Abstract: Attachment devices and methods of using the same are disclosed. The attachment devices can be fenestrated. The fenestrations can control the flow of fluid out of and/or into the device.

Abstract: The invention describes a sinus balloon catheter and methods of use. Specifically a sinus balloon catheter for dilating a sinus cavity lumen is provided with a tip that can be extended. The catheter comprises a guide tube with a proximal and distal end, a sleeve member, a balloon disposed upon the sleeve member and a rounded tip arranged at the distal end and extendable along with the extension of the sleeve member.

Abstract: An infusion catheter is disclosed. An example infusion catheter includes an elongate tubular member having a proximal portion and a distal portion, wherein the distal portion includes an infusion region extending along a portion thereof. Further, the infusion region of the elongate tubular member includes a plurality of apertures, and the apertures reduce the surface area of the infusion region by 0.25%-10%.

Abstract: A method of monitoring contact between a probe and a tissue surface includes placing the probe in proximity to the surface, robotically moving the probe, measuring a tissue parameter at the distal end of the probe, calculating an amount of change in the measured tissue parameter between measurements thereof, and indicating a change in proximity or degree of contact between the probe and the surface based upon the amount of change. The indication of change may be based directly upon the calculated amount of change in the measured parameter or upon a calculated rate of change in the parameter. The rate of change may be relative to the time between measurements or the distance traveled by the probe between measurements, and may be calculated as a first, second, or other derivative of the tissue parameter.

Abstract: The finding that patients with Sjögren's syndrome exhibit a statistically significant increase in expression of BMP6 in the salivary gland relative to healthy control subjects is described. Also described is the finding that overexpression of BMP6 in the salivary glands of mice results in an increase in electrical potential across the salivary gland. Thus, methods of diagnosing a subject as having Sjögren's syndrome, or at risk for developing Sjögren's syndrome, by measuring the level of BMP6 expression in a salivary gland of a subject, measuring electrical potential in a salivary gland of a subject, or both, are disclosed. Also described are methods of treating a subject with Sjögren's syndrome by administering an agent that inhibits expression of BMP6 expression or activity. Further disclosed is the use of XIST and MECP2 as diagnostic and therapeutic targets for male Sjögren's syndrome patients.

Abstract: A bone fastener includes a shaft. The shaft includes a wall that defines a longitudinal cavity and a plurality of openings in communication therewith. The openings are disposed in axial alignment along the shaft and the wall is closed exclusive of the openings. In some embodiments, systems, spinal constructs, surgical instruments and methods are disclosed.

Abstract: A blood pump for supporting the heart may be provided that includes: a rotor with delivery elements; a rotor drive; a pressure sensor; and a regulating device that regulates a pressure or a hemodynamic parameter by means of control of the rotor drive. The pressure and/or the hemodynamic parameter may be determined by means of one or a plurality of hemodynamic sensors and/or from operating parameters of the pump. The regulating device may be suitable for regulating a hemodynamic parameter successively, such as periodically, to different target values. Using such regulation, the blood pump may be operated in an optimized manner, and operation of the blood pump may be varied in a targeted and patient-protective manner in order to attain certain goals.

Abstract: A method is disclosed for the mask-etching of a piercing element having an elongate shaft, a distally protruding tip, a proximal holding part, and a laterally open collecting channel that collects bodily fluid and extends along the shaft as far as the area of the tip, wherein a side of a double-sided etching mask is applied respectively to the two sides of a substrate and, under the action of an etching agent, the piercing element is formed as a part made by chemical blanking, wherein a channel side of the etching mask is provided with a channel etching slit for unilateral etching of the collecting channel.

Abstract: Disclosed are puncture sealing systems and methods of locating a puncture site within a vessel. The systems can include puncture locating dilators and access sheaths that are configured to locate the puncture site within a vessel so that the position of the puncture site relative to a distal end of the access sheath is known during a puncture sealing procedure.

