Abstract: A guidewire stop is disclosed which can be positioned and frictionally locked to a bare guidewire at a user-defined location. The guidewire stop can be used to stop and/or lock a medical device, such as an embolic filter, at a treatment site inside a body lumen. The medical device may be attached to the guidewire stop.

Abstract: A trocar system for endoscopic surgery, cap assembly, and related methods are provided. The cap assembly includes a housing with an opening formed in line with an axis of the housing. The cap assembly also includes a variable opening flexible sealing gland having a stack of valve body sections each including a valve extension extending from a valve ring and having a valve opening and a slit extending between a valve opening and the valve ring. The combination of the individual valve body sections forms a substantially conically shaped iris diaphragm portion of the sealing gland. The iris is positioned to individually and separately receive elongate tools so that when any one of the elongate tools is positioned through the valve opening, a seal is maintained between peripheries of the seal gland surrounding the iris and outer peripheries of the inserted elongate tool.

Abstract: A system for positioning a catheter includes a nerve stimulator needle carried within the lumen of the catheter. A microelectrode is configured as a needle tip precisely protruding beyond a tapered distal end of the catheter. The catheter and needle are fixed against axial movement relative to one another to maintain the precise configuration of the microelectrode needle tip conductive surface by a releasable clamp which is grasped by the practitioner to compress the catheter lumen against the needle without permanent deformation of the needle shaft while simultaneously advancing the needle and the catheter toward a target nerve.

Abstract: Apparatus for creating an anatomic space in tissue in a body including an introducer device having a tubular member with a bore extending therethrough. A tunneling shaft assembly is slidably mounted in the bore of the introducer device. The tunneling shaft assembly includes a tunneling shaft having proximal and distal extremities. A blunt tip is secured to the distal extremity of the tunneling shaft. A balloon assembly is provided. The balloon assembly is removably secured to the tunneling shaft. The balloon assembly includes a deflated collapsed balloon. A sheath encloses the balloon and is carried by the tunneling shaft. The sheath has a weakened region extending longitudinally thereof permitting the sheath to be removed to release the balloon.

Abstract: An apparatus for the injection of therapeutic and other agents at a target site within a patient's body. A catheter including a first elongated shaft having a distal end and a proximal end and a lumen extending therebetween. The catheter also including a second elongated shaft slidingly disposed in the first elongated shaft, the second elongated shaft having a distal end and a proximal and a lumen extending therebetween. The catheter further including a third elongated shaft disposed in and attached to the second elongate shaft, the third elongated shaft to move in a one-to-one relationship with the first elongated shaft and the second elongated shaft to maintain a predetermined needle deployment length as each are subjected to various bend configurations.

Abstract: The present invention generally provides methods and devices for removing fluid from a surgical instrument. Surgical access devices and seal systems are generally provided having one or more valves or seal assemblies to create a closed system between the outside environment and the environment in which the surgical access device is being inserted. The devices of systems can also include a fluid remover in the form of a sorbent element, a scraper element, a wicking element, or any combination thereof that is configured to remove fluid from a working channel of the device or system and/or from a surgical instrument inserted therethrough.

Abstract: An apparatus for imparting motion from at least one of a plurality of motion sources into linear, rotary, or combined linear and rotary motion of an elongated device, the apparatus comprising a transmission for translating the motion to linear or rotary motion of the elongated device.

Abstract: An apparatus may serve as a surgical portal for the reception of surgical instruments for use in laparoscopic or similar surgery. The apparatus may include inner and outer tubular elongate members adapted for a longitudinal translation relative to one another to effect a length adjustment of the apparatus. An interface between the two elongate members includes a helical thread providing a mechanism for the translation of the elongate members, and indentations in one of the members provides a locking mechanism for affixing the length.

Abstract: A system for positioning a catheter includes a nerve stimulator needle carried within the lumen of the catheter. A microelectrode is configured as a needle tip precisely protruding beyond a tapered distal end of the catheter. The catheter and needle are fixed against axial movement relative to one another to maintain the precise configuration of the microelectrode needle tip conductive surface by a releasable clamp which is grasped by the practitioner to compress the catheter lumen against the needle without permanent deformation of the needle shaft while simultaneously advancing the needle and the catheter toward a target nerve.

