxial with the tube, and an inflatable balloon at a distal end of the sheath. The balloon may receive a fluid from a lumen of the sheath, and may have a central opening along a longitudinal axis thereof, and into which the tube extends, a proximal portion, a middle portion adjacent to and distal of the proximal portion, and a distal portion adjacent to and proximal of the middle portion. When the balloon is inflated with the fluid, a maximum diameter of the middle portion may be less than a maximum diameter of the proximal portion, and less than a maximum diameter of the distal portion. The medical instrument may also include an extraction member provided at a distal end of the tube, distal to the balloon, and movable axially relative to the balloon.

Abstract: A vacuum aspiration system may be used to treat thromboembolic disease, such as deep vein thrombosis or pulmonary embolism. The system includes a housing, and a fluid flow path extending through the housing. A first catheter is in fluid communication with the flow path, and a connector is configured to place a source of aspiration in communication with the flow path. A clot container is carried by the housing. A hemostasis valve is provided in the housing, and configured to receive a second catheter and direct the second catheter through the first catheter.

Abstract: An aspiration system exhibits an accelerated drop in negative pressure at the distal end of an aspiration catheter from the time of opening a valve. The system includes an aspiration pump in communication with a first chamber, and an aspiration catheter configured for placement into fluid communication with the first chamber by way of an elongate aspiration tube. A second chamber is provided between the aspiration tube and the catheter, and a valve is provided between the second chamber and the aspiration catheter. Upon opening of the valve with negative pressure at equilibrium in the first and second chambers, resistance to fluid flow between the second chamber and the distal end of the catheter is less than the resistance to fluid flow between the second chamber and the first chamber, causing a rapid aspiration into the second chamber.

Abstract: A methods of placing large bore aspiration catheters is disclosed. The method of removing a vascular obstruction includes the steps of transvascularly advancing a distal end of an aspiration catheter into proximity with an obstruction, activating a low flow, detection mode of aspiration through the catheter, and thereafter activating a momentary control to activate a high flow, aspiration mode of operation and draw obstructive material into the distal end of the access catheter.

Abstract: A method or use for managing one or more acute ischemic events. The method can include determining criteria of a clot; classifying the clot based on the criteria and generating a classification; determining an individualized treatment protocol for the clot based on the classification, the individualized treatment protocol comprising one or more techniques selected from using aspiration, restoring perfusion using a first reperfusion device, and/or restoring perfusion using a second reperfusion device; and treating the clot based on the individualized treatment protocol.

Abstract: An intravascular articulating retrieval apparatus may be used to move objects within the vasculature, such as to remove an intravascular filter, tissue and other items from the vasculature. The apparatus has a user interface to manipulate a first and second actuating portion that are coupled to the distal end of the apparatus conduit. A retrieval apparatus may include forceps coupled to the second actuating portion whereby the retrieval actuator opens and closes the forceps for retrieval of an IVF or other device, such as stent or stent graft. An intravascular articulating retrieval apparatus may be used to dissect thrombus from the interior of the vascular wall, move a stent or remove a portion of a stent or stent graft to provide better blood flow or to allow blood flow into a branched vessel.

Abstract: The present invention provides enhanced ESWL efficacy for therapeutic and operational outcomes. Device behavior and performance data is measured in-situ and analyzed for both intra-procedure and inter-procedure breadth of regard such that both therapy optimization and maintenance optimization engines are provided an accurate and current assessment of ESWL system and device state and performance. This feedback and control provides the ability to compensate in real time for the current patient therapy and offline for future patient therapy for machine/therapy idiosyncrasies and realize continuous calibration of system/devices to the performance required for maximum ESWL patient efficacy.

Abstract: A treatment tool includes: a sheath that extends along a first axis; an end effector that is arranged on the sheath, the end effector being configured to apply energy to living tissue according to power that is supplied; a first operation portion into which the sheath is inserted and that is rotatable on the first axis together with the sheath; a housing configured to support the first operation portion; a conductive wire that is laid at least in the housing and in the first operation portion, is electrically connected to the end effector, and serves as a path via which the power is supplied; and a rotation portion that is at least partially positioned in the housing, that is rotatable on the first axis together with the sheath and the first operation portion, and around which the conductive wire is wound in the housing.

