Abstract: A system for creating an endoluminal valve from a blood vessel wall, includes: a tubular assembly having a longitudinal axis, a proximal end, a distal portion with a distal end, and a first lumen extending from the proximal end to a distal port located proximate the distal portion, the distal port located along the longitudinal axis, the distal portion having a supporting surface on a same side of the tubular assembly as the distal port, the supporting surface extending in a longitudinal direction and offset from a surface of the tubular assembly proximal the distal port and configured to contact the blood vessel wall; and a tissue dissection probe disposed within the first lumen, the tissue dissection probe having a fluid delivery lumen extending to a fluid delivery port located at a distal end of the tissue dissection probe, the tissue dissection probe configured to be inserted into the blood vessel wall.

Abstract: Methods and/or devices to determine patient respiration information are disclosed which comprise sensing acceleration.

Abstract: The present disclosure provides an apparatus comprising a wire having a first end and a second end opposite the first end. A first portion of the wire including the first end comprises a malleable region that is configured to remain deformed after bending, and a second portion of the wire including the second end comprises a superelastic region that is configured to return to a straight configuration after bending.

Abstract: Systems, apparatuses, and methods for electroporation ablation therapy are disclosed, with a protection device for protecting electronic circuitry, devices, and/or other components from induced currents and voltages generated during a cardiac ablation procedure. A system can include an ablation device near cardiac tissue of a heart. The system can further include a signal generator configured to generate a pulse waveform, where the signal generator coupled to the ablation device and configured to repeatedly deliver the pulse waveform to the ablation device in synchrony with a set of cardiac cycles of the heart. The system can further include a protection device configured to suppress induced current and voltage in an electronic device coupled to the protection device.

Abstract: An example system includes an apparatus having a first elongated medical device and a second elongated medical device; and a controller coupled to the apparatus. The controller is provided to determine a magnitude and a direction of linear translation of the first elongated medical device and responsive to the determined translation of the first elongated medical device, cause a linear translation of the second elongated medical device, the linear translation of the second elongated device having a substantially equal magnitude to the linear translation of the first elongated medical device and being in a direction opposite the direction of translation of the first elongated medical device. The controller is further provided to modify at least one parameter of the linear translation of either (a) the first elongated medical device or (b) the second elongated medical device in response to the determined translation of the first elongated device.

Abstract: A method of inserting an electrode into a cranial cavity of a cranium can include determining a length, between a target within the cranial cavity and a proximal end of a multipiece cannula, of the electrode for insertion of the electrode to the target. A distal end of the electrode can be inserted through a multipiece cannula supported by an instrument holder of a surgical arm. The surgical arm can be positioned such that a distance from the target to the proximal end of the cannula is equal to the length. The electrode can be fed through the cannula and through the anchor bolt into the cranial cavity. Feeding of the electrode through the cannula and into the cranial cavity can be stopped when the length of the electrode fed into the cavity reaches the length between the proximal opening of the multipiece cannula and the target.

Abstract: The objectives for the designs presented herein can be for a variably flexible and kink-resistant catheter for vascular applications. The designs benefit from good compressive and tensile stiffness. A braided wire support structure can be disposed around an inner liner and an outer layer having a plurality of outer jackets of variable durometer. A metallic reinforcing layer can be cut from a hypotube and be used as the primary structure for catheter stiffness, reducing the reliance on and number of jackets to transition stiffness changes along the length of the catheter. The metallic reinforcing layer can have one or more ribbon cut segments and one or more axial hole patterns laser cut into the hypotube to progressively evolve the stiffness from proximally regions with more column stiffness and distal regions with greater lateral flexibility. The polymer jackets can be reflowed to bond the structure together.

Abstract: An elongated medical catheter includes a marker band with sidebands. The elongated medical catheter and the marker band have a radiopacity being different from the radiopacity of the sidebands.