Abstract: Locking device that is mounted on an endoscope or the like for selectively securing the position of a guide wire and/or catheter relative to the endoscope or the like. The locking device preferably includes a side wall with an opening therein for receiving the proximal end of a guide wire or catheter. The opening is preferably J-shaped or boot shaped, and has an entry end and a locking end. Once a guide wire or catheter is in a desired position within a body cavity, the portion of the guide wire or catheter that extends outside of the endoscope or the like may be moved into the opening. More particularly, a portion of the guide wire or catheter may be inserted by an operator through the entry end of the opening and into the locking end, wherein the locking end frictionally secures the position of the guide wire or catheter relative to the endoscope or the like.

Abstract: A catheter connector for coupling to a catheter, the connector having a body part, a tubular shaped compressible plug situated in a bore in part, with the proximal end of the catheter insertable into the bore of the plug, and a lever pivotably mounted to the housing part. Pivoting of the lever applies an axial force on one end of the plug causing the plug to deform radially inward and tightly engage the proximal end of the catheter.

Abstract: A transfer device and catheter assembly for the delivery of treatment elements to a selected location within the intraluminal passageways of a patient as part of an intraluminal radiation system. The transfer device includes a gate member that permits the treatment elements to have the transfer device only if the catheter is attached thereto. A pressure indicator provides a visual indication of the fluid pressure within the transfer device, and provides for a release of the fluid if the pressure exceeds a predetermined pressure. The catheter also includes detents to secure it to the transfer device and which must be manually activated to remove the catheter from the transfer device. The transfer device includes circuiting that determines whether the treating elements reside within the transfer device based upon the reflectivity of the treating elements. A method for determining whether treating elements reside in the catheter is also disclosed.

Abstract: A peritoneal dialysis catheter for insertion into the abdominal cavity of a patient for delivering and withdrawing fluid from a patient comprising a catheter body having a proximal portion, a distal tip portion and a first longitudinally extending lumen configured to deliver fluid into the abdominal cavity. First and second side openings are formed in an outer wall of the catheter body adjacent the distal tip portion and are in fluid communication with the first lumen and configured for passage of fluid therethrough. A stiffening insert is positioned in the distal tip portion and has a first stiffness greater than a second stiffness of the distal tip portion to facilitate entry into the abdominal cavity. The stiffening insert has a lumen therethrough communicating with the first lumen. A method for insertion of the dialysis catheter is also disclosed.

Abstract: A micro perfusion device and method for obtaining at least one constituent of a body fluid. The at least one constituent is obtained using a subcutaneously-positioned perfusion catheter into which perfusate is introduced by a supply channel and an injection needle. The perfusate absorbs the at least one constituent as it flows out of the perfusion catheter and through a discharge channel.

Abstract: An endoscopic infusion needle device includes a catheter within which an injection tube having a distal injection needle is slideably disposed. A proximal actuating handle is coupled to the proximal ends of the catheter and the injection tube, and a distal stopping structure is provided on distal portions of the catheter and the injection tube. In one embodiment, the stopping structures include a rigid elongate skeletal structure occupying a portion of the annular space between the tube and the catheter, and an annular band on the tube which resides within the skeletal structure. The skeletal structure fits tightly within the cannula, allows irrigation fluid to pass through the annular space between the tube and the catheter to exit the distal end of the catheter, prevents the annular band from escaping through the proximal end or the distal end of the skeletal structure, and maintains the tube in substantial axial alignment with the catheter.

Abstract: A catheter introducer system is provided with a catheter sheath having a valve providing for a friction fit around a catheter. The friction fit is selectively adjustable to vary between a first configuration for longitudinal movement of the catheter through the valve and a second configuration for holding the catheter longitudinally in place. The valve may includes a chuck to grip the catheter radially. The chuck may include an annular base and an opposed annular clamp, and a washer disposed between the base and the clamp. At least one of the base and the clamp may include a beveled surface that forces the washer radially inwardly as the base and the clamp are drawn together. The system also includes one or more dilators layered within the sheath. The layered dilators and sheaths are typically softer and more hydrophilic proceeding from the innermost dilator out to the sheath. The dilator may be reinforced by a wire embedded in the body of the dilator.

Abstract: A dual blunting needle assembly for use in blood collection procedures is provided. The needle assembly includes a hub assembly having a first external cannula with an intravenous puncture tip, a second external cannula with an external blunt tip and an internal lumen extending through the hub assembly from the intravenous puncture tip to the blunt tip. The needle assembly further includes an internal cannula extending concentrically within the internal lumen of the hub assembly. The internal cannula includes an internal blunt tip at a first end and a non-patient puncture tip at a second end.