Abstract: A collagen fiber extraction tool, which includes a handle, a connecting rod fixed to a front end of the handle, and a tooth member fixed to a front end of the connecting rod. The tooth member includes a body and comb teeth, the comb teeth are strip-shaped, one end of each comb tooth is fixed to the body, a tooth tip is provided at the other end of the comb tooth, and a tooth edge having an acute angle is disposed on a rear side or on both front and rear sides of the comb tooth. The plurality of comb teeth are arranged in a row along the front-rear direction of the body, and a gap is disposed between adjacent comb teeth in the same row.

Abstract: In one embodiment, a system for providing a distal embolic protection including a distal embolic protection flow catheter configured for insertion into an artery, the catheter comprising one or more outlet apertures configured to eject fluid into the artery to drive embolic particles within the artery in a desired direction

Abstract: A surgical instrument includes an ultrasonic transducer, an ultrasonic transmission waveguide extending from the ultrasonic transducer, and an ultrasonic blade acoustically coupled to the ultrasonic transmission waveguide. The ultrasonic blade includes a base and a curved body extending distally from the base. The curved body includes a tissue-treating surface extending on a first side of the curved body and a curved edge extending on a second side of the curved body opposite the first side. The curved edge has a proximal end and a distal end, wherein the proximal end is offset from the distal end in a first direction, wherein the proximal end is offset from the distal end in a second direction, and wherein the first direction is perpendicular to the second direction.

Abstract: A catheter for scoring or slicing a lesion. The catheter has a first receiver at a distal end of an expandable portion of the catheter shaft. A first carrier at least partially within the first receiver is moveable axially along the catheter shaft to deploy a first cutter along the expandable portion for cutting or scoring the lesion. In an alternative embodiment, the first carrier may be a wire having a loop, and thus forming a first length including the first cutter and a second length including a second cutter. Actuation of the wire thus causes simultaneous, reciprocal movement of the first and second cutters. Related methods are also disclosed.

Abstract: A surgical kit includes a cannula assembly and a camera assembly. The cannula assembly includes a cannula housing and a cannula member extending from the cannula housing. The cannula member defines a channel therethrough. The camera assembly includes an insertion member including an elongate shaft including a supporting member extending proximally from a distal end portion of the elongate shaft, and a camera detachably supported on a proximal end portion of the supporting member of the insertion member. The camera is configured to be coupled to an outer surface of the cannula. The camera and the insertion member are dimensioned to be received through the channel of the cannula member.

Abstract: A trocar assembly can include a cannula, a seal cartridge, and an obturator. The seal cartridge is configured to be releasably coupled to the cannula and to be disposed at least partially within the cannula in a coupled configuration of the seal cartridge. The obturator is configured to directly latch to the cannula and to extends through the cannula and the seal cartridge in a coupled configuration of the obturator.

Abstract: A medical device includes a tube comprising a proximal end, a distal end, a wall extending from the proximal end to the distal end of the tube and surrounding a hollow interior of the tube, and one or more engagement features on the lateral wall. An inflatable member is located at a distal end portion of the tube. The medical device also includes a repositionable anchor located on the tube proximal to the inflatable anchor and configured to engage the one or more features on the lateral wall. In a first configuration of the medical device, the repositionable anchor is translatable along the tube, and in a second configuration of the medical device the repositionable anchor is fixed in translation relative to the tube.

Abstract: The invention relates to a device (14, 14?) for loading hair grafts into a Choi implanter-type implantation instrument, including an element comprising a first hole (18a) connected to a channel (17) that opens into a fluid-discharge chamber (21); a second hole (22) which can be connected to the fluid-discharge chamber (21) and define a path with the channel (17) such as to allow a needle (5) of an implantation instrument (1) to be introduced into the path through the second hole (22); and a connection means (23) for connecting the fluid-discharge chamber (21) to a vacuum source (27). The first hole (18a) is connected to a first tubing (20) used to deliver a graft (12) such that the graft (12) can be inserted into the needle (5) of the implantation instrument (1).