Abstract: A guidewire made from a drawn-filled tube composite wire is described. The composite wire has a stainless steel outer sheath jacketing a nitinol core wire. The drawn-filled tube composite wire is ground at its distal end to expose the nitinol core, which has superelastic and kink resistant properties that are desirable for the distal end of a guidewire. The proximal end of the drawn-filled tube is not ground or if ground, the outer sheath of stainless steel is not removed to an extent sufficient to expose the nitinol core.

Abstract: The present disclosure relates to a RF ablation catheter for septal reduction therapy having a cooling effect, and more particularly, to a RF ablation catheter for septal reduction therapy that is for performing RF ablation, in which RF energy is applied to an interventricular septum, for septal reduction therapy such as therapy for hypertrophic cardiomyopathy, which is a disease in which an interventricular septum of the left ventricle of the heart of the animal or human body thickens, therapy that requires reduction of an interventricular septum, or therapy for ventricular tachycardia. Also, the present disclosure relates to a RF ablation catheter for septal reduction therapy having a cooling effect that is for preventing carbonization of a tissue of the body (interventricular septum) around an electrode.

Abstract: The subject guide catheter extension/pre-dilatation system includes an outer delivery sheath, an inner member extending within the sheath, and a mechanism for engagement/disengagement of the inner member to/from the sheath. The inner member is configured with a tapered distal tip having a delivery micro-catheter and a pre-dilatation balloon member attached to the tapered distal tip in proximity to the micro-catheter. The outer delivery sheath and the inner member are modified for different engagement/disengagement mechanisms operation. The delivery micro-catheter provides for an improved crossability for the balloon member to the treatment site in an atraumatic, expedited and convenient fashion. During the cardiac procedure, a guidewire and a guide catheter are advanced to the vicinity of the treatment site within a blood vessel.

Abstract: An endovascular apparatus for crossing through an obstruction in a blood vessel comprises an elongate endovascular wire and a coupling. The coupling when in use transmits ultrasonic energy along the wire from an ultrasonic energy source to an active tip at a distal end of the wire. The coupling is arranged to couple the source to the wire at any of a plurality of discrete operational positions along the length of the wire for said transmission of ultrasonic energy to the active tip.

Abstract: A guidewire formed from drawn filled tubing having an inner core member encased in an outer layer. The inner core member is formed from a linear elastic or superelastic material and the outer layer is formed from a metal alloy such as 35N LT. A portion of the outer layer is ground down to form a feather edged joint between the outer layer and the inner core member.

Abstract: Disclosed is a guidewire having a core wire and an outer tube within which the distal section of the core is inserted. The outer diameter of the tube is greater than the outer diameter of the proximal section of the core wire. The guidewire also includes a proximal coil and a distal, radiopaque coil each disposed over the distal section of the core. A bushing coil is disposed over the proximal coil and distal coil. The proximal coil, distal coil, and bushing coil aid in filling the annular space between the core and the tube and thereby centering and aligning the core and tube.

Abstract: A deflectable sheath or dilator or catheter used for cardiac procedures; it has a shaft with one or more lumens; an optical fiber for use in channeling light used for visualization of calcification, heart tissue architecture or the progress of the cardiac procedure; the sheath or dilator or catheter includes an additional optical fiber for use as part of an ultrafast laser for calcium removal on or in heart valve tissue or for performing surgical intervention of the heart, or where the optical fiber is configurable for propagating a photon beam as part of an ultrafast laser for removing calcium on or in heart valve tissue or for performing surgical intervention of the heart.

Abstract: A rotational atherectomy device includes a drive shaft, a cutter mechanism coupled to the drive shaft and configured to cut occlusive material from a lesion, and a multi-stage macerator coupled to the drive shaft and configured to macerate cut occlusive material into a fine slurry. Successive stages of the multi-stage macerator macerate the cut occlusive material into successively smaller particles, which are moved proximally through a lumen of a sheath of the device that surrounds the drive shaft proximal to the macerator. The device may include a movable cutter mechanism guard that is passively rotatable between a first position in which it covers the cutter mechanism and a second position in which it exposes the cutter mechanism. One or more features of the device may limit a depth to which the cutter mechanism is able to cut the occlusive material to reduce a likelihood of undesirable tissue dissection.