Abstract: A needle holder for use with a needle assembly for blood collection is provided, and in particular, for use with a needle assembly including an activation mechanism adapted for axial displacement between a first position and a second position with respect to the needle assembly through engagement with a blood collection tube. The needle holder includes an outer body having a first end adapted for attachment to such a needle assembly and a second end having an internal opening therein. The needle holder is adapted for accommodating a blood collection tube within the internal opening for engagement with the needle assembly.

Abstract: A method of performing dialysis with a catheter system which includes (i) a working catheter having a distal working orifice, and (ii) a guide catheter having a guide lumen and a distal guide orifice is disclosed. The method includes the step of locking the working catheter in an operative position in which (i) the working catheter extends through the guide lumen of the guide catheter and out of the distal guide orifice of the guide catheter, and (ii) the distal working orifice of the working catheter is positioned outside of the guide catheter. The method further includes the step of performing a dialysis procedure including advancing and withdrawing blood through the working catheter while the working catheter is locked in the operative position.

Abstract: A micro perfusion device and method for obtaining at least one constituent of a body fluid. The at least one constituent is obtained using a subcutaneously-positioned perfusion catheter into which perfusate is introduced by a supply channel and an injection needle. The perfusate absorbs the at least one constituent as it flows out of the perfusion catheter and through a discharge channel.

Abstract: Featured is a system for delivering a fluid or therapeutic agent to target tissue of an organ, such as a heart. Such a delivery system includes a catheter having a distal end portion, a proximal end portion and a lumen extending therebetween and a delivery device movably disposed within the catheter at the distal end portion thereof, the delivery device having a first end portion that is configured and arranged for penetrating the target tissue. The distal end portion of the catheter is also configured and arranged such that when the delivery device is extended beyond the distal end portion of the catheter, a portion of the delivery device that is disposed within the distal end portion of the catheter is put into fluid communication with the lumen, whereby fluid or therapeutic agent being communicated via the lumen is fluidly coupled to the first end portion of the delivery device and thence for delivery to the target tissue.

Abstract: A cannula includes a coupling interface adapted to receive and engage a wide variety of medical instruments having engaging portions which are different. In general, the cannula includes an elongated insertion member having a passage for receiving the medical instrument and a clamping assembly disposed at the proximal end of the elongated insertion member to engage the medical instrument. The clamping assembly includes a second surface axially spaced from the first surface of the elongated insertion member, and a biasing member positioned to bias at least one of the first surface and the second surface axially toward each other and to clamp an engaging portion of the medical instrument between the first and second surfaces.

Abstract: A single operator exchange fluid jet thrombectomy method employing a single operator exchange fluid jet thrombectomy device having an outer catheter assembly and separable and exchangeable components in the form of an inner catheter assembly allowing functioning as a rheolytic thrombectomy catheter or as a crossflow thrombectomy catheter. The outer catheter assembly is common to any mode of usage and includes a guide catheter having a lumen through which a guidewire and the greater portion of a hypo-tube carrying a jet emanator and a flow director are passed and advanced. In the method, thrombus is dislodged, entrained, and broken into pieces by fluid jets and evacuated through the lumen of the guide catheter.

Abstract: Disclosed herein is an improved core wire for use in a medical catheter. In one aspect, a tapering core wire is incorporated into the distal end of a catheter. The catheter has a tubular body. Both ends of an inflatable balloon are mounted to the tubular body. The core wire extends from the distal end of the tubular body. In one embodiment, substantially all of the taper of the core wire occurs in the extending portion of the core wire over a length of at least 15 mm but no more than 60 mm. In another aspect, a core wire with a shapeable tip and method of manufacturing the same are provided. A core wire previously made superelastic is subject to additional processing to remove its superelasticity thereby allowing the material to be shapeable to aid in advancing the core wire through a blood vessel or other body cavities. In another aspect of the present invention, a method is provided for securing the core wire to the distal end of an elongated catheter tubular body.