Abstract: A system including includes an intraosseous needle and a handle. The intraosseous needle includes a distal end configured for insertion into a bone and a proximal end configured to extend from the bone. The handle is configured to releasably engage the intraosseous needle. The handle includes a cylindrical body portion, a handle portion, and a channel. The cylindrical body portion includes a distal end configured to receive the proximal end of the intraosseous needle. The handle portion extends from the cylindrical body portion and has a bulb-like cross-sectional shape and opposing first and second substantially planar surfaces. The channel is configured to receive the proximal end of the intraosseous needle.

Abstract: A surgical kit includes a cannula assembly and a sheath. The cannula assembly includes a housing, an elongate shaft defining a lumen and extending from the housing, a fluid port adapted to be coupled to a fluid source, and an expandable body in fluid communication with the fluid port. The sheath is configured to be disposed over the expandable body of the cannula assembly to apply a compressive force to the expandable body. The sheath is transitionable between a contracted configuration and an expanded configuration.

Abstract: A spine implant for receipt between and fastened to a lower vertebra and an adjacent upper vertebra is characterized by an expandable cage and an expandable plate attached to the expandable cage. When the expandable cage is expanded, both the expandable cage and the expandable plate expand together at a uniform rate of movement. Engagement features of the expandable cage cooperate with engagement features of the expandable plate such that expansion of the expandable cage carries the expandable plate along during its expansion. The engagement features of the expandable cage may be configured as notches, cavities, or recessed pockets, while the engagement features of the expandable plate may be configured as tangs, flanges, or protuberances styled to be received by the configured notches of the expandable cage. Cam locks on the expandable plate help bone fastener backout.

Abstract: This disclosure describes exemplary intramedullary implant systems. The intramedullary implant systems may be used for performing bone fracture, bone fusion, or osteotomy procedures within joints.

Abstract: Systems for treating bone fractures are disclosed. Exemplary systems may include a backpack and one or more bone plates for engaging bone members. The backpack may be configured to be temporarily attached to the bone plate in order to provide trajectories for fasteners received by the bone plate. The bone plates can receive one or more screws to secure the bone plates to an underlying bone member. The one or more screws can be inserted into bone plate holes that can be considered locking or non-locking. The bone plates described herein can have particular combinations of locking and/or non-locking holes. Additional bone plate holes can be used to accept sutures, K-wire, or other instrumentation.

Abstract: The presently disclosed and claimed inventive concept(s) relates generally to the field of bone plates for the reduction and fixation of bone fractures. In particular, the presently disclosed and claimed inventive concept(s) relates to a quadrilateral surface bone plate for the fixation of acetabular fractures having at least one securing port therein and methods of making and using same.

Abstract: A fracture fixation system includes a plate having a laterally extending bore passing therethrough and configured to receive a first wire when the plate is placed in contact with a bone. The plate has a recess for receiving and securing a first end of a first wire, and includes an entry hole and an exit hole to at opposite ends of a first bore to allow the first wire to pass through the plate. A screw is configured to capture said the wire in the first bore to maintain a desired tension on the first wire.

Abstract: An osseous anchoring implant with facilitated extraction having: an expandable sleeve extending between a proximal portion, and a distal portion, defining a longitudinal axis, a screw extending between a proximal portion and a distal portion on an axis collinear with the axis, having an external profile complementary to the internal profile of said expandable sleeve, the screw comprising at least one distance marker to visualize the moment when the screwing of the screw in the expandable sleeve must be carried out in the opposite direction to the screwing of the expandable sleeve. The implant switches from a folded rest position to a deployed position by the penetration of the screw in the expandable sleeve. The distal portion including self-tapping notches. The distal portion includes a self-milling head.

