Abstract: A catheter and associated method for taking a plurality of samples from within a length of a blood vessel. The catheter includes an elongate central body arranged to be inserted into and positioned along a central region of a blood vessel. A plurality of collection areas are defined along the elongate central body for collecting samples at the central region of the blood vessel. A plurality of mixers are provided radially outwardly of the elongate central body and arranged to create a flow of blood from a boundary layer at a wall of the blood vessel to the elongate central body. This enables the collection areas to collect samples from the boundary layer.

Abstract: An anchoring mechanism and method for anchoring a device within a biological conduit include an expandable element configured for retaining the device at a desired angle relative to a central axis of the biological conduit. A steering mechanism is preferably provided for orienting the device prior to operation of the anchoring mechanism. The anchoring mechanism and method are employed in drug delivery devices, brachytherapy devices or for anchoring a catheter or sheath to provide a working channel for reliable guidance of a wide range of tools to a target location within the body.

Abstract: A surgical access port for insertion into a body cavity can have an elongate tubular body extending along an axis between a proximal end and a distal end, and a tip at the distal end of the tubular body for penetrating through a body wall and into the body cavity. The distal tip moves from a first, penetrating position to a second, retaining position when the body wall has been traversed. The surgical access port may further comprise a seal housing connected to the proximal end of the tubular body, the seal housing having an access port providing an opening into the tubular body to allow passage of surgical instruments. The distal tip may be sharp, pointed or bladed. The distal tip may also be substantially blunt or have a conical surface. The access port may further comprise a retention member for connecting the tubular body and the distal tip.

Abstract: A treatment method and medical device are disclosed for cutting a substance inside a body lumen. The medical device includes a drive shaft that is rotatable; a strut that is rotatably connected to a distal side of the drive shaft, that extends along a rotation axis, and whose central portion is expandable radially outward; and a support portion that is rotatably connected to the distal side of the drive shaft, that is formed in a mesh shape and a tubular shape while including multiple gaps, at least a portion of which is positioned on a radially inner side of the strut, and that is expandable radially outward by a central portion in a direction extending along the rotation axis being bent.

Abstract: An embolic microcoil can be formed into a complex shape for use in treating aneurysms and other vascular disorders. The microcoil features a distal portion including several loops that together comprise a substantially spherical shape, and an elongated proximal portion that is deployable within the distal portion. The distal portion can create a stable frame with adequate loop coverage across a neck of the aneurysm. The proximal portion can include a series of substantially omega-shaped loops, which can apply a force against the interior of the substantially spherical shaped distal portion, expanding it into apposition with additional portions of the aneurysm wall. Methods of treating vascular disorders and methods of manufacturing certain microcoils are also disclosed.

Abstract: This invention is directed to devices and methods for improving wound closures produced during endoscopic surgery. These methods are directed to delivering and applying a quantity of hemostatic agents in either powder, solid, liquid, or gel form onto an open wound produced e.g., by polyp removal, followed by the application of pressure. The method is implemented preferably using existing endoscopic equipment; however, modifications to existing endoscopic insertion tubes, application and tamping devices and endoscopic clips deployed from the distal end of the insertion tube during endoscopic surgery are also within the scope of this invention.

Abstract: An implantable digestive organ is provided for the transport of materials through the digestive tract and in one particular application to an artificial large bowel for replacing all or part of a colon. The prosthetic organ of one embodiment includes an outer support structure, an expandable member or members located within the support structure, and a flexible inner member forming a conduit for passage of material. The inner member is located within the outer member and the expandable member(s) is located between the inner member and the support structure. The expandable members are expanded and contracted, or inflated and deflated to provide pumping action that pumps material through the organ. The prosthesis may also include valves or sphincters at its entrance and/or exit points where material moves into and out of the prosthesis. An implantable pump may be included for inflating and deflating the expandable members in a desired sequence.

Abstract: A surgical access assembly for a surgical instrument and/or a surgeon's hand, the assembly including a housing, such as a wound retractor, and a seal body mounted to the housing. The seal body may have a pleated configuration when viewed in cross-section. The seal body may have a first surface and a second surface, the first surface having a plurality of radially-extending first channels and the second surface having a plurality of radially-extending second channels, the plurality of first channels being offset from the plurality of second channels. The seal body may define a substantially centrally disposed opening for reception of a hand/arm or instrument. In addition, the seal body may define one or more additional openings for simultaneous reception of an instrument and a hand.

