Abstract: A tissue-removing catheter for removing tissue in a body lumen includes an elongate body and a tissue-removing element mounted on a distal end portion of the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen. An inner liner is received within the elongate body. The inner liner defines a guidewire lumen. The inner liner isolates an interior of the guidewire lumen from the elongate body and tissue-removing element such that rotational forces are not transferred from the elongate body and tissue-removing element to the interior of the guidewire lumen when the elongate body and tissue-removing element are rotated during removal of tissue from the body lumen.

Abstract: A lumenal element configured to transit a body lumen comprising a lumenal member (102) and an outer member (200) disposed over at least part of the lumenal member with a structural support (350), e.g. a mesh or stent, having a facing surface facing a surface of the lumenal member and wherein the facing surface includes at least one non-smooth surface portion, discontinuity, or non-uniformity, wherein the structural support is between the lumenal member and the outer member wherein the outer member is at least partly sealed to adjacent surfaces of the lumenal member sufficient to withstand fluid pressure within a space about the structural support, wherein the lumenal member has a first flexibility in the area of the structural support, and increasing the flexibility of the area of the structural support by moving at least a part of the outer member out of contact with the structural support. The flexibility of a lumenal element can be changed. Also disclosed a method of assembly of the lumenal element.

Abstract: A tubular structure having variable support includes a tubular member and a structural support member with a flexible tubular member over the structural support member, such that the flexible tubular member can engage and disengage or squeeze and release the structural support member. The structural support member can be a tubular mesh, stent, framework, skeleton, braid or other flexible framework. A fluid passage can be used to inflate and deflate the flexible tubular member. Methods of assembly and methods of use are also described.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes an elongate body and a tissue-removing element mounted on a distal end portion of the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen. An inner liner is received within the elongate body. The inner liner defines a guidewire lumen. The inner liner isolates an interior of the guidewire lumen from the elongate body and tissue-removing element such that rotational forces are not transferred from the elongate body and tissue-removing element to the interior of the guidewire lumen when the elongate body and tissue-removing element are rotated during removal of tissue from the body lumen.

Abstract: Flexible high-pressure angioplasty balloons are disclosed herein which utilize an inflatable balloon positioned upon the catheter and a supporting structure secured over or along the catheter at a first location proximal to the balloon and at a second location distal to the balloon. Inflation of the balloon reconfigures the supporting structure to urge the first location and the second location towards one another thereby inhibiting longitudinal elongation of the balloon relative to the catheter. The supporting structure may surround, support, or otherwise extend over the entire length of the balloon and allows for the balloon to retain increased flexibility which enables the balloon to bend or curve even at relatively high inflation pressures.

Abstract: The disclosure describes a reinforced catheter system, such as a wire, that includes an inner layer having an inner lumen configured to allow an object to slideably move within the inner lumen. The catheter system may include a reinforcement structure, having an outer coating, such as a polymer. The reinforcement structure may be coupled over the inner layer to thereby at least partially encapsulate the inner layer. The catheter system may include an outer surface coupled over the reinforcement structure and the inner layer to thereby encapsulate both the inner layer and the reinforcement structure. The outer coating of the reinforcement structure may be re-flowed to thereby bond the inner layer to the outer surface to thereby create a reinforced homogeneous structure.

Abstract: A catheter includes: a tube having a distal end, a proximal end, and a tube body extending between the distal end and the proximal end, the tube having a tube wall and a first channel in the tube wall; a first elongated element located in the first channel of the tube, the first elongated element slidably moveable in the first channel relative to the tube wall; and a suction port configured to apply suction in the first channel; wherein a first part of the tube wall is configured to deform to apply a first force against the first elongated element in response to the suction in the first channel.

