Abstract: Methods and apparatus are provided for treating congestive heart by actively or passively enhancing perfusion to the renal arteries. A first embodiment comprises a specially configured balloon catheter and extracorporeal pump, wherein the pump operates in a “once-through” fashion or alternating volume displacement mode. In another embodiment the catheter includes a pair of balloons to isolate a region of the aorta, and a third balloon that directs flow into the renal arteries. In still further embodiments, a stent or cuff having a constricted region is deployed in or around the aorta, respectively, to create a backpressure upstream of the stent or cuff. Methods of enhancing renal perfusion also are provided.

Abstract: In one aspect of the invention a multi-balloon catheter, such as a double-balloon catheter, with coating comprising a hydrogel polymer on the exterior surface of the occlusion balloons is provided. The balloons may be inflated inside the lumen to occlude a plaque-affected segment of the lumen thereby forming a lumen space between the balloons, wherein this plaque-affected lumen segment may be treated with a biologically active agent. The presence of the coating can reduce de-nuding of healthy endothelial lumen tissue after contact with the inflated balloons during the occlusion. In another aspect of the invention, a method is provided for using a multi-balloon catheter having a coating comprising a hydrogel polymer for treating a plaque-affected lumen segment, the method reducing the subsequent de-nuding or injury to healthy endothelial tissue that is contacted by the balloon during occlusion.

Abstract: The present invention provides for an improved stent design and stent delivery catheter assembly for repairing a main vessel and a side branch vessel forming a bifurcation. The present invention includes a trap door stent design, a stent delivery catheter assembly, an apparatus for crimping the stent and the method for crimping the stent onto the catheter assembly, and the method for delivering and implanting the stent in a bifurcated vessel. More particularly, the invention relates to a stent having rings aligned along a common longitudinal axis and connected by links, where the stent has a proximal section, a distal section and a central section. The number of rings and the expanded diameter of the sections is varied to create a “trap door” capable of expanding to a slightly larger diameter than the proximal section and distal section of the stent.

Abstract: A method and device for perfusing an organ system is provided. The device may be further described as a catheter or cannula with an expandable flow control member positioned of the distal portion of the catheter shaft. The flow control member has a porous portion, and at least one impermeable portion, which prevent fluid from flowing out the ends of the flow control member. The flow control member is further characterized as having an interior chamber that is in fluid communication with a perfusion lumen that extends along the length of the catheter shaft and is in fluid communication with an external perfusion pump. The perfusion lumen is configured for providing flow to the interior of the flow control member, to create radial expansion thereof and to provide adequate flow to the arch vessels through said porous portion to sustain the metabolic demands of the brain.

Abstract: A device (10) for extracting biliary or urinary stones, calculi or the like (stones 104) from the biliary or urinary tract (100) of a patient including a catheter shaft (12), a first expandable apparatus for dilating the tract entrance or the sphincter thereat, and a second expandable apparatus for capturing the stone and/or urging it out of the tract. The first expandable apparatus may be an inflatable balloon (14) fixed on the catheter shaft (12), and the second expandable apparatus may be a second inflatable balloon (18) fixed on the catheter shaft or on a second tube telescopically associated with the catheter shaft, or may be a reversibly collapsible extraction basket (154) such as of nitinol wires, that is slidably receivable in and extendable from the catheter shaft (112).

Abstract: A vascular catheter assembly includes an over-the-wire stent deployment catheter and a flow-by-channel assembly. The stent deployment catheter is positioned just below the occluded artery in accordance with standard procedures. The flow-by-channel then shunts blood, and thus all friable plaque, from the high pressure carotid occlusion to the negative pressure extremity to effectively reverse the flow of blood through the occluded artery. The stent is then advanced into the narrowed artery and deployed. Thus, the vascular catheter assembly takes advantage of the collateral blood flow to solve the problem of stroke during endovascular procedures.

Abstract: A catheter 100 for prostatomegaly treatment comprises a catheter body 1 including a perfusion passage 11, a first fluid passage 13, a second fluid passage 14, and an urination passage 15; a branch member 2 integrally formed on a proximal end of the catheter body 1 and having fluid injection and ejection ports communicated to the respective passages; a first balloon 3 adapted to be retained in a bladder, the first balloon 3 being provided on a distal end of the catheter body 1 and communicated to the first fluid passage 13; a second balloon 4 adapted to press a prostate gland, the second balloon 4 being provided on a distal end of the catheter body 1 at the upper stream than the first balloon 3 and communicated to the second fluid passage 14; and a distal end stopper 5 provided on a distal end of the catheter body 1.