Abstract: A dilator may include a leading portion that includes a leading end coupled to a leading stem. The dilator may further include a trailing portion that includes a trailing end coupled to a trailing shaft. The dilator may also include a segmented body disposed between the leading end and the trailing end. The segmented body may include a plurality of segments disposed circumferentially around the leading stem. The leading stem may extend through a passageway of the segmented body, an opening of the trailing end and a channel of the trailing shaft. The leading stem and the trailing shaft may be configured to move longitudinally relative to one another to radially outwardly expand the segmented body.

Abstract: A biologics delivery device and method of use for promoting angiogenesis in occluded vessels and ischemic tissue of a patient are provided, wherein the biologics delivery device includes a catheter having a proximal end, a distal region having a distal end, and a side wall defining a catheter lumen; an expandable member disposed in the distal region, the expandable member configured to support a subintimal space in an occluded blood vessel of a patient, and to transition between a collapsed state and an expanded state; and a hollow needle having a penetration tip deployable from inside the catheter lumen to outside the catheter lumen, and into tissue surrounding the occluded blood vessel, wherein the expandable member in the expanded state allows the flow of oxygenated blood to the occluded blood vessel. Methods of using the inventive biologics delivery device also are provided to deposit the biologic from a subintimal space to tissue surrounding the occluded blood vessel.

Abstract: A sacroiliac joint fusion screw and associated delivery tools and method. Embodiments of the sacroiliac joint fusion screw comprise a shaft having proximal and distal end portions and a head on the proximal end of the shaft. A threaded portion on a distal portion of the shaft is configured to engage a sacrum. A glide zone portion on the shaft between the threaded portion and the proximal end portion is configured to extend through an ilium. The screw can provide stability and compression to the joint.

Abstract: A vascular closure assembly is configured to seal a vascular puncture in a vessel. The vascular closure assembly includes a balloon location device and a sealant delivery device. The balloon location device includes an inflation tube and an inflatable balloon positioned at a distal end of the inflation tube and operable, when inflated, between a first position blocking blood flow through the vessel and a second position sealing the puncture from within the vessel. The sealant delivery device includes a sealant delivery tube having a first lumen sized to advance over the inflation tube to the puncture, and a second lumen configured to deliver a volume of sealant to the puncture. The first lumen may include a rapid exchange feature.

Abstract: An actuator includes an effective stiffness. The effective stiffness is based at least in part on non-linear deflection characteristics of buckling. A method of varying an effective stiffness of an actuator includes providing an actuator and varying an effective stiffness of the actuator based at least in part on non-linear deflection characteristics of buckling. Another method of varying an effective stiffness of an actuator includes applying a load to a member. The load causes the member to buckle, and the buckling produces non-linear deflection of the member. The method further includes varying an effective stiffness of an actuator based at least in part on the non-linear deflection of the member.

Abstract: The present invention relates generally to medical devices and, in particular, to a self-dilating catheter introducer and obturator system for introducing implantable medical devices into a body cavity. Depending on the size of the orifice or opening in which the device is required to pass through determines the French scale size of the device (e.g. The French scale is a measure of the external diameter of a catheter not internal channel).

Abstract: Methods and devices are provided for anchoring suture to tissue, incorporating anchoring devices constructed substantially from suture. The anchoring devices are constructed as longitudinally extended, preformed knot configurations that upon deployment are reconfigured to form anchoring knots having an increased cross-section relative to the preformed knot configuration, for secure lodging in tissue. The anchoring devices are suitable for single and multi-anchor surgical procedures in soft tissue or bone, and multiple anchors can be delivered using a single delivery device.