Abstract: A method of determining a measure of wave speed intensity in a fluid conduit uses ultrasound measurements to determine the conduit diameter, as a function of time, at a longitudinal position of the conduit, and to determine a measure of fluid velocity, as a function of time, in a volume element at said longitudinal position of the conduit. The ultrasound measurement to determine the measure of fluid velocity is effected by decorrelation of scattering objects within the fluid flow in successive frames sampling the volume element. A wave speed may be determined from a ratio of the change in fluid velocity at the longitudinal position as a function of time and the change in a logarithmic function of the conduit diameter as a function of time. A measure of wave intensity may be determined as a function of change in determined conduit diameter and corresponding change in fluid velocity.

Abstract: A catheter assembly includes: a catheter including a distal end portion, and a body portion that is continuous with a proximal end of the distal end portion and extends along an axial direction; a hollow inner needle that has a needle tip and is removably inserted into the catheter; and a guide wire that is inserted into the inner needle so as to be movable back and forth and that is deliverable from the needle tip. The distal end portion of the catheter includes a constituent portion that is harder than, has a higher lubricity than, or has a higher elasticity than the body portion at at least a part of a surface of the distal end portion.

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: A tracheostomy dilator may include a distal portion, a handle portion, a lumen, and a proximal portion. The distal portion may have a curve extending to a distal opening and be configured to dilate a tracheostomy. The handle portion may be proximal of the distal portion and be configured to be grasped by a user. The lumen may be configured to receive a guidewire. The proximal portion may be proximal of the handle portion and have a proximal opening in communication with the lumen. The proximal portion may be configured to deflect the guidewire at an angle of at least 30 degrees from a longitudinal axis of the handle portion.

Abstract: A vascular occlusion catheter for partial occlusion or full occlusion includes a proximal outer shaft, a distal outer shaft, and an occlusion balloon therebetween. The proximal shaft has first and second internal lumens, the first internal lumen being in fluid communication with the balloon. The distal shaft has a distal internal lumen. A hypotube extends through the first internal lumen, through the balloon and into communication with the distal internal lumen. A first window is formed in the proximal shaft and a proximal sensor is positioned within the second internal lumen at the window. A second window is formed in the distal shaft and a distal sensor is positioned within the distal internal lumen at the window. A display hub is positioned along the proximal shaft and electrically connected with the sensors The uninflated vascular occlusion catheter has a greatest outer diameter of seven French or less.

Abstract: An assembly for driving linear movement and roll movement of an elongate surgical tool, comprising: an elongate shaft comprising a central lumen extending along the shaft long axis; the elongate shaft comprising a plurality of apertures extending across walls of the elongate shaft and into the central lumen; a set of wheels positioned opposing each other and aligned on two sides of the central lumen, the set of wheels at least partially extending through the apertures beyond the walls of the elongate shaft and into the central lumen to contact an elongate surgical tool received therein; the set of wheels being coupled to the elongate shaft and configured to rotate with the elongate shaft as a single unit when the elongate shaft is rotated about the shaft long axis.

Abstract: A custom length stylet assembly for meeting medical device length tolerances. The custom length stylet assembly including a stylet wire having a length extending between a distal end and a proximal end, stylet handle defining a longitudinally oriented throughbore sized to retain a proximal portion of the stylet wire, the stylet handle further defining a proximately positioned track and tab, the track configured to retain a bent proximal end portion of the stylet wire, the length of the stylet wire selected during assembly of the stylet assembly to conform to the corresponding length of a body implantable lead within a predefined tolerance, the tab of the stylet handle melted into the track, thereby securely fastening stylet wire to the stylet handle to inhibit rotation or dislodgement.

Abstract: A guide wire includes a core shaft and a coil body including a wire wound around the core shaft. The wire includes a long axis and a short axis in a transverse section. The coil body includes an inclined portion where an angle formed by the long axis of the wire and an axial line of the coil body is acute.