Abstract: The invention is an intraluminal therapy catheter having a least two treatment members disposed near the distal end of the catheter, the members being independently inflatable to perform angioplasty and/or fluid-sourced brachytherapy. A first treatment member is helically mounted about the shaft of the catheter, and forms a helical perfusion channel when inflated into contact with the vessel being treated. In a first embodiment of the invention, the second treatment member is also helically mounted about the catheter shaft and capable of forming a helical perfusion channel when inflated into contact with the vessel. The first and second treatment members are intertwined to form a double helix configuration wherein each member is capable of being inflated to generally fill the helical perfusion channel created by simultaneous inflation of the other member.

Abstract: Compositions, methods, kits, and apparatus are provided for delivering a macromolecular assembly such as a plasmid, virus vector, or other gene vector, to an extravascular tissue such as muscle tissue. The composition comprises the macromolecular assembly and a vascular permeability-enhancing agent. In another embodiment, the composition further comprises a vasodilating agent. The method of the invention comprises proving a vascular permeability-enhancing agent to a blood vessel and providing a macromolecular assembly to the vessel. An oxygenator useful for providing oxygen to a fluid extracorporeally prior to providing the fluid to a blood vessel of a mammal is included in the invention. Kits, apparatus, and methods for using the catheters described herein for isolating cardiac circulation, diverting caval blood flow from the right atrium, and for other purposes, are also described.

Abstract: Described is a closed chest intravascular catheter system for a simultaneous biventricular approach to (1) intravascular cardiopulmonary surgery; (2) acute or prolonged mechanical circulatory support. The catheter system includes a left heart catheter and a right heart catheter with flow control members that segment the circulatory system into subcirculations of cardiopulmonary support. The left heart catheter has an elongated shaft with a first flow control member positioned at the entry site into a peripheral artery, a second flow control member positioned in the proximal descending aorta, a third flow control member positioned in the ascending aorta, and a fourth flow control member positioned within the left ventricle.

Abstract: A system and methods are described for performing catheter based procedures on high risk patients that mitigate the risk to the patient and extend the acceptable time window for response when emergencies or complications arise. The system is useful for stopped heart catheter procedures or as a safety backup in beating heart catheter procedures and is compatible with concurrent or sequential surgical interventions. The system combines a therapeutic or diagnostic catheter subsystem with a selective aortic perfusion and cardiopulmonary bypass subsystem. The catheter subsystem may include catheters for angioplasty, stent delivery, atherectomy, valvuloplasty or other diagnostic or therapeutic procedures.

Abstract: The present invention is an intra-aortic circulatory enhancing apparatus for use in human patients to improve blood flow to other arteries continuous with the aorta of the patient. The apparatus comprises an internal inflation means located within the aorta of the patient and an external inflation means located outside of the patient. The internal inflation means can be an internal balloon coupled to a hollow extent which is operatively coupled to a blood communication means. The blood communication means can be a first hollow catheter tube in one embodiment. The external inflation means can be an external balloon coupled to a hollow extent running through the center of the balloon and continuous with a second hollow catheter tube. The blood communication means is coupled to the internal and external inflation means, allowing blood within the aorta to communicate with the secondary inflation means.

Abstract: An aid in the percutaneous navigation through chronic total occlusions by imaging of the vasa vasorum is provided. A cavity is established in a vessel proximal to the occlusion of interest. Once the cavity is established, fluid is introduced into the cavity. The fluid is introduced under a pressure that is sufficient enough to drive the fluid into the vasa vasorum that is accessible from the cavity. An image is taken with an imaging means of the fluid filled cavity and vasa vasorum. This image is used as a visual aid for a physician to visualize the path/curvature of the vessel. With this visualization, the physician would be able to navigate a medical instrument through an occlusion. In addition, this visualization would aid the physician to open the occlusion and therewith promote blood flow in vessel, for instance, by expanding open, stenting open, or cutting away part of the occlusion.

Abstract: Clot disruption and dissolution are achieved using a catheter having both an agitator and the ability to deliver a thrombolytic agent. The catheter is introduced to a target region with a blood vessel and the agitator manipulated to engage and disrupt a region of clot therein. The thrombolytic agent, such as tPA, streptokinase, or urokinase, is directly released into the clot at the point where the agitator is engaging the clot. In this way, the thrombolytic activity of the agent is enhanced and the dissolution of the clot is improved.