Abstract: A dilator retractor and the dilators that are used for minimally invasive spinal surgery or other surgery are configured to accommodate the anatomical structure of the patient as by configuring the cross sectional area in an elliptical shape, or by forming a funnel configuration with the wider end at the proximate end. In some embodiments the distal end is contoured to also accommodate the anatomical structure of the patient so that a cylindrically shaped, funnel shaped, ovoid shaped dilator retractor can be sloped or tunneled to accommodate the bone structure of the patient or provide access for implants. The dilator retractor is made with different lengths to accommodate the depth of the cavity formed by the dilators.

Abstract: A variable scale medical implant deployment device comprising a variable inner diameter scale sleeve insert is provided. Also described are kits containing the variable scale medical implant deployment device and methods for deploying a medical implant into a body lumen using a variable scale medical implant deployment device.

Abstract: A puncture assistance device for use in connection with an ultrasound probe to guide a Veress needle through the layers of the wall into a bodily cavity is provided. The puncture assistance device comprises a tenaculum-like forceps, a needle guide body provided with a slot for guiding the Veress needle within the scan plane of the ultrasound probe, attachment means to the ultrasound probe, and attachment means of the needle guide to the tenaculum-like forceps. Also provided is a balloon catheter for use as a retractor in gaining access into the abdominal cavity, presenting at its distal end an inflatable balloon membrane and an framework of non-distendable flexible fibers disposed in a specific arrangement. A method access the abdominal cavity with the aid of said devices under ultrasound guidance is also provided.

Abstract: A mechanism can include a step feature guidewire having a guidewire with a proximal end, a distal end, and a diameter. A self-expanding element can be disposed approximate to the distal end of the guidewire and can have at least two states which include a contracted diameter and an expanded diameter. The self-expanding element can be expandable under its inherent properties, based at least on its original shape and the nature of the materials that make up the element. Further, the expanded diameter can be approximately 70% to 280% of the guidewire diameter. While the guidewire is designed for passing through a body lumen while treating a patient, the expanded diameter is less than any body lumen diameter the guidewire is determined to pass through.

Abstract: A cannula for administration of a medicine to a target location includes a tube with at least one nodule disposed along the circumferential surface and spaced at a defined distance from the distal end of the tube. An arrangement for delivery of a medicine to a target location includes the cannula and a pump fluidly coupled to the cannula. The distal end of the cannula may be inserted into a target location until the nodule reaches a surface that limits a depth of penetration before delivery of the medication.

Abstract: A catheter insertion device which employs back-and-forth longitudinal axial movement to advance the catheter by the cooperative interface of an incline ramp and a decline ramp with a split gripping mechanism is described.

Abstract: A retrieval system for a medical device includes an access sheath, a clot catch with an attached mesh, and a filter catch having an attached retrieval member. The filter catch is translatable within clot catch, and the clot catch is translatable within the access sheath. The mesh is expandable into engagement with a body vessel during retrieval of the medical device. The mesh captures emboli that are dislodged during retrieval of the device. The device is captured by the clot catch during retrieval, and the clot catch is subsequently captured by the access sheath. The system can further include an inner sheath translatable within the clot catch, with the inner sheath capturing the medical device and the clot catch capturing the inner sheath.

Abstract: The present invention provides devices and methods for use in the perfusion of organs and anatomical regions. In one aspect the present method provides a percutaneously deliverable device for supporting a vessel in a human or animal subject including means for supporting the vessel during delivery of a fluid thereto or collection of a fluid therefrom. In another aspect the invention provides a method for delivery or collection of a fluid to or from an organ or anatomical region in a human or animal subject, the method including the step of supporting a vessel associated with the organ or anatomical region. The devices and methods may be used to deliver, remove or recirculate a therapeutic agent to an organ or anatomical region.

Abstract: Flexible implantable devices or stents can navigate tortuous vessels of the neurovasculature. The devices can also conform to the shape of tortuous vessels of the vasculature. In some embodiments, the devices can direct blood flow within a vessel away from an aneurysm or limit blood flow to the aneurysm. Methods and structures are provided for adjusting, along a length of the device, the porosity of the device while maintaining a cross-sectional dimension. In some embodiments, small hooks releasably engage the stent at a proximal end and are able to resheath the stent by retracting a proximal retaining member where the hooks are coupled to. The hooks straighten, unfurl, or otherwise disengage the stent when either unrestrained by a catheter or when coming into contact with an external stimulus found in the patient's vasculature.