Abstract: An osseous anchoring implant with optimized expansion, having a tubular body and a rod whose external profile of the rod and internal profile of the tubular body are complementary. The implant being expandable between a rest configuration in which an abutment mechanism interlocks the tubular body and the rod thanks to the reversal of their two respective screw pitches, so that they provide in an expanded configuration radially: a proximal bearing point, a distal bearing point, a “central” bearing point located between these two bearing points, formed by the cooperation between the outer diameter of the rod and the inner diameter of the tubular body which induce an outer diameter of the tubular body at the “central” level greater than the outer diameter of the tubular body at the proximal bearing point.

Abstract: A bone fixation system is provided for use in the spine between vertebrae. The system comprises a first fastener configured to anchor into a first vertebrae, a second fastener configured to anchor into a second vertebrae, and a set screw to retain the second fastener to the first fastener. The first fastener includes a shaft extending along a longitudinal axis and a head. The shaft includes a first cylindrical body. The head of the first fastener includes a second cylindrical body defining a passageway having an interior surface. The passageway defines a longitudinal axis that is different than the longitudinal axis of the shaft. The first cylindrical body of the shaft and the second cylindrical body of the head are angled relative to each other. The second fastener includes a shaft and a head. The head of the second fastener is configured to engage the interior surface of the passageway of the head of the first fastener.

Abstract: The present disclosure describes a bone screw for use in orthopedic procedures. The bone screw includes a shank portion having a helical thread and a head portion also having a helical thread. The head portion has a reverse frustoconical shape, with the conical taper decreasing in the proximal direction.

Abstract: An osseous anchoring implant with cortical stabilization. The implant having: an expandable sleeve having a first threading inside and a second threading outside, a screw having an external profile complementary to the internal profile of said expandable sleeve and an external threading with a reverse screw pitch of the second threading, The implant switching from a folded rest position to a deployed position by the actuation of said reversed threading, causing the penetration of the screw into the expandable sleeve and generating the radial expansion of the expandable sleeve by deformation on a distal portion. In the deployed position, the expandable sleeve has a frustoconical shape. The proximal portion of the screw includes an outer osseous anchoring threading and a frustoconical portion whose flaring is reversed relative to that of the expandable sleeve in the deployed position.

Abstract: A method of treating a bone of a patient includes identifying a portion of the patient to be protected. A cannula is provided that includes a shaft extending between opposite first and second end surfaces. The shaft incudes an inner surface defining a lumen. The cannula includes a scoop extending from the second end surface. The scoop includes an inner surface that is continuous with the inner surface of the shaft and an opposite outer surface. The cannula is inserted into the bone such that the outer surface of the scoop is positioned adjacent to the portion of the patient to be protected. A balloon is inserted into the cannula such that the balloon is positioned within the scoop. The balloon is inflated such that the balloon expands away from the scoop as the balloon is inflated and creates a void in the bone. Systems are disclosed.

Abstract: A device and a method for coagulation and/or dissection of biological tissue is disclosed. The device comprises an apparatus and an instrument electrically connected thereto. The instrument includes an operation circuit with a manually operated switch. An evaluation circuit of the apparatus provides an evaluation signal for the instrument. The apparatus can create a supply voltage or a supply current for the instrument. In the initial condition the evaluation signal comprises only one polarity. The evaluation signal is provided to a control circuit of the instrument in which a characteristic of the evaluation signal is adjusted depending on the operating condition of the switch. The evaluation circuit detects this characteristic and initiates the output of the supply voltage and changes the polarity of the evaluation signal according to the requested cutting mode. In the cutting mode the evaluation signal comprises at least temporarily also a second polarity.

Abstract: Described here are methods and systems for the manipulation of ovarian tissues. The methods and systems may be used in the treatment of polycystic ovary syndrome (PCOS). The systems and methods may also be useful in the treatment of infertility associated with PCOS.

Abstract: A cryoablation device comprises a freezing balloon, a catheter, a storage tank, a delivery pipeline, a recovery pipeline, and a freezing element. Within the freezing balloon circulates a freezing substance, such as a low pressure liquid or gas or a gas-liquid mixture. A cryoablation method comprises the following four steps: pre-freezing, ablation, recovery, and rewarming. Advantages of the cryoablation device and method provided herein: low risk factor, easy to operate, convenient to use, exhibits high freezing efficiency, and temperature control accuracy.