Abstract: A device for preparing a pregnant woman to delivery and facilitating the delivery itself, which comprises an entirely expandable stretch body, which is positioned in the expulsion area of the urogenital canal in such a way that it is partly inside the vagina and partly outside. There is also disclosed a preparatory gymnastics method involving the inventive device.

Abstract: A system for controlling patient temperature uses a central venous line catheter having axially spaced distal and proximal heat exchange balloons. The central venous line catheter is provided with one or more lumens for providing access to the central blood supply of the patient, and with additional lumens for communicating heat exchange fluid to the balloons. Heat exchange fluid temperature is controlled through a feed back loop in which patient temperature is sensed and used to control a temperature control unit comprising a heating device and/or a cooling device in heat exchange relationship with the heat exchange fluid. A tubing set transports the heat exchange fluid between the central venous line and the temperature control unit, with a pump serving to circulate the fluid in a closed fluid circuit in the system.

Abstract: An intravascular drug delivery balloon catheter incorporating a highly compliant balloon having a plurality of infusion holes. The highly compliant balloon elastically expands at a low inflation pressure (e.g., less than 1.0 ATM), and preferably has a compliance of 2.0 mm/ATM or more at pressures less than 2.0 ATM. A pressure relief valve may be incorporated into the catheter to avoid over pressurization. The infusion holes may be open when the balloon is deflated and may enlarge when the balloon is inflated. The balloon may define a single lobe or two inflatable lobes with the infusion holes disposed therebetween.

Abstract: A fluid operated retractor for use in surgery. The retractor has a portion that is expandable upon the introduction of fluid under pressure. The expandable portion, is made of a material strong enough, and is inflated to enough pressure, to spread adjoining tissues within the body. The retractor is especially useful in fiber optic surgery because it can be inserted percutaneously through a small opening then expanded to a much larger dimension when in the desired location, to retract tissue from within. The retractor may be used to spread a joint such as a knee joint or a shoulder joint, or may be used to separate tissue planes generally, to improve visualization and create a working space for the surgeon.

Abstract: An occlusion catheter for the ascending aorta capable of obstructing the blood flow within the ascending aorta without inserting through the femoral artery. The occlusion catheter is provided with a drug release aperture formed in the region, which is closer to the proximal end of the catheter tube than a balloon on the outer circumference of the distal end and which is to be located in the vicinity of the coronary ostium when the balloon is placed within the ascending aorta. The present occlusion catheter, when inserted directly into the ascending aorta in the vicinity of the heart to obstruct the blood flow therewithin, enables delivery of a cardiac muscle protective drug to the vicinity of the coronary ostium without inserting the occlusion catheter through the femoral artery in the conventional manner.

Abstract: An apparatus and method for treating a disease process in a luminal structure comprises a balloon catheter having a central balloon and two edge balloons. The central balloon may be separately inflated temporally and with different radioactive fluid than the edge balloons. Other arrangements include a wire, stent and concentric balloons, which provide spatial and temporal control enabling differential radioactivity at different spatial locations along the structure.

Abstract: A medical device comprises an inner tube and an outer tube disposed about at least a portion of the inner tube. A balloon extends from the distal end of the outer tube. Within the balloon is a first expandable diaphragm, one end of which is attached to the inner tube. The first expandable diaphragm is covered by a retractable sheath disposed about the inner tube. Upon retraction of the retractable sheath, the diaphragm expands to sealingly contact the interior of the balloon in a first contact region and form at least a first compartment and a second compartment in the balloon.

Abstract: A catheter for intravascular corporeal cooling comprises an elongated tubular member having at least one lumen extending therethrough for providing cooled blood, an inflatable annular balloon positioned on the outer surface of the elongated tubular member, and a pressure reliever positioned in the external wall of the elongated tubular member and proximal to the annular inflatable balloon, wherein when the pressure of blood within a lumen reaches a predetermined value, the pressure reliever opens to permit fluid to be released from the elongated tubular member. In other embodiments of the invention the catheter may have two or more inflatable annular balloons that are separately inflatable and/or the catheter has an insulative outer annular member.

Abstract: A catheter assembly of the type having at least two balloon catheters extending from a proximal end of the assembly to a distal end of the assembly. At least a portion of the assembly having a cross-sectional profile having a cross-sectional profile which is substantially circular in shape.