Abstract: Funnel-trap type delivery and/or retrieval devices for temporary Inferior Vena Cava (IVC) filters or other medical implants or foreign bodies are described. These may employ a locking sheath or a proximal-aperture capture feature or features for IVC filter (or other device) retrieval.

Abstract: A spacer including a first part made from a first shape memory material, and a second part made from a second shape memory material.

Abstract: Non-expandable space-occupying devices for treating voids within the body are disclosed. The devices can have multiple non-expandable space-occupying elements connected to a flexible leader. Methods of making and using the devices are also disclosed.

Abstract: Vascular treatment devices and methods include a woven structure including a plurality of bulbs that may be self-expanding, a hypotube, for example including interspersed patterns of longitudinally spaced rows of kerfs, and a bonding zone between the woven structure and the hypotube. The woven structure may include patterns of radiopaque filaments measurable under x-ray. Structures may be heat treated to include various shapes at different temperatures. The woven structure may be deployable to implant in a vessel. A catheter may include a hypotube including interspersed patterns of longitudinally spaced rows of kerfs and optionally a balloon. Laser cutting systems may include fluid flow systems.

Abstract: A catheter has an entrance opening defined by the first end of a catheter body and non-circular inner surface in cross section. The entrance opening intersects a longitudinal axis extending longitudinally through the center of a lumen adapted to drain urine from a bladder. The non-circular inner surface can have dimples, channels, or grooves, all of which decrease frictional fluid forces against the inner surface as the urine drains. The catheter is free of any eyelets formed in the side wall of the catheter body. The catheter further includes a plurality of distinct longitudinally extending convex outer surfaces and may have an enlarged head.

Abstract: The apparatus includes a ureter occlusion apparatus, which comprises, in combination: at least one longitudinally extending plug body (26) of flexible, physiologically acceptable material which obstructs the passage of all particulate matter great than 5 microns in diameter, is laterally compressible to a compressed diameter of not more that 2 millimeters and is laterally expandable in the presence of liquid to an external diameter of at least 1.

Abstract: A collapsible medical device and associated methods of occluding an abnormal opening in, for example, a body organ, wherein the medical device is shaped from plural layers of a heat-treatable metal fabric. Each of the fabric layers is formed from a plurality of metal strands and the assembly is heat-treated within a mold in order to substantially set a desired shape of the device. By incorporating plural layers in the thus-formed medical device, the ability of the device to rapidly occlude an abnormal opening in a body organ is significantly improved.

Abstract: A surgical instrument includes a handle portion and a body portion extending distally from the handle portion and defining a first longitudinal axis. The surgical instrument includes an articulating tool assembly defining a second longitudinal axis and having a proximal end. The articulating tool assembly is disposed at a distal end of the body portion and is configured to be articulated with respect to the body portion, namely, the articulating tool assembly is movable from a first position in which the second longitudinal axis is substantially aligned with the first longitudinal axis to at least a second position in which the second longitudinal axis is disposed at an angle with respect to the first longitudinal axis. The surgical instrument also includes an articulation mechanism configured to articulate the articulating tool assembly.

Abstract: A surgical apparatus includes an elongate outer sheath dimensioned for positioning within a body lumen of a patient, a reference member and a removal device. The reference member is adapted for longitudinal movement relative to the elongate outer sheath between a first position at least partially disposed within a longitudinal lumen of the outer sheath and a second position at least partially exposed from the longitudinal lumen. The reference member is adapted to expand when in the second position to generally conform to an internal dimension of the body lumen. The reference member includes a radiopaque material for visualizing the reference member to assist in determining physical characteristics of the body lumen when in the second position. The removal device is adapted for longitudinal movement relative to the reference member, and is configured for disrupting at least a portion of the occlusion within the body lumen.