Abstract: A catheter-mounted balloon includes an inflatable chamber defining a volume expandable from a deflated state to an inflated state, the inflatable chamber having a distal transition portion, a proximal transition portion, and a cylindrical body portion disposed between the distal transition portion and the proximal transition portion. The cylindrical body portion of the inflatable chamber includes a pleat zone having a pleat when the inflatable chamber is in the deflated state. The catheter-mounted balloon further includes an electrode disposed along a wall of the inflatable chamber. The pleat traverses the electrode such that is electrode is pleated as well.

Abstract: A balloon catheter includes a balloon that is formed of film and includes an inflation/deflation portion. The inflation/deflation portion includes a plurality of linear projections that projects in a thickness direction of the film and extends along a surface of the film. One of the linear projections is an inner projection that projects inside the balloon.

Abstract: The present invention relates to an endoscopic treatment instrument, and more particularly, to an endoscopic treatment instrument including a detachable end-effector and a contamination prevention cover. The endoscopic treatment instrument includes an end-effector for performing treatment in the endoscopic surgery or an endoscope treatment, a connection section being detachably coupled to an end of the end-effector, and a contamination prevention cover being coupled to the connection section or the end-effector and surrounding a portion of an outer peripheral surface of the connection section so as to prevent contamination of the connection section. According to an embodiment of the present invention, since only the end-effector is separable for replacement and the cover is formed to protect a control unit, it is possible to prevent cross infection between patients caused by the contamination of the end-effector and the control unit.

Abstract: An inflatable balloon includes a base balloon having a cylindrical section and a conical section and at least one circumferential fiber extending circumferentially around the conical section. The inflatable balloon includes a plurality of reinforcing strips in the conical section over the at least one circumferential fiber. Each reinforcing strip includes a plurality of fibers extending at an angle relative to the at least one fiber. Each reinforcing strip is positioned a set circumferential distance away from a neighboring reinforcing strip.

Abstract: A dilator for sheathless access to a vessel of a patient, having a distal portion with a maximal outer diameter that extends from a distal end to a guidewire exit port and a proximal portion with a reduced profile that extends from the guidewire exit port to the proximal end and a lumen that extends between the distal end and the guidewire exit port. A first guidewire may be positioned within the vessel and the dilator advanced over the guidewire. A guide catheter may then be advanced over the dilator.

Abstract: A ureteral stent is provided. The stent may include a first section having a first wall defining a first luminal section. The stent may further include a second section having a second wall defining a second luminal section. The second section can be enabled to substantially close at times external pressure is applied to the stent.

Abstract: An apparatus includes a shaft, an expandable dilation member, and a bulbous tip. The shaft has a first outer cross-sectional dimension. The dilation member is positioned proximal to the distal end of the shaft. The dilation member is operable to transition between a non-expanded configuration and an expanded configuration. The dilation member is sized to pass through a passageway associated with drainage of a paranasal sinus or a Eustachian tube when the dilation member is in the non-expanded configuration. The bulbous tip is positioned at the distal end of the shaft. The bulbous tip is distal to the dilation member. The bulbous tip has a second outer cross-sectional dimension. The second outer cross-sectional dimension is larger than the first outer cross-sectional dimension. The bulbous tip is removably secured to the distal end of the shaft.

Abstract: A medical elongated body is disclosed, which includes a shaft having a lumen through which a contrast agent can flow; and a tubular structure portion which is provided at a distal portion of the shaft and has an insertion hole. The tubular structure portion includes an inner tube fixed to the distal portion of the shaft; an outer tube which is disposed radially outward of the inner tube and is liquid-tightly fixed to the distal portion of the shaft and a proximal portion of the inner tube; a space portion communicating with the lumen of the shaft between the inner tube and the outer tube, and an opening portion through which a contrast agent flows from the lumen into the space portion flows out.

Abstract: A tubular structure having variable support includes a tubular member and a structural support member with a flexible tubular member over the structural support member, such that the flexible tubular member can engage and disengage or squeeze and release the structural support member. The structural support member can be a tubular mesh, stent, framework, skeleton, braid or other flexible framework. A fluid passage can be used to inflate and deflate the flexible tubular member. Methods of assembly and methods of use are also described.