Abstract: A medical device for cryotreatment of bodily regions is disclosed. The device comprises an inflatable support structure coupled to the distal end portion of a catheter shaft, the support structure being further enveloped by an expandable membrane to define an expansion chamber between the support structure and the membrane. An inflation lumen is coupled to the support structure to inject an inert, insulating fluid in the support structure, thereby expanding the support structure and the expandable membrane, wherein the resultant expansion chamber formed therebetween is substantially conical in shape. Refrigerant is injected into the expansion chamber, thereby creating localized cooling of tissues adjacent to the expansion chamber, the cooling region being substantially conical in shape.

Abstract: A kidney perfusion catheter assembly is disclosed having an introducer catheter, a renal artery seal, a perfusion tip, and a guide wire. The perfusion catheter provides a flow of supplemental blood to increase the local blood pressure in the renal artery and to perfuse the kidney. The introducer catheter is maneuvered through the femoral artery to the aorta and positioned at the branch of a renal artery. The perfusion catheter tip is telescoped from the distal end of the introducer catheter into the renal artery. A blood pump attached to the proximal end of the perfusion catheter assembly provides a flow of blood that streams from the perfusion catheter tip into the renal artery. This stream of blood increases the pressure and volume of the blood flowing through the renal artery. The catheter includes a seal to block the opening of the renal artery to prevent the runoff of the blood from the renal artery into the aorta.

Abstract: A trans-septal guide catheter for providing access through the septum separating a first heart chamber from a second heart chamber that includes an elongated guide catheter body extending between guide catheter proximal and distal ends. A distal segment of the guide catheter is adapted to be inserted through the septum to locate the distal segment of the guide catheter within one of the first heart chamber and the second heart chamber. The catheter body encloses a guide catheter lumen adapted to provide access into the one of the first heart chamber and the second heart chamber through a guide catheter lumen proximal end opening and a guide catheter lumen distal end opening.

Abstract: A medical device assembly is adapted to isolate the heart from systemic circulation while perfusing oxygenated blood to the systemic arterial circulation during a minimally invasive bypasss procedure. An arterial catheter with an external shunt valve forms a funnel which shunts antegrade aortic blood flow from the aortic root, into a distal flow port and through an internal flow lumen in the catheter, out an intermediate flow port along the catheter proximally of the anchor, and into the systemic arterial circulation. A distal internal valve selectively occludes the shunted antegrade aortic blood flow between the distal flow port and the intermediate flow port and isolates the left heart chambers from the systemic arterial circulation. Oxygenated blood may then flow from a cardiopulmonary bypass pump, distally through the internal flow lumen, out the intermediate port.

Abstract: The present invention pertains to a local delivery device comprising a distal catheter unit and a proximal catheter unit which may be positioned by sliding over the distal catheter unit. Both the distal and the proximal catheter units have separate inflatable occluding balloons. The slidable positioning of the catheter units in relation to each other provides for variable inter-balloon distances, which in turn provides for a variably sized occlusion region in a hollow tubular organ, for example a vessel. Dispersed on the catheter shaft between the two occluding balloons are multiple infusion ports through which therapeutic agents may be delivered to an occluded region of a hollow tubular organ. The local delivery device may further comprise a quantifying device for determining the distance between the two occluding balloons. Therefore, precise adjustment of the inter-balloon distance permits controlled delivery of therapeutics to a discreet length of the hollow tubular organ wall.

Abstract: A device for the optical spectroscopic examination of interior surfaces (2, 2′) of a body, e.g. of blood vessels (1), comprising an optical spectrometer and an endoscope (3) with a light guide for illuminating the surfaces, wherein at the proximal end of the light guide it is supplied with light and at the distal of the light guide the light can be launched to the surfaces to be examined, wherein at the distal end of this endoscope there is provided a device for receiving the light reflected by the surfaces to be examined, is characterized in that the distal end of the light guide is arranged within an inflatable balloon (4) with an elastic exterior, and that the light decoupled from the light guide and the light reflected by the surfaces to be examined to the receiving device penetrates in each case the exterior of the balloon. In this way, the light launched by the light guide and also the light directed to the surface to be examined and the light scattered by them, if e.g.