Abstract: A method for mechanically capturing and removing a thrombus from a blood vessel includes contacting the thrombus with an inner catheter. A self-expanding body is advanced toward the thrombus, wherein the self-expanding body has a proximal end fixed to a distal end of an elongate catheter. The self-expanding body is preferably made from nickel-titanium and includes a tapered proximal end portion and an open distal end. The self-expanding body preferably has a mesh structure. The self-expanding body is allowed to self-expand in the blood vessel. At least a portion of the thrombus is captured by the self-expanding body and the captured thrombus is then retrieved into a lumen of an aspiration catheter. Negative pressure is applied through the lumen of the aspiration catheter during retrieval of the captured thrombus. A thrombolytic drug may be delivered into the blood vessel before capturing and removing the thrombus.

Abstract: A surgical instrument comprises a handling portion with a control junction and a plurality of vertical members operatively disposed within the control junction. The handling portion includes a top nut. Manipulation of the handling portion allows the vertical members to toggle between a narrowed configuration and an expanded configuration. Systems and methods are disclosed.

Abstract: The present invention provides a medical device that may include a catheter body having proximal and distal portions, a fluid injection lumen disposed within elongate body, and a guidewire lumen disposed within the elongate body. A tip portion defining a cavity in fluid communication with the fluid injection lumen may be coupled to the distal end of the guidewire lumen, and an expandable element may be coupled to the distal portion of the catheter body and to the tip portion, such that the expandable element is in fluid communication with the fluid injection lumen. A shaping element may at least partially surround the expandable element, where the shaping element is configurable in a first geometric configuration and a second geometric configuration.

Abstract: A rapid exchange catheter comprises a guide wire lumen including a substantially sealed portion in which a lumen wall extends around an entire periphery thereof and a channel portion including a channel opening the lumen to an exterior of the catheter, wherein a width of the channel is less than a maximum width of the channel portion. A guide wire ramp extends into the channel portion, with the ramp extending further into the lumen of the channel portion as a distal end of the ramp is approached.

Abstract: Multiple surgical devices that may be used during surgical procedures are shown and described herein. A surgical device includes an outer cannula and an inner member that has a pair of electrodes positioned at a distal end. The inner member defines an aspiration delivery channel with an opening. The inner member further defines a pair of electrode channels within which the electrodes are positioned. A handle assembly actuates the outer cannula relative to the inner member, thereby adjusting a size of the opening of the aspiration delivery channel. An irrigation hub is provided to deliver irrigation through the surgical device to the electrode channels.

Abstract: Filtration systems with integrated filter element(s) forming portions of the wall of the filtration catheter are disclosed. The filtration catheters disclosed herein are designed to be used alone or in conjunction with another filter device to provide embolic protection of both carotid arteries. Occlusive element such as balloon is placed on the exterior of the filtration catheter to redirect blood flow in the vessels during the filtration process as well as to help anchor the filtration catheter inside the vessel. The integrated filter element(s) does not require collapsing thus significantly reduces the complexity of the filtration system retrieval process and the chances of releasing emboli back into the blood stream. The compact design of the filtration systems makes them particularly suitable for embolic protection during endovascular procedures on or close to the heart.

Abstract: An introducer provides access to a surgical site in a patient. The introducer includes a proximal housing configured to be positioned outside the patient and a sheath extending from the proximal housing to a distal end of the introducer. One or more handles may be housed at least partially within the proximal housing and configured to translate axially in proximal and distal directions with respect to the proximal housing. A securing element may be slideably coupled to the sheath and may have a flange extending radially outwardly from the sheath. A radially expanding portion of the sheath may have a first edge, a second edge, and a middle section extending from the first edge to the second edge. The sheath portion may have a rolled configuration in which the middle section at least partially overlies the first edge, and the second edge at least partially overlies the middle section.

Abstract: A device and method for placing a jejunal feeding tube through a stomach and into a small intestine. A mechanism is formed to a shape that contacts walls of the small intestine along a length of the small intestine to grip the walls and anchor the jejunal feeding tube. The mechanism is present on a distal end of the jejunal feeding tube that is present in the small intestine after placement of the jejunal feeding tube. The mechanism is straightened for placement into the small intestine with a stiffening apparatus.

Abstract: A catheter system is disclosed, having a plurality of expandable arms with radiopaque markers at their ends. Once deployed at a patient's valve, a user can obtain a correct 3D localization image for placement of the replacement valve by aligning the radiopaque markers to be substantially equidistant from each other and substantially located in the same plane, relative to the sensor of an X-Ray machine.