Abstract: Locking device that is mounted on an endoscope or the like for selectively securing the position of a guide wire and/or catheter relative to the endoscope or the like. The locking device preferably includes a side wall with an opening therein for receiving the proximal end of a guide wire or catheter. The opening is preferably J-shaped or boot shaped, and has an entry end and a locking end. Once a guide wire or catheter is in a desired position within a body cavity, the portion of the guide wire or catheter that extends outside of the endoscope or the like may be moved into the opening. More particularly, a portion of the guide wire or catheter may be inserted by an operator through the entry end of the opening and into the locking end, wherein the locking end frictionally secures the position of the guide wire or catheter relative to the endoscope or the like.

Abstract: A biological agent delivery device for delivering biological agents includes a sheath having a longitudinally extending wall surrounding an interior region, and a closed tip at a distal end. A flexible pouch formed in the sheath wall for containing a biological agent is capable of being displaced radially outwardly for radially displacing the biological agent.

Abstract: A soft over-the-needle (OTN) catheter that has been treated at a distal end to provide a higher durometer (i.e., harder) surface to facilitate insertion of the catheter into a patient is provided. The catheter preferably comprises a soft flexible tube made of polyurethane and having a hardness in the range of 50A to 90A where the treated distal end has a hardness of above 90A. The OTN catheter may also include an annular abutment shoulder formed at a distance from the distal end of the catheter. An insertion needle also comprises an abutment means, preferably a collar positioned on the exterior of the insertion needle, to abut the abutment shoulder of the catheter. Where the catheter is to be fed significantly into the vascular system, an optional metal ring may be secured within the catheter, adjacent the internal shoulder. When the needle is removed, the metal ring remains in place, permitting electromagnetic tracking of the catheter as it is fed through the vascular system.

Abstract: According to the present invention, improved methods and apparatus are provided for regaining hemostasis or otherwise minimizing leakage during endoluminal, surgical or percutaneous intraluminal procedures, and for providing a seal during laparoscopic surgical procedures where there is leakage of the CO2 insufflation, when the primary means of hemostasis or pneumatic CO2 seal is compromised or fails. More particularly the present invention relates to devices having a front hub and a rear hub, one or other of which is adapted to retain a compression seal such that when the front and rear hub are matingly engaged, axial and radial pressure is applied to the compression plug and any devices located therebetween, thereby achieving a seal. The compression device can be applied while a guidewire or additional devices remain within the leaking sheath or trocar, thereby allowing the physician to maintain hemostasis or adequate CO2 insufflation, without exchanging the introducer sheath or laparoscopic port.

Abstract: An endoscopic needle device includes an inner fluid conduit, an outer sheath extending over the length of the conduit, a longitudinally stiff wire extending through the conduit, and a needle fixedly attached to the distal end of the conduit. The distal end of the wire is coupled to one or both of the needle and the distal end of the conduit. The needle includes a proximal opening such that the hollow of the needle is in fluid communication with a lumen of conduit. A proximal handle includes a stationary member and a movable member longitudinally movable relative to the stationary member. The proximal end of the outer sheath is coupled to the stationary member, and the stationary member includes structure to mount the handle to a port of an endoscope. The movable member includes a passageway, and the proximal end of the conduit is coupled to the distal end of the movable member, and a port is provided at the proximal end of the movable member.

Abstract: A medical needle protector sheath comprises a tubular body for surrounding and shielding a needle with the sheath defining an anchor member integrally attached to the front of the body for manual holding, plus a closure cap for the front end which is integrally attached to the body. Also, a manually removable wing member may be carried about the hub of the needle. A tunnel member typically of the inverted U-cross section provides longitudinal securance to the needle and hub while penetrating the skin of the patient while at the same time permitting axial rotation of the needle.

Abstract: A brain lead anchoring system is described which allows for installation of a brain stimulation lead or a drug delivery catheter without the lead or catheter ever being unsupported during installation so that the lead or catheter does not move during the anchoring procedure. An anchor assembly contains an anchoring mechanism that is biased in the closed or anchoring position and is only open to allow installation of a lead when it is mated to an introducer instrument, which has prongs that open the anchoring mechanism. Once the lead is appropriately positioned within the brain and while the lead is still supported by the installation guiding device, the introducer instrument is withdrawn from the anchoring mechanism, which thus allows the anchoring mechanism to return to its closed position. A locking cap covers the aperture through the anchor assembly into the skull and mechanically ensures that the anchoring mechanism remains in the closed position.