Abstract: There is provided an apparatus for use in a bodily lumen. The apparatus comprises a guidewire and a catheter. The guidewire has a proximal end portion and a distal end portion. The catheter has a proximal end portion and a distal end portion. The catheter includes a lumen for receiving the guidewire. The catheter is configured to be translated along the guidewire. The catheter is configured to be biased towards a translated position along the guidewire by a magnetic attraction between the guidewire and the catheter.

Abstract: Disclosed are a puncture guider (02, 2) and a puncture guiding system, wherein a puncture channel (80) automatically adapted to the diameter of a puncture needle (03) can be realized in the puncture guider (02, 2). The puncture guider (02, 2) is used for connecting to a puncture support, and the puncture guider (02, 2) comprises a depth block (21) and a push plate (22), wherein the depth block (21) comprises: a connection structure for being connected to the puncture support, and a first guiding wall (211) and a second guiding wall (212), which are connected to each other and form an included angle; and the push plate (22) comprises: a needle groove plate (222), and an adaptive component.

Abstract: A method for inserting a catheter assembly into a vessel using a storage case in which an outer pipe body and an inner pipe body which accommodate a guiding catheter and an inner catheter are connected to each other includes: pulling out the inner catheter from the inner pipe body, inserting the inner catheter into a proximal opening portion of the guiding catheter, causing a locking rotation portion of the inner catheter to rotate and be connected to a locking projection portion of the guiding catheter, assembling the guiding catheter and the pulled-out inner catheter, pulling-out, from the outer pipe body, the guiding catheter which is in a state where the inner catheter is assembled, taking out, from the storage case, a catheter assembly assembled by the guiding catheter and the pulled-out inner catheter, and inserting the catheter assembly into a vessel.

Abstract: A snare device for retrieving and/or manipulating an object within a space, such as a body lumen. In one embodiment, the snare device includes a support and a core wire. The support includes a proximal portion terminating in a proximal end, a distal portion terminating in a distal end, and a lumen, the lumen extending distally from the proximal end. The core wire is flexible and includes a proximal portion and a distal portion. The distal portion of the core wire and the distal portion of the support are complementarily shaped and are fixedly fitted together, wherein the core wire forms a loop extending away from the distal end of the support, and wherein the core wire passes through the lumen and emerges from the proximal end of the support. The distal portion of the support and the distal portion of the core wire may be complementarily dimensioned helical structures.

Abstract: A medical stent, including a squeezable and expandable tubular wire mesh and an anti-sticking atomic layer deposition coating deposited on surfaces of the wire mesh. A method for manufacturing a medical stent, including taking a squeezable and expandable (i.e., deformable) tubular wire mesh, and depositing an anti-sticking atomic layer deposition coating on surfaces of the wire mesh to prevent the wire mesh from being stuck with itself when expanding from a squeezed form to a fully expanded form.

Abstract: A system for controlled sympathectomy procedures is disclosed. A system for controlled micro ablation procedures is disclosed. Methods for performing a controlled surgical procedure are disclosed. A system for performing controlled surgical procedures in a minimally invasive manner is disclosed. Systems and methods for accessing target tissues as part of a neuromodulation procedure from within a lumen are disclosed.

Abstract: Disclosed herein are various exemplary systems, devices, and methods for inhibiting premature implant deployment. The delivery member can include a body including a lumen extending therethrough, the body including a compressed distal portion. The delivery member can include a pull wire extending through the lumen. The pull wire can include a pull wire portion that extends radially to abut a sidewall of the body to provide frictional resistance against the body. The pull wire can be positioned to secure the implantable medical device to the delivery member, and the pull wire portion can be effective to inhibit premature detachment of the implant by inhibiting proximal translation of the pull wire due to the frictional resistance provided by the pull wire portion against the body.

Abstract: A guidewire includes: a shaft having a proximal end, a distal end, and a body extending from the proximal end to the distal end; a blunt tip; and a sleeve; wherein the body of the shaft comprises at least a segment that is surrounded by the sleeve, the segment coupled to the blunt tip; and wherein the segment of the body of the shaft comprises a flat portion having one or more openings extending through a thickness of the flat portion.