Abstract: A lead for navigating small vessels and a catheter system for implantation of leads into small vessels. Veins that return blood to the heart against the force of gravity often have valves in them to prevent backflow of deoxygenated blood. Leads and catheter systems in accordance with embodiments of the invention allow cannulation and lead implantation in small, tortuous, obstructed, and difficult to access veins enabling a range of stimulation and sensing applications.

Abstract: A medical kit, including a split-tip catheter, a first intra-catheter stiffener element, a second intra-catheter stiffener element, a first guidewire, and a second guidewire. The split-tip catheter includes a first lumen in fluid communication with a first distal opening and a second lumen in fluid communication with a second distal opening with the first distal opening proximal to the second distal opening. The first intra-catheter stiffener element is designed for disposition in the first lumen, and the second intra-catheter stiffener element is designed for disposition in the second lumen. The first intra-catheter stiffener element includes a first guidewire lumen, and the second intra-catheter stiffener element includes a second guidewire lumen.

Abstract: An irrigation catheter for the treatment of the sinus anatomy is described. The catheter comprises a proximal portion, a rigid middle portion, and a flexible distal portion. The flexible distal portion comprises an irrigation tip and the proximal portion has a stiffness that is intermediate the stiffness of the rigid middle portion and the flexible distal portion. The irrigation tip has a tip opening and one or more radially facing openings. A method for irrigating or suctioning the sinus anatomy includes inserting an irrigation catheter into a patient's anatomy and irrigating or suctioning a target space.

Abstract: The present invention relates to a single-lumen vascular catheter to be inserted into a blood flow channel for the injection of a product by the venous or arterial route, comprising a tube having a hollow longitudinal body with a lumen, the lumen extending along the full length of the tube and being intended to permit the injection of a given volume of product at a prescribed flow rate the tube having lateral orifices which are of substantially identical size and are arranged in the longitudinal body substantially symmetrically about the longitudinal axis, near a distal end of the tube, an end surface at the distal end of the tube reducing a total surface area of the lumen starting from the distal end of the tube.

Abstract: A method of making a flexible medical article or tube, for example, a sheath for a vascular access device, is provided. The method can include extruding a polymer, for example, a polycarbonate-urethane copolymer, to form a tube and annealing the extruded polymer. The method can further include cutting the extruded tube to a desired length before or after annealing, flaring one end of the annealed tube and over-molding the flared portion onto a hub, and forming the other end of the tube into a tip. A sheath formed by such a method is also provided.

Abstract: A clot retrieval system comprises an elongate member having a proximal end and a distal end, and a clot engaging element at the distal end of the elongate member the clot engaging element having a collapsed delivery configuration and an expanded deployed configuration. The force that is applied on retraction of the elongate member is transmitted to the clot engaging element.

Abstract: A catheter is described for use in cannulating a bile duct in ERCP or sphincterotomy procedures. The catheter has a continuous compound curve that has first and second curves. The first and second curves have radii of curvature and lengths that orient the tip of the catheter selectively toward a bile duct.

Abstract: A stent includes a hollow wire formed into a stent pattern. The hollow wire includes an outer member, a lumen extending longitudinally within the hollow wire, at least one opening extending from an outer surface of the outer member to the lumen, and a surface area component within the hollow wire. The surface area component increases the amount of surface area available for tissue in-growth within the hollow wire. More than one surface area component may be utilized. Each surface area component may be disposed within the lumen or the at least one opening of the hollow wire. A pharmacologically or biologically active agent may be disposed within the lumen.

Abstract: The invention relates to an assembly for ultrasound-assisted manipulation at the female reproductive organs of large mammals, such as rhinoceros, elephant and hippopotamus, and to the use of the assembly. The assembly comprises a support pipe with an end element and a handle piece, a guide pipe provided in the support pipe, a puncture needle, an ultrasound head support provided at the distal end of the support pipe and having accomodators for an ultrasound head and the distal end of the guide pipe, wherein the axis of the ultrasound head and of the distal end of the guide pipe is in each case angled with respect to the horizontal axis of the support pipe such that the position of the tip of the puncture needle is in the ultrasound scan range of the ultrasound head.