Abstract: A fluid delivery mechanism that has a substantially cylindrical sleeve and an actuator coupled to the sleeve for controlling a circumference of the sleeve.

Abstract: An apparatus and method for supporting a tubular medical device, such as a stent or scaffold, includes a rod disposed between two collets. The rod can be shaped to form a range of different size or length helical supports to support a wide range of tubular medical devices. The rod is shaped into a full or partial helix by rotating one of the collets relative to the other.

Abstract: An apparatus and method for supporting a tubular medical device, such as a stent or scaffold, includes a rod disposed between two collets. The rod can be shaped to form a range of different size or length helical supports to support a wide range of tubular medical devices. The rod is shaped into a full or partial helix by rotating one of the collets relative to the other.

Abstract: An endoscope and methods of use thereof are provided, which includes at least one multi-functional extending arm supporting a plurality of imaging, lighting and other sensory elements. The arms provide a mounting platform upon which cameras, lights and sensors may be mounted to generate multiple-angled images and video, arena-like lighting and other data for performing a minimally-invasive surgical (MIS) procedure. The arms may be inserted through a single portal in the endoscope and extended outward in multiple directions from the single portal once inserted into a body cavity. The endoscope may also include support arms which support the extending arms within the body cavity and a stabilization plate which anchors the endoscope to an external surface of the body. An endoscopic tool with optical, lighting and other sensors integrated into a functional end is also provided.

Abstract: An infusion system includes an infusion catheter defining a fluid passage extending between a proximal catheter end and a distal catheter end, and having a plurality of infusion ports in communication with the fluid passage and defining an infusion zone. A filtration device is provided which may be retrofitted upon the infusion catheter and includes a filter sleeve coupled to a slidable control sleeve. The filter sleeve is deformable between a first configuration having a radially contracted footprint and a second configuration having a radially expanded footprint, responsive to sliding the control sleeve over the infusion catheter such that the deformable filter sleeve buckles outwardly from the infusion catheter.

Abstract: A cannula assembly includes a cannula adapted for insertion within tissue and having a longitudinal passage extending along a longitudinal axis of the cannula for passage of a surgical instrument. An expandable member is mounted to the cannula and longitudinally spaced from a distal end of the cannula. The expandable member is adapted to expand, upon introduction of fluids therein, in a radially outward direction relative to the longitudinal axis whereby the expandable member engages the tissue to facilitate anchoring of the cannula relative to the tissue, and also to expand in a radially inward direction relative to the longitudinal axis and within the longitudinal passage to engage the surgical instrument positioned within the longitudinal passage to facilitate formation of a seal about the surgical instrument.

Abstract: A system for deploying a prosthesis over a Carina between an ipsilateral lumen and a contralateral lumen includes a guidewire, a guidewire capture catheter, a self-expanding tubular prosthesis, and a delivery catheter. The guidewire is first placed in the ipsilateral lumen. The guidewire capture catheter is then advanced from the contralateral lumen to a position at or above the ipsilateral lumen. The guidewire is typically advanced through an occlusion, which may be a total occlusion, and captured by a capture element on the guidewire capture catheter. The guidewire capture catheter pulls the guidewire out through the contralateral side, and the guidewire is used to advance a delivery catheter from the ipsilateral side. The delivery catheter delivers a first segment of the tubular prosthesis in the ipsilateral lumen and a second segment of the prosthesis in the contralateral lumen.

Abstract: An expandable, bioabsorbable stent having a coiled-coil configuration is described. The stent further comprises regions of variable pitch that allow for variation in either rigidity, or variability diameter within sub-regions along the length of the deployed stent. By varying the diameter allows the stent to extend into regions such as branched vessels, or into the neck of aneurysms. In some embodiments, the stent comprises longitudinal support fibers that run substantially the length of the deployed stent to provide additional strength. In addition, the stent may also comprise regional support fibers that run less than the length of the stent, and which provide increased regional strength while permitting flexibility of the stent. The stent further comprises micro-tubes that are configured to be visible using medical imaging techniques. The stent can be manufactured from materials that are bioabsorbable and/or include the ability to release pharmacologically active substances over time.