Abstract: A method for treating loosely formed, friable or fragile lesions in a patient's blood vessel. A catheter having a pair of sealing mechanisms is advanced such that the sealing mechanisms are positioned distal to and proximal to the lesion. The sealing mechanisms are activated to seal the vessel on either side of the lesion. A medication is then delivered through the catheter to the sealed area of the vessel. The medication interacts with the lesion in order to partially or completely solidify it. Once the lesion is solidified, the catheter is removed and the lesion can be treated with a conventional intravascular device.

Abstract: An intravascular balloon occlusion device according to the invention is shown. The device is ideally suited for use in a coronary artery bypass graft procedure. The device includes a body having at least one selectively inflated balloon provided on the distal end thereof. Preferably, the body is a closed end body so that fluid can only flow from the proximal end of the body into the balloon. In use, the distal end of the body and the balloon are inserted into an aperture provided in the aorta. The balloon is inflated and then the device is retracted until the balloon seats against the incision or aperture in the aorta, thereby effectively sealing the aperture from the blood flow through the aorta, but not occluding blood flow through the body of the aorta itself. Next, the graft vessel is telescopically positioned on the occlusion device and mounted to the aorta. Once the vessel is secured thereto, the balloon is deflated and then the occlusion device is retracted from both the aorta and the graft vessel.

Abstract: Methods and devices for providing a medical device for use within the subarachnoid space are presented. The medical device may be a guide catheter including anchoring members or other mechanisms for securing a location or a pathway within the subarachnoid space. In some embodiments, the medical device may include multiple articulating elements which may pass through one another, with one or more of the articulating elements including an anchoring member.

Abstract: A bifurcated catheter assembly is provided for treating bifurcated vessels. The bifurcated catheter assembly comprises an elongate main catheter shaft having a stiffer proximal portion, a more flexible distal portion, and a pair of branch catheters attached to the distal portion. An expandable member is located on each of the branch catheters. The balloons are held together to provide a low profile as the device is advanced over the tracking guide wire. Upon reaching the bifurcated vessel, the balloons separated and are advanced over separate guide wires into separate branches of the bifurcated vessel. The bifurcated catheter assembly can be used to dilate a stenoses or deliver and implant a Y-shaped stent in the bifurcation.

Abstract: The present invention describes a catheter suitable for introduction into a tubular tissue for dissolving blockages in such tissue. The catheter is particularly useful for removing thrombi within blood vessels. In accordance with the preferred embodiments, a combination of vibrating motion and injection of a lysing agent is utilized to break up blockages in vessels. The vessels may be veins, arteries, ducts, intestines, or any lumen within the body that may become blocked from the material that flows through it. As a particular example, dissolution of vascular thrombi facilitated by advancing a catheter through the occluded vessel, the catheter causing a vibrating, stirring action in and around the thrombus usually in combination with the dispensing of a thrombolytic agent such as urokinase into the thrombus. The catheter has an inflatable or expandable member near the distal tip which, when inflated or expanded, prevents the passage of dislodged thrombus around the catheter.

Abstract: A method and device for perfusing an organ system is provided. The device may be further described as a catheter or cannula with an expandable flow control member positioned of the distal portion of the catheter shaft. The flow control member has a porous portion, and at least one impermeable portion, which prevent fluid from flowing out the ends of the flow control member. The flow control member is further characterized as having an interior chamber that is in fluid communication with a perfusion lumen that extends along the length of the catheter shaft and is in fluid communication with an external perfusion pump. The perfusion lumen is configured for providing flow to the interior of the flow control member, to create radial expansion thereof and to provide adequate flow to the arch vessels through said porous portion to sustain the metabolic demands of the brain.

Abstract: An evacuation sheath assembly and method of treating occluded vessels which reduces the risk of distal embolization during vascular interventions is provided. The evacuation sheath assembly includes an elongated tube defining an evacuation lumen having proximal and distal ends. A proximal sealing surface is provided on a proximal portion of the tube and is configured to form a seal with a lumen of a guided catheter. A distal sealing surface is provided on a distal portion of the tube and is configured to form a seal with a blood vessel. Obturator assemblies and infusion catheter assemblies are provided to be used with the evacuation sheath assembly. A method of treatment of a blood vessel using the evacuation sheath assembly includes advancing the evacuation sheath assembly into the blood vessel through a guide catheter. Normal antegrade blood flow in the blood vessel proximate to the stenosis is stopped and the stenosis is treated.