Abstract: A stent is disclosed that has an elongated body composed of a bioabsorbable polymer having a proximal end, a distal end, two open spiral channels formed on the exterior surface of the body to provide fluid communication between the proximal end and the distal end. The stent also has a central lumen open at the proximal and distal ends of the stent for the passage of a guide wire. A method for using the stent and a kit containing the stent are also disclosed.

Abstract: A device and method is provided to gain access to interior body regions. The system includes a safety needle, a stylet assembly, a blade assembly, an obturator assembly, a cannula assembly, a handle assembly, an actuator assembly, and a lock assembly. The safety needle accesses an interior body region. The actuator assembly, lock assembly, and handle assembly interact to expose the blade assembly, after which the blade assembly expands the pathway created by the safety needle. The obturator then further expands the pathway and delivers the cannula assembly to the desired location. The safety needle, obturator assembly, blade assembly, handle assembly, actuator assembly, and lock assembly are removed, leaving the cannula assembly in place for future procedures.

Abstract: An endoluminal needle or punch is describes wherein the distal end of the endoluminal needle is able to articulate laterally out of the longitudinal axis of the steerable endoluminal needle. The endoluminal needle further comprise a blunted distal end configuration that is minimally traumatic. Under control by the user, at the proximal end of the endoluminal needle, a sharp stylet can be advanced to punch tissue and then be retracted to maximize safety. The endoluminal needle is configured for use within an introducer.

Abstract: An interventional medical device is provided that incorporates a forward-directed ultrasound or optical coherence tomography imaging system that is replaceable depending on how close the device is to the target site for a given medical procedure, the device and system integrated into a single minimally invasive device comprising a first probe housing, needle guide assembly and sheath, a sleeve lock for closing a normally open needle channel of a needle guide of the first distal assembly and a second probe and cable housing assembly locked to the first distal probe housing, needle guide assembly and sheath by a locking tab. The probe and cable housing assembly may comprise a linear phased ultrasound array and an accelerometer for orienting an image produced by the device with the gravitational field of the earth. The medical device can be in the form of an image guided catheter or probe, used in a body orifice, externally on skin tissue or subcutaneously.

Abstract: A medical tube 10 (drain tube 10) includes a main shaft tube 20, a flow path opening/closing mechanism 40, and a branch tube 30. The main shaft tube 20 internally has a main shaft side distal opening 21a and a main shaft lumen 21. The flow path opening/closing mechanism 40 brings the main shaft lumen 21 into a communicating state by applying pressure smaller than predetermined pressure, and brings the main shaft lumen 21 into a blocked state by applying pressure equal to or greater than the predetermined pressure. The branch tube 30 promotes a pancreatic juice pj to flow into a branch lumen 31, based on the applied pressure which is equal to or greater than the predetermined pressure.

Abstract: Multiple endoscopic devices and methods for closing perforations and/or creating anastomoses in tissue are described. For example, this document provides devices and methods for performing esophagogastric anastomoses and for closing esophageal perforations in a minimally invasive fashion. The devices and methods provided herein can also be used for, without limitation, colorectal anastomoses, any bowel anastomosis, gastric bypass anastomoses, and broader vessel anastomoses.

Abstract: The purpose of the “Dissolvable on-command Implant” is to act as a pressure equalizer tube in the eardrum, which has the unique characteristic that the tube can be dissolved with a specially formulated drop solution on-command. This tube can have various shapes and sizes, although the tube is usually a cylindrical tube with a hollow center, which maintains a ventilatory port for the middle ear space. With this design, the ear tube promotes drainage of middle ear fluid, lets air enter the middle ear, and allows for instillation of antibiotic drops.

Abstract: A system for use in monitoring blood circulation data of a user is disclosed.