Abstract: A catheter-mounted balloon includes an inflatable chamber defining a volume expandable from a deflated state to an inflated state, the inflatable chamber having a distal transition portion, a proximal transition portion, and a cylindrical body portion disposed between the distal transition portion and the proximal transition portion. The cylindrical body portion of the inflatable chamber includes a pleat zone having a pleat when the inflatable chamber is in the deflated state. The catheter-mounted balloon further includes an electrode disposed along a wall of the inflatable chamber. The pleat traverses the electrode such that is electrode is pleated as well.

Abstract: A catheter that includes a reinforcing body including a wire wound or woven so that a gap is provided between each winding or weave of the wire; an inner layer, the reinforcing body being embedded in at least a part of the inner layer; and an outer layer that covers an outer periphery of the inner layer in a circumferential direction, and the reinforcing body is formed integrally including a first diameter portion with a first outer diameter, a second diameter portion with a second outer diameter larger than the first outer diameter, and a tapered portion increasing in diameter toward a distal end side or a proximal end side between the first diameter portion and the second diameter portion, and at least the second diameter portion of the reinforcing body is embedded in the outer layer.

Abstract: Polymeric tubing, for use with catheters or other medical devices, where the polymeric tubing can have regions of customized properties including, but not limited to, durometer, torque control, flexibility, axial strength, stiffness, etc. One variation of the device allows for transitions between regions to be configured such that there can be gradual or customized transitions between various regions such that the structural characteristics differential between the regions selectively designed. Additional variations include outer layers having a plurality of material sections extending in a spiral direction along the axial length to form a continuous wall of the outer layer. In certain variations, the structural characteristic differential is minimized or eliminated as compared to conventional catheters.

Abstract: Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

Abstract: A non-compliant medical balloon may be changed from a deflated state to an inflated state by increasing pressure within the balloon. The non-compliant medical balloon is composed of randomly oriented fibers forming an angle. The angle remains substantially unchanged when the balloon changes from a deflated state to an inflated state.

Abstract: An absorbable endoluminal stent and method for preparing the same are provided in the present invention. The absorbable endoluminal stent comprises a stent body, a plurality of through holes formed in the stent body, and bioabsorbable polymeric materials filled in the through holes. When the stent is implanted into the blood vessels, damages on stent caused during crimping and expansion processes are reduced. Radical supporting force duration of stent is improved and mechanical properties of stent after implantation are guaranteed by compositing the materials in the through holes and materials of the stent body.

Abstract: The invention provides methods for the treatment of vaginal laxity which include delivering a cell-containing composition to the vagina. The composition can include fat tissue to provide a bulking effect to reduce the size of the vaginal opening. The cells can provide healing and revascularization of the vaginal treatment area to sustain the bulking provided by the fat. The invention also provides systems and compositions useful for performing the method, and can include instruments and devices for removal of autologous adipose tissue from a patient (e.g., by liposuction), equipment for the enrichment of cells from adipose tissue, mechanical processing of adipose tissue, and the mixing of cells and processed adipose tissue. Devices for the delivery of the cell compositions to the vagina can also be included in the system.

Abstract: The current document is directed to length-adjustable catheters and methods that employ length-adjustable catheters to treat malformations, constrictions, obstructions, lesions, and blockages within patients' blood vessels. The length of the shaft of a length-adjustable catheter, to which the current application is directed, can be adjusted over a range of lengths prior to and during medical procedures. In many implementations, length adjustment is accompanied by indications, to the medical provider, of the extent of a length adjustment. The indications may include one or more of visual markings, haptic feedback, radio-opaque markings, and/or other types of indications. In many implementations, the variable-length mechanism of the length-adjustable catheter is mechanically lockable following length adjustment.

Abstract: A large lumen guide catheter (10) has an elongate tubular body (22), which has an outer surface (24), an inner surface (44), and a braided wire layer between the inner surface and the outer surface, wherein the wires winding a first helical direction are thicker and wider than the wire winding in a second helical direction opposite the first helical direction.