Abstract: A catheter system includes a multi-lumen working catheter having a first distal working orifice and a second distal working orifice. The catheter system further includes a guide catheter having a guide lumen and a distal guide orifice. Also, the catheter system includes a locking mechanism which locks the working catheter relative to the guide catheter in (i) an operative position, and (ii) a stowed position. When the working catheter is locked in the operative position, (i) the working catheter extends through the guide lumen of the guide catheter and out of the distal guide orifice of the guide catheter, and (ii) the first distal working orifice and the second distal working orifice are each positioned outside of the guide catheter.

Abstract: A hemostasis valve which has a varying diameter. The hemostasis valve is actuated by a mechanism which provides mechanical advantage. Actuation of the hemostatis valve provides selective incremental sizing such that the valve will fit a variety of different intravascular devices.

Abstract: A mechanical rapid exchange device is provided which plastically deforms a guidewire and constrains the guidewire in a non-linear configuration such that a catheter may be moved relatively proximally or distally over the guidewire to facilitate catheter exchange. The device generally includes a housing having a channel along a length of one side of the housing, a central first punch movable between a first position in which the first punch is located substantially to one side of the channel and a second position in which it extends at least partially into the channel, lateral second and third punches movable between a respective first position in which they are located to the other side of the channel and a respective second position in which they extend at least partially into the channel. The device also includes a handle attached via levers to the second and third punches such that when the handle is actuated, the second and third punches are moved into the second position.

Abstract: A surgical needle assembly including a hollow needle body, a push rod slidingly fit within the hollow needle body, and a hand-actuable lock mounted on the needle body. The lock selectively limits movement of the push rod relative to the needle body in response to a squeezing or releasing of the lock.

Abstract: An endoscopic needle device includes an outer sheath, an elongate shaft extending through the sheath, a needle rigidly attached to the distal end of the shaft, and a handle assembly having a housing coupled to the proximal end of the sheath and having a syringe port in fluid communication with the sheath and a knob rotatably coupled to the housing. Rotation of the knob relative to the housing causes rotation of the shaft relative to the sheath. The needle and the distal end of the sheath are mated by a threaded connection. As such, rotation of the knob relative to the housing causes precise longitudinal movement and extension of the needle relative to the distal end of the sheath. A set of intermeshing gears are provided between the knob and shaft which function to permit at most one rotation of the knob to cause complete extension and/or retraction of the needle. Furthermore, assemblies are provided with permit the shaft to accommodate movement of the needle relative to the sheath.

Abstract: The invention provides a method and device for selectively controlling the temperature of a selected organ of a patient for performance of a specified application. The method includes introducing a guide catheter into a blood vessel. The guide catheter may have a soft tip and a retaining flange, and may be used to provide treatments such as administration of thrombolytic drug therapies, stenting procedures, angiographic procedures, etc. A supply tube is provided having a heat transfer element attached to a distal end thereof. The heat transfer element having a plurality of exterior surface irregularities, these surface irregularities having a depth greater than the boundary layer thickness of flow in the feeding artery of the selected organ. The supply tube and heat transfer element may be inserted through the guide catheter to place the heat transfer element in the feeding artery of the selected organ.

Abstract: A surgical needle assembly including a hollow needle body, a push rod slidingly fit within the hollow needle body, and a hand-actuable lock mounted on the needle body. The lock selectively limits movement of the push rod relative to the needle body in response to a squeezing or releasing of the lock.

Abstract: A positive engagement/disengagement catheter sleeve to reduce risks of needle sticks. The sleeve has a base and a body which define a pair of grooves. The grooves define a deformable region of the sleeve therebetween. At least one detent is provided inside the base within the deformable region. A mechanism is provided to cause the detent to disengage when the mechanism is actuated.

Abstract: A rheolytic thrombectomy catheter and method of using same to remove thrombus from a body vessel or other body cavity. Several embodiments are disclosed. All embodiments include an outer catheter having a lumen and an inner high pressure tube of a size to enable it to be passed through the lumen of the catheter. The distal end of the inner high pressure tube extends beyond the distal end of the catheter and carries a jet cap for directing one or more jets of saline proximally toward the distal end of the catheter. In some embodiments, the catheter has a distally located inwardly directed stationary stop and the inner high pressure tube includes a distally located outwardly directed transitional stop for engaging the inwardly directed stationary stop to thereby position the jet cap at a defined distance from the distal end of the catheter.