Abstract: A cryoablation apparatus for creating a lesion in a target tissue includes an expandable energy transfer region formed of a plurality of independent spline ablation members. Manipulation of a control member extending from a handle to the energy transfer region controllably adjusts the shape of the energy transfer region to contact complex anatomies. A service lumen extending through the length of apparatus can slidably receive an ancillary catheter such as a guide catheter or diagnostic catheter. The catheter has particular application to treating conditions of the heart. Related methods and systems are also described.

Abstract: A system for monitoring electrical activity at an ablation site where the system includes an ablation device having an elongate, flexible shaft and a distal treatment section for delivering ablation energy to target tissue, a first electrode mounted on the distal treatment section, a second electrode mounted on the distal treatment section where the second electrode is spaced from the first electrode a distance (D1), a plurality of conducting elements extending along the distal treatment section and being connected to the first electrode and the second electrode, the plurality of conducting elements for connecting the first electrode and the second electrode to an electrophysiological recording system, a processing device programmed to receive the electrical information from the ablation site from the first electrode and the second electrode, and an electrophysiological recording system.

Abstract: A method of creating a shunt between a right atrium and a left atrium of a mammalian heart including puncturing an atrial septum between the right atrium and the left atrium to create a shunt. An ablation device having balloon is advanced at least partially through the shunt. The balloon is inflated and configured to thermally isolate the atrial septum from blood within the left atrium and the right atrium. Ablation energy is delivered to ablate the atrial septum.

Abstract: Diathermy tonsillectomy suction dissector apparatus has a body having a proximal handle, a distal curved tip and a diathermy cutting blade member slidably retained within the body to selectively extend from the tip. The diathermy cutting blade member comprises a flexible metallic blade comprising a proximal electrical connector socket and a hand operable electrically insulative position locking mechanism attached to the blade. The locking mechanism is hand operable via apertures and interlocks therewith to position the diathermy cutting blade member between retracted and extended positions and to lock the diathermy cutting blade member at the extended position.

Abstract: A signal return-path symmetry measurement apparatus includes a transformer and monitoring circuitry. The transformer is coupled to first and second return-path electrodes that are attached to a body of a patient and serve as a return path for an electrical signal applied to the patient. The transformer is configured to generate a return-path-difference electrical signal responsive to a difference between electrical signals returning from the first and second return-path electrodes. The monitoring circuitry is configured to generate an electrode symmetry measure responsive to the return-path-difference electrical signal.

Abstract: Systems and techniques for nerve monitoring are described herein. The system can include a remote transmitter configured to send a stimulation signal to a nerve, and an electrosurgical device including an end effector configured to perform a surgical function in response to receiving a therapeutic signal from an electrosurgical generator. The system can also include a receiver configured to detect the stimulation signal, and in response to detecting the stimulation signal, determine a location of the nerve, and an in-vivo transmitter configured to emit a location signal in response to the determined location of the nerve.

Abstract: Disclosed is a system for monitoring physiological parameters during a medical interventional procedure involving high intensity/energy radiofrequency electrical currents/voltages applied through a body of a subject, the system including an electrode-based sensor, configured to close an electrical conduction path passing through a body of a subject, and one or more non-electrode-based sensors, a plurality of electrical lines, a monitor, and a filter array including EMI filters mounted at specific locations and characterized by a frequency response curve having a magnitude of an attenuation in a first frequency range (typical of operating frequencies of high intensity/energy radiofrequency medical interventional equipment), which is greater than a magnitude of an attenuation in a second frequency range (typical of the sampling frequencies of the electrode-based sensor and the one or more non-electrode-based sensors), the system being thereby configured for suppressing noise induced by the medical interventiona

Abstract: The invention generally relates to systems and methods for improving sleep by treating at least one of rhinitis, congestion, and/or rhinorrhea to thereby reduce or eliminate symptoms associated therewith, including, but not limited to, nasal congestion, coughing, sneezing, and nasal or throat irritation and itching.