Abstract: A catheter handle (1) includes handle body (2), and rotary member (3) being free to rotate with respect to the handle body (2) and connected to the wire. The handle body (2), in a planar view from a rotation axis direction of the rotary member (3), has second space (12) for the conductive wire is located from more distal side to more proximal side than first space (11) for the rotary member (3). The operating part (4) of the rotary member (3) is disposed on one side, and the second space (12) is disposed on another side, in the width direction of the handle (1). Length L1 from the center of the rotation axis to the rotary member (3) on the one side is longer than length L2 from the center of the rotation axis to the rotary member (3) on the another side.

Abstract: A manipulator, including an elongated chassis containing a U-shaped channel defining a distal direction and a proximal direction. The manipulator also includes an adjuster that is configured to slide in the U-shaped channel. The adjuster includes a first wheel which on rotation translates a guidewire positioned in the adjuster along an axis of the guidewire, and a second wheel which on rotation rotates the guidewire positioned in the adjuster about the axis of the guidewire. The adjuster also includes a port, distal to the first and the second wheel, that is configured to accept a tubular balloon and the guidewire.

Abstract: A system for accessing a patient's vascular system may have a tube with a wall that defines an exterior surface and lumen with a proximal end and a distal end, and a guidewire that is deployable, by sliding distally, from a retracted position in which the guidewire resides in the lumen, to a deployed position in which the guidewire extends beyond the distal end. The system may further have a retraction mechanism that can be actuated to retract the guidewire from the deployed position to the retracted position, or a protective shield that can be actuated to extend distally from the distal end of the tube to cover the guidewire in the deployed position.

Abstract: Devices, systems and methods for treating diseases and disorders effecting the cardiovascular system of the human body are disclosed. An exemplary device in accordance with this disclosure comprises a shaft, tip member fixed to the shaft, and a probe extending beyond a distal surface of the tip member. In some useful embodiments, the tip member is relatively atraumatic and the probe is shaped so as to be more likely to produce trauma than the tip member.

Abstract: The disclosure relates to an electrode array that comprises a first region including a first group of electrodes of a plurality of electrodes and a second region including a second group of electrodes of the plurality of electrodes, where a silicone notch carrier is arranged between the electrodes of the second group, and where each of the silicone notch carrier includes a notch that is formed into the silicone notch carrier, and when the electrode array is straighten each notch has an opening angle and/or a bending radius which varies between the silicone notch carriers.

Abstract: The disclosure relates to an electrical contact structure, and corresponding method of manufacturing an electrical contact structure, for a discrete semiconductor device. The electrical contact includes a first metal layer configured and arranged to contact a strained active area of a semiconductor die, a second metal layer configured and arranged to contact the first metal layer, and a third metal layer configured and arranged to contact the second metal layer.

Abstract: Apparatus, systems, and methods are provided for localizing lesions within a patient's body, e.g., within a breast. The system may include one or more markers implantable within or around the target tissue region, and a probe for transmitting and receiving electromagnetic signals to detect the one or more markers. During use, the marker(s) are into a target tissue region, and the probe is placed against the patient's skin to detect and localize the marker(s). A tissue specimen, including the lesion and the marker(s), is then removed from the target tissue region based at least in part on the localization information from the probe.

Abstract: A catheter is provided with increased flexibility and radiopaque measurement visibility. The radiopaque measurement bands are formed of a continuous coil of radiopaque material defined by areas of tightly packed coils spaced by areas of loosely wound coils. Systems and methods of utilizing the measurement structure are also provided.