Abstract: Devices and methods for delivering treatment fluids or particulates such as, stem cells, drugs, Botox and like, to an inner lining of a bladder for treatment of urinary tract disorders, including over active bladder. A balloon delivery system can include an inflation balloon having a plurality of micro-needles configured to pierce and otherwise puncture an inner bladder wall so as to deliver the treatment fluid to bladder tissue. The treatment fluid can be directly injected into the bladder tissue using the micro needles. Alternatively, the micro needles can be fabricated of bioabsorbable or bioresorbable materials such that the micro needles can remain embedded within the bladder tissue to deliver the treatment fluid or particulate.

Abstract: A catheter including a balloon. The balloon has an elastic inner layer and an elastic outer layer. The inner and outer layers are tubular and are inflatable and deflatable in response to a change of internal pressure of the balloon. The catheter includes a tubular reinforcement member positioned radially between the inner layer and the outer layer. The reinforcement member has a first end portion and a second end portion opposite the first end portion in the axial direction of the catheter. The reinforcement member has an intermediate portion between the first end portion and the second end portion in the axial direction. At least one of the first and second end portions is not directly fixed to both the inner layer and the outer layer. The intermediate portion is not directly fixed to both the inner layer and the outer layer.

Abstract: A non-compliant medical balloon may be changed from a deflated state to an inflated state by increasing the internal pressure within the balloon. The balloon comprises a balloon layer having an outer surface, the balloon layer including a base layer, a first reinforcing layer and a second reinforcing layer. The base layer is formed of a polymer material. The first reinforcing layer is one of either a plurality of discrete inelastic fibers oriented substantially parallel to the long axis of the balloon and a first layer of textile fabric material, the textile fabric material being one of a woven, knitted, braided and non-woven fabric. The second reinforcing layer is one of either at least one inelastic fiber wrapped around the circumference of the balloon substantially transverse to the long axis of the balloon and a second layer of textile fabric material, the textile fabric material being one of a woven, knitted, braided and non-woven fabric.

Abstract: Catheter having a hypotube with a skive defined by a first angled cut, an axial cut, and a second angled cut. A midshaft member includes a guidewire lumen and an inflation lumen in fluid communication with an inflation lumen of the hypotube, the inflation lumen of the midshaft member configured to receive at least a portion of the hypotube. A distal tubular shaft member extends distally from the midshaft member. The distal tubular shaft member has a guidewire lumen and an inflation lumen defined therein, the guidewire lumen of the distal tubular shaft member in fluid communication with the guidewire lumen of the midshaft member. The inflation lumen of the distal tubular shaft member is in fluid communication with the inflation lumen of the midshaft member and a balloon is coupled to the distal tubular shaft member and in fluid communication with the inflation lumen.

Abstract: A device for winding a filament around a structure disposed concentrically around a distal end of a balloon catheter includes a rotatable holder for retaining a distal end of the balloon catheter, a translatable winding carriage for helically winding the tensioned filament around the balloon catheter distal end, a heater for applying a predetermined amount of heat to a section of the balloon catheter having the filament wound therearound, and a controller for controlling at least the rate of rotation of the holder, the tensioning force applied to the filament, the amount of heat applied by the heater, and the rate of travel of the translatable winding carriage along the longitudinal dimension of the balloon catheter. By use of the device, the balloon is heat set and a predetermined checkering pattern of surface indentations are provided in the structure exterior surface in a single pass.

Abstract: A high torque vascular catheter system includes an inner catheter, a proximal outer catheter section, a distal outer catheter section, at least one discrete connection point connecting the inner catheter to the proximal outer catheter section, and at least one discrete connection point connecting the inner catheter to the distal outer catheter section. The distal outer catheter section is more flexible than the proximal outer catheter section. Methods of construction and use of the catheter system are also disclosed.