Abstract: Disclosed herein are systems, devices, and methods for treating heart failure. In some variations, a catheter for forming an anastomosis in a heart may comprise a first catheter comprising an electrode. A second catheter may be slidably disposed within the first catheter. The second catheter may comprise a barb and a dilator comprising a mating surface configured to engage the electrode.

Abstract: A virtual camera may be positioned relative to a 3-D model of a patient anatomy in order to provide a virtual camera view of the surrounding anatomy and tracked surgical instruments being deployed to the anatomy. Visual context provided by the virtual camera may be limited in some cases, such as where a surgical instrument is being used within a very narrow anatomical passageway or cavity. To provide more placement flexibility, an IGS system providing a virtual camera receives inputs defining variable visual characteristics for different segments or regions of the 3-D model, which may include hiding certain segments or making certain segments semi-transparent. With such a system, the view of the 3-D model provided by the virtual camera view may be modified to remove or deemphasize less relevant segments, to display or emphasize more relevant segments (e.g., critical patient anatomy), or both.

Abstract: A robotically-assisted surgical system that assists robotic surgery by a surgical robot having a robot main body includes one or more processors. The one or more processors are configured to plan a position of a port to be perforated on a body surface of a subject which is a target of the robotic surgery, acquire a captured image obtained by capturing the subject including at least a part of the subject by an overview camera included in the robot main body, recognize a planned position of the port in the captured image based on the captured image and the planned position of the port, and show the captured image and port position information indicating the planned position of the port in the subject illustrated in the captured image, on a display unit.

Abstract: The invention generally relates to systems and methods for providing detection, identification, and precision targeting of specific tissue of interest to undergo a therapeutic treatment while minimizing or avoiding collateral damage to surrounding or adjacent non-targeted tissue.

Abstract: Provided are devices and techniques to compare current across treatment plans as well as between various clinician and/or clinic protocols. Current from an ablation therapy treatment can be measured and normalized to compare the normalized current between ablation therapy treatments. An efficacy of a treatment, a real-time display of treatment progression, a completion of a treatment, and/or effective treatment planning can be determined based on a change (or a potential change) in the normalized current. Also provided is a database of treatment results including indications of normalized current from the treatments.

Abstract: A computer-implemented method of improving a patello-femoral response is described. A computing system characterizes an anterior geometry of a patella and determines a position of a posterior apex of the patella in relation to one or more features of the anterior geometry of the patella. The computing system further receives location information related to the patella as a knee joint is moved through a range of motion. The computing system provides one or more recommendations to improve a patello-femoral response.

Abstract: Described embodiments include a system that includes a current source generator and a processor. The processor is configured to drive the current source generator to supply, for application to tissue of a subject, an electric current having an amplitude that varies in accordance with a predefined function of time, such that the amplitude initially monotonically increases to a maximum value. Other embodiments are also described.

Abstract: A computer-implemented method for creating an activity-optimized cutting guides for surgical procedures includes receiving one or more pre-operative images depicting one or more anatomical joints of a patient, and creating a three-dimensional anatomical model of the one or more anatomical joints based on the one or more pre-operative images. One or more patient-specific anatomical measurements are determined based on the three-dimensional anatomical model. A statistical model of joint performance is applied to the patient-specific anatomical measurements to identify one or more cut angles for performing a surgical procedure. A patient-specific cutting guide is created that comprises one or more apertures positioned based on the one or more cut angles.

Abstract: A system and method of displaying images from an imaging device includes a display device and one or more processors. The one or more processors are configured to track movement of an imaging device, determine a display-device-to-imaging-window transform based on the tracked movement and a corresponding command to move the imaging device, and render an image received from the imaging device on the display device at a position and orientation on the display device based on the display-device-to-imaging-window transform. In some embodiments, the display-device-to-imaging-window transform is determined based on at least one of a difference between: a commanded and an actual position of the imaging device, a commanded and an actual orientation of the imaging device, a commanded and an estimated position of the imaging device, or a commanded and an estimated orientation of the imaging device.