Abstract: An end effector includes first and second jaws, a drive screw, a lead screw nut, and a drive beam. The drive screw is disposed within the first jaw. The lead screw nut defines a threaded bore that receives the drive screw. The lead screw nut is advanced along the drive screw as the drive screw is rotated in a first direction and is retracted along the drive screw as the drive screw rotates in a second direction. The drive beam is releasably coupled to the lead screw nut when the lead screw nut is in a retracted position. As the lead screw nut is advanced the drive beam is pulled by the lead screw nut. The drive beam is decoupled from the lead screw nut as the lead screw nut is advanced such that the lead screw nut is advanced relative to the drive beam.

Abstract: A catheter for ablation, mapping, injection, and directional control by an external magnetic system has a catheter body, an intermediate section, and a tip section having a tip electrode with an omnidirectional distal end and a concentric needle port. The tip electrode houses a magnetic device and a position sensor in an integrated configuration that facilitates a path in the tip section for extension and retraction of a component, including an injection needle, with reduced stress and friction. The integrated configuration is an efficient use of space in the tip electrode that allows the tip section to carry both the position sensor and the necessary volume of magnetic or magnetizable material to accomplish magnetic navigation. The catheter also includes a very soft and flexible intermediate section and an even softer and more flexible distal transitional section carrying additional magnetic members to facilitate remote magnetic navigation.

Abstract: A rotary, cutting medical device configured to be used during surgeries, such as ACL reconstruction, to drill holes and retrograde sockets is disclosed. The device may include a blade at a distal end that is movable between a first position aligned with a longitudinal axis of the device and a second position nonparallel to the longitudinal axis used to create retrograde sockets. The device may include a blade position control system connecting the blade to distal ends of both the outer tube and inner shaft and configured to control movement of the blade between first and second positions for drilling a hole and then creating a retrograde socket. The device may include a position retention system configured to retain the blade in the second position while allowing the inner shaft and blade to rotate to cut the socket.

Abstract: A nasogastric tube comprising at least one main lumen and at least one vacuum lumen comprising at least one suction port for sealingly drawing an inner wall of an esophagus thereagainst, said at least one suction port has a unique concave structure which substantially prevents tissue damage is provided.

Abstract: A coaxial dual lumen pigtail catheter utilizes coaxial construction incorporating a thin wall guiding catheter technology for the outer lumen and using a strong braided diagnostic technology for the central lumen to accommodate high-pressure injections. The catheter includes a manifold body to provide for connection to each of the dual lumens. The distal end of the coaxial dual lumen pigtail catheter tapers to a more flexible portion that is perforated by spiral side holes to provide for more undistorted pressure readings in the left ventricle. The coaxial dual lumen pigtail catheter also utilizes proximal straight sideholes at the end of the dual lumen portion and a taper between the dual lumen portion and the single lumen portion.

Abstract: An apparatus for supporting an operator in operating a medical device has a signaling device that signals a necessary operation of a component to be operated of the medical device. The signaling device emits a signal from the component to be operated and/or orients a signal onto the component to be operated. The signaling device emits at least one of an optical, an acoustical, and a haptical signal. The apparatus also includes a control apparatus that controls the signaling device based on the component operation to be performed, with the control by the control apparatus being independent of an operator request.

Abstract: Methods and apparatus provide treatment with a first therapeutic agent and a second therapeutic agent for an extended time. The first therapeutic agent may comprise a VEGF inhibitor and the second therapeutic agent may comprise an antiinflammatory, such as a non-steroidal anti-inflammatory, for example a cyclooxygenase inhibitor. One or more of the first therapeutic agent or the second therapeutic agent can be injected into the eye, for example injected into a therapeutic device implanted into the eye to release the injected therapeutic agent for an extended time.

Abstract: An intravascular catheter may include a distal end for insertion and a proximal end. The distal end for insertion may terminate with a tip. It may define at least two openings, of which one is proximal-most in the distal end. The distal tip may include a first radiopaque marker that is discretely positioned at the proximal-most opening and radiographically distinguishes the proximal-most opening from the rest of the distal end. The distal tip may also include a second radiopaque marker that marks the tip.

Abstract: A crushing tip dramatically increases a contact area between the crushing tip ultrasonic vibrated and a crystalline lens, compared