Abstract: A non-compliant medical balloon may be changed from a deflated state to an inflated state by increasing pressure within the balloon. The non-compliant medical balloon is composed of randomly oriented fibers forming an angle. The angle remains substantially unchanged when the balloon changes from a deflated state to an inflated state.

Abstract: A balloon catheter has an inner tube having a first lumen, an outer tube part coaxial with the inner tube and forming a second lumen between the outer tube part and an outer surface of the inner tube, and a balloon part having a front end portion fixed to a front end portion of the inner tube and an inside communicating with the second lumen. The balloon part has a bulged portion, having an expansion forming mode formed in advance, which is elastically deformable beyond the expansion forming mode by an expansion liquid injected thereinto. The outer tube part has a front side sleeve portion extending from a rear end portion of the bulged portion of the balloon part to a proximal end of the outer tube part, integrally formed with the balloon part using the same material as that of the balloon part, and substantially non-expandable.

Abstract: A balloon catheter junction includes a distal junction on a distal end of a balloon. The junction includes an inner member, a balloon inner sleeve encompassing the inner member and bonded to an interior of a mid-shaft, and a balloon distal leg bonded to an exterior of the mid-shaft. A connection medium is disposed between the balloon inner sleeve and the inner member.

Abstract: Catheter and methods for designing, making, and using catheters are disclosed. An example catheter is a balloon catheter. The balloon catheter may include a proximal shaft. The proximal shaft may be a bare metal hypotube having a skew value of ?1.0 to ?2.5. A midshaft may be attached to the proximal shaft. A distal shaft may be attached to the midshaft. A balloon may be coupled to the distal shaft. An inflation lumen may be defined that extends from the proximal shaft, through the midshaft, and into the distal shaft. The inflation lumen may be in fluid communication with the balloon.

Abstract: An implant device may include a body of a first material and defining a lumen and at least two arcuate rings of a second material embedded within the body. In one embodiment, the second material does not connect a first ring of the at least two arcuate rings to an adjacent second ring of the at least two arcuate rings.

Abstract: An elongate shaft of a medical catheter including a thermoset polymeric tubular member including a skived distal portion. The skived distal portion includes a distally extending trough having a convex surface and a concave surface. A thermoplastic tubular sleeve may be positioned over at least a portion of the skived distal portion of the thermoset polymeric tubular member. In some instances, the thermoplastic tubular sleeve includes a crescent-shaped tubular portion defining a crescent-shaped lumen. The trough of the skived distal portion may extend through the crescent-shaped lumen. The thermoplastic tubular sleeve is thermally bonded to the inner and outer tubular members of a distal section of the elongate shaft at a guidewire port joint.

Abstract: A balloon catheter assembly is provided with an outer catheter, an inner catheter, an outer adapter, a balloon and a support sheath, and is configured such that the balloon resides entirely within a predetermined volume having an outer diameter substantially equal to or less than the outside diameter of the distal end of the outer catheter when the balloon is in a deflated configuration. Methods of using and steering the catheter assemblies are also provided.

Abstract: Various embodiments concern a guide catheter for delivery of an implantable lead within the coronary vein. Such a guide catheter can comprise a tubular body having a main lumen and at least one preformed bend. The tubular body can comprise a liner defining an inner surface, braiding circumferentially surrounding the liner, a jacket covering the braiding and defining an exterior surface of the tubular body, and a plurality of inflation tubes embedded within the jacket. The guide catheter can include a balloon mounted on the tubular body, each of the plurality of inflation tubes in communication with the balloon. The guide catheter can further include a hub providing access to the main lumen, the hub comprising a first port for introduction of contrast media into the main lumen and a second port in communication with the plurality of inflation tubes.

Abstract: Implantable medical endoprosthesis delivery systems as well as related systems and methods are disclosed.

Abstract: A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity adapts to tissues having different thickness. The surgical instrument includes a proximal portion with at least one bendable structure attached thereto. The at least one bendable structure is configured to fold anywhere along its length. Folding the at least one bendable structure causes the proximal end of the proximal portion to propagate in a distal direction.