Abstract: Apparatus and methods are provided for localized, minimally invasive administration of sclerotherapy in the treatment of varicose veins. A treatment site within a vein is isolated from blood flow through the vain. Sclerotherapeutic agents are delivered to the isolated vessel segment. A-substantial portion of the agents are then removed from the vein, and isolation is removed from the treatment site. Inflammation, clotting, scarring, and closure of the varicose vein ensues at the treatment site. In a preferred embodiment, this technique is accomplished with a catheter having an inflatable member. The inflatable member is expandable to a deployed configuration in which its central region is of reduced cross-section as compared to its proximal and distal regions. The central region comprises one or more perforations extending through the inflatable member so that sclerotherapeutic agents may be delivered through the perforations.

Abstract: A catheter balloon arrangement for application in tortuous blood vessels. First and second spiraled balloons are coupled to a catheter body portion. The spiraled balloons can have first and second apexes with a pitch length there between configured to encourage tortuous compatibility between the catheter balloon arrangement and a body lumen. A method of treatment with an embodiment of a catheter balloon arrangement is also provided.

Abstract: The present invention describes a catheter suitable for introduction into a tubular tissue for dissolving blockages in such tissue. The catheter is particularly useful for removing thrombi within blood vessels. In accordance with the preferred embodiments, a combination of vibrating motion and injection of a lysing agent is utilized to break up blockages in vessels. The vessels may be veins, arteries, ducts, intestines, or any lumen within the body that may become blocked from the material that flows through it. As a particular example, dissolution of vascular thrombi facilitated by advancing a catheter through the occluded vessel, the catheter causing a vibrating, stirring action in and around the thrombus usually in combination with the dispensing of a thrombolytic agent such as urokinase into the thrombus. The catheter has an inflatable or expandable member near the distal tip which, when inflated or expanded, prevents the passage of dislodged thrombus around the catheter.

Abstract: A circulatory support system and method for circulatory support are described for performing cardiopulmonary bypass using differential perfusion and/or isolated segmental perfusion of the circulatory system. The circulatory support system includes one or more venous cannulae for draining blood from the venous side of the patient's circulatory system, one or more arterial cannulae for perfusing the arterial side of the patient's circulatory system, and one or more blood circulation pumps connected between the venous cannulae and the arterial cannulae. The arterial cannulae and the venous cannulae of the circulatory support system may take one of several possible configurations. The circulatory support system is configured to segment a patient's circulatory system into one or more isolated circulatory loops.

Abstract: The invention is an intraluminal therapy catheter having a least two treatment members disposed near the distal end of the catheter, the members being independently inflatable to perform angioplasty and/or fluid-sourced brachytherapy. A first treatment member is helically mounted about the shaft of the catheter, and forms a helical perfusion channel when inflated into contact with the vessel being treated. In a first embodiment of the invention, the second treatment member is also helically mounted about the catheter shaft and capable of forming a helical perfusion channel when inflated into contact with the vessel. The first and second treatment members are intertwined to form a double helix configuration wherein each member is capable of being inflated to generally fill the helical perfusion channel created by simultaneous inflation of the other member.

Abstract: A dilation balloon catheter is disclosed comprising a non-compliant balloon attached to a catheter, the balloon portion includes a plurality of sections having different outer diameters, as measured at the central portion or midpoint of the section, when the balloon is inflated. In one embodiment that is deployable from an endoscope to treat esophageal, pyloric, or colonic strictures, a series of progressively larger balloon sections are used to safely dilate the stricture in stages. Each section includes a central portion having a waist for centering the balloon over the stricture, with the distal section having the smallest diameter and the intermediate and proximal sections being about 2 and 4 mm larger, respectively. A wire guide extends throughout the length of the catheter and balloon and forms a distal portion of the dilation balloon catheter for assisting in cannulation of the stricture.

Abstract: One embodiment of the present invention is directed to a method of heating the inner lining of a lumen or cavity of a patient. In this embodiment, the method includes the use of a bipolar electrosurgical instrument which includes a flexible elongated tube having a proximal and a distal end, a first balloon electrode attached to the distal end of the flexible elongated tube, a first electrode in electrical contact with the first balloon electrode through a conductive fluid, a return balloon electrode spaced proximally from the first balloon electrode and a return electrode in electrical contact with the second electrically conductive fluid. In one embodiment, the first balloon electrode and the return balloon electrode include expandable sleeves formed from an electrically insulating material and conductive fluid disposed in the expandable sleeve.