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 method is used to manufacture a surgical guidewire that includes an outer coil assembly, a position sensor, a communication wire, an adhesive, a core wire, a hollow tube, and an atraumatic tip. The outer coil assembly has an outer coil that extends distally from a proximal coil retainer to a distal coil retainer. The position sensor is located distally within the outer coil assembly and is configured to be in communication with a processor via the communication wire. The core wire is between an outer coil proximal portion and the hollow tube. A distal end of the hollow tube is bonded to the atraumatic tip. The method includes affixing the atraumatic tip to the distal end of the hollow tube with the adhesive. The adhesive is constructed of instant glue.

Abstract: An intravascular imaging device is provided. In one embodiment, the intravascular imaging device includes a flexible elongate member sized and shaped for insertion into a vessel of a patient, the flexible elongate member having a proximal portion and a distal portion; a conductor extending between the proximal and distal portions of the flexible elongate member; an imaging assembly disposed at the distal portion of the flexible elongate member, the imaging assembly including: a flex circuit including a body and a tab extending therefrom, the tab having a conductive portion coupled to the conductor; and a support member around which the flex circuit is disposed, the support member including a shelf on which tab is positioned.

Abstract: One general aspect includes a system for ablation including a catheter including a sheath defining a sheath lumen and a distal end, and an elongate electrode assembly axially moveable within the sheath lumen. The electrode assembly includes a shaft defining a central channel and a distal central channel opening. The electrode assembly also includes an expandable electrode array including two or more electrode elements positioned at the distal portion of the electrode assembly, where the electrode array is moveable between a retracted position contained within the sheath lumen and an expanded position protruding from the sheath.

Abstract: Devices described herein include an actuated clot retrieval catheter system. The system includes a catheter having a metallic region positioned at the distal tip of the catheter. The metallic region includes at least two abutting metals in a bimetallic coil configuration. The bimetallic coil expands to form a seal with the inner wall of a vessel. In some examples, the bimetallic coil also captures a clot for removal from the vessel. The bimetallic coil is manufactured from metal-based materials having different thermal expansion coefficients. Conductive wires extend along a longitudinal axis of the catheter from an electrical current controller to at least a portion of the metallic region. Electrical current to the metallic region causes the bimetallic coil to transition from a tight configuration to an expanded configuration and remove the clot.

Abstract: The present disclosure is directed to a multi-segment device, such as an intravascular guide wire. The multi-segment device includes an elongate first portion comprising a first metallic material, an elongate second portion comprising a different metallic material, the first and second elongate portions being directly joined together end to end by a solid-state weld, and a heat affected zone surrounding an interface of the weld where the first and second portions are joined together, wherein the heat affected zone has an average thickness of less than about 0.20 mm.

Abstract: A guide wire includes a core shaft, a coil body curved from the proximal end side to the distal end side of the guide wire, and a fixing portion fixing the core shaft to the coil body. The core shaft includes a first contact part in contact with an inner surface of the coil body on an opposite side to the curving direction, and a second contact part in contact with the inner surface of the coil body in the curving direction, at a position closer to the distal end than the first contact part. The fixing portion includes a first fixing portion fixing the core shaft to the coil body at a position closer to the proximal end than the first contact part, and a second fixing portion fixing the core shaft to the coil body at a position closer to the distal end than the second contact part.

Abstract: A lead delivery apparatus and a method of delivering a medical lead to an anatomic target site. The method includes inserting a hydraulic plug into an internal delivery lumen of a delivery shaft, and coupling a medical lead to the hydraulic plug. Hydraulic pressure is applied to the hydraulic plug through the delivery lumen, thereby moving the hydraulic plug toward an anatomic target site, and advancing the medical lead toward the target site.

Abstract: Prosthetic heart valves described herein can be deployed using a transcatheter delivery system and technique to interface and anchor in cooperation with the anatomical structures of a native heart valve. Deployment systems and methods for using the deployment systems described herein facilitate accurately and conveniently controllable percutaneous, transcatheter techniques by which the prosthetic heart valves can be delivered and deployed within a patient.

Abstract: A guidewire for use in intravascular procedures has a solder or weld joint at a distal end thereof. A plurality of dimples are formed on the solder/weld joint to increase the engagement and penetration of fibrous material including chronic total occlusions (CTO).