Abstract: A device for intravascular intervention can comprise an intervention element, an elongate manipulation member, and a joining element. The elongate element can comprise a hooked portion extending about a proximal portion of the intervention element. The hooked portion can comprise a bend. The hooked portion can have (i) no substantial surface crack at an interior region of the bend and (ii) a maximum lateral dimension that is less than 0.027 inch. The joining element can substantially permanently attach the hooked portion to the intervention element.

Abstract: The devices and methods described can be used to create and maintain a working space within the lumen of an organ or between or among organs or tissue structures during medical procedures in order to elicit a diagnosis, biopsy, surgery, or therapy.

Abstract: The present invention may include a medical device having a handle, a catheter coupled to the handle, and an expandable element coupled to the catheter. The medical device may also include first and second elongate bodies that traverse a length of the handle and the catheter. A housing may be disposed within the handle, with the housing defining a first opening able to receive a portion of the first elongate body, a second opening able to receive a portion of the second elongate body, and a third opening opposite the first and second openings able to receive a portion of both the first and second elongate bodies. A separation element may be disposed within the housing, with the separation element defining a path able to receive a portion of the second elongate body, and whereby a portion of the first elongate body forms a loop around the separation element.

Abstract: A medical device comprising a shaft having a kink radius; a tube disposed within the shaft; a fluid source in fluid communication with the tube; an elongate member disposed within the tube, and the elongate member imparting a kink radius on the tube, the imparted kink radius of the tube being larger than the kink radius of the shaft.

Abstract: A catheter assembly includes an elongate member and a balloon. The elongate member defines at least one lumen and an outer surface. The outer surface defines at least one opening in fluid communication with the at least one lumen. The balloon is disposed within the at least one lumen. The balloon is inflatable such that a portion of the balloon expands from the at least lumen through the at least one opening. The expansion of the balloon increases the flow restriction through the at least one opening compared to the flow restriction through the at least one opening when the balloon is in a deflated condition. Methods for using a catheter assembly to remove occlusive material from a catheter are also described.

Abstract: Methods for treating an annulus fibrosis having a defect include inserting a flexible device into the defect. The flexible device is advanced distally beyond an outer layer of the annulus fibrosus. The flexible device is then expanded such that a width of the flexible device is larger than the defect, where the flexible device prevents escape of nucleus pulposus through the defect. The flexible device may have at least two appendages made from a shape-memory metal. Alternatively, the flexible device may have a U-shaped structure that includes a central portion and two legs. The flexible device may also be anchored to the annulus fibrosis and/or the vertebrae.

Abstract: A remote sensing catheter system including an injection catheter and a collection catheter. In one method of use, an external sensor of the system determines the timing of operation of the collection catheter. In another method of use, a sensor determines the volume of medium in the injection.

Abstract: A medical catheter assembly including either a reinforced balloon bolster or the combination of a balloon bolster and a wire-basket bolster. According to one embodiment, the medical catheter assembly is a low-profile replacement PEG device comprising a feeding tube, an external bolster, an end cap and an internal bolster. The internal bolster comprises a first expandable structure and a second expandable structure. In one embodiment, the first expandable structure is a balloon and the second expandable structure comprises reinforcing members. In another embodiment, the first expandable structure is a balloon and the second expandable structure is a wire basket bolster. The feeding tube has a feeding lumen and an inflation lumen, extending parallel longitudinally. The external bolster is fixed to the external end of the feeding tube and has a feeding lumen aligned with that of the tube and an inflation lumen aligned with that of the tube.

Abstract: An inflatable balloon includes a base balloon having a cylindrical section and a conical section and at least one circumferential fiber extending circumferentially around the conical section. The inflatable balloon includes a plurality of reinforcing strips in the conical section over the at least one circumferential fiber. Each reinforcing strip includes a plurality of fibers extending at an angle relative to the at least one fiber. Each reinforcing strip is positioned a set circumferential distance away from a neighboring reinforcing strip.