Abstract: The emboli protection system provides one or more inflatable blocking balloons for isolation of a section of a blood vessel to prevent migration of emboli from the section during an interventional procedure, and fluid infusion and evacuation ports for flushing emboli from the isolated section. One embodiment provides for a distal blocking balloon catheter, over which an interventional device can be introduced, and a proximal blocking balloon catheter to be introduced over the interventional device for isolating a portion of a blood vessel to be treated. The blocking balloons can be perforated to provide the infusion ports, and thrombolytic inflation fluid may be used to break down and dissolve thrombus and plaque in the isolated portion of the blood vessel.

Abstract: A vascular catheter assembly includes an over-the-wire stent deployment catheter and a flow-by-channel assembly. The stent deployment catheter is positioned just below the occluded artery in accordance with standard procedures. The flow-by-channel then shunts blood, and thus all friable plaque, from the high pressure carotid occlusion to the negative pressure extremity to effectively reverse the flow of blood through the occluded artery. The stent is then advanced into the narrowed artery and deployed. Thus, the vascular catheter assembly takes advantage of the collateral blood flow to solve the problem of stroke during endovascular procedures.

Abstract: An evacuation sheath assembly and method of treating occluded vessels which reduces the risk of distal embolization during vascular interventions is provided. The evacuation sheath assembly includes an elongated tube defining an evacuation lumen having proximal and distal ends. A proximal sealing surface is provided on a proximal portion of the tube and is configured to form a seal with a lumen of a guided catheter. A distal sealing surface is provided on a distal portion of the tube and is configured to form a seal with a blood vessel. Obturator assemblies and infusion catheter assemblies are provided to be used with the evacuation sheath assembly. A method of treatment of a blood vessel using the evacuation sheath assembly includes advancing the evacuation sheath assembly into the blood vessel through a guide catheter. Normal antegrade blood flow in the blood vessel proximate to the stenosis is stopped and the stenosis is treated.

Abstract: A high pressure dilation medical device delivery catheter having a proximal and distal end comprising two tubes mounted generally concentrically about an inner tube. The balloons being characterized as a relatively short inner tube which is inflated with high pressure and a longer outer tube which is inflated with low pressure. The balloons have independent inflation lumens which extend toward the proximal end of the inner tube. A medical device mounting region is disposed about at least a portion of the outer balloon and may have a stent or other medical device mounted thereupon. A retractable outer sheath is further disposed about the medical device mounting region and is operatively connected near the proximal end of the catheter.

Abstract: An intravascular balloon occlusion device according to the invention is shown. The device is ideally suited for use in a coronary artery bypass graft procedure. The device includes a body having at least one selectively inflated balloon provided on the distal end thereof. Preferably, the body is a closed end body so that fluid can only flow from the proximal end of the body into the balloon. In use, the distal end of the body and the balloon are inserted into an aperture provided in the aorta. The balloon is inflated and then the device is retracted until the balloon seats against the incision or aperture in the aorta, thereby effectively sealing the aperture from the blood flow through the aorta, but not occluding blood flow through the body of the aorta itself. Next, the graft vessel is telescopically positioned on the occlusion device and mounted to the aorta. Once the vessel is secured thereto, the balloon is deflated and then the occlusion device is retracted from both the aorta and the graft vessel.

Abstract: A catheter apparatus is provided including an arterial catheter and a venous catheter wherein the distal ends of the catheter are insertable in an artery and a adjacent vein, respectively to a position adjacent a site for creating a fistula. The venous catheter includes a radially expandable structure adjacent the distal end which can be selectively extended outwardly to expand a portion of the wall of the vein adjacent the venous fistula site towards contact with the wall of the artery adjacent the arterial fistula site. The radially expandable structure of the venous catheter may include one or more balloons which can be inflated or a wire basket, or the vein can be expanded by injecting a fluid through an injection port into an isolated portion of the vein.

Abstract: A process for inducing cardioplegic arrest of a heart in situ in a patient's body, comprising maintaining the patient's systemic circulation by peripheral cardiopulmonary by-pass, occluding the ascending aorta through a percutaneously placed arterial balloon catheter, venting the left side of the heart, and introducing a cardioplegic agent into the coronary circulation. This procedure readies the heart for a variety of surgical procedures that can be performed percutaneously through lumina in the catheter. An aortic catheter for use in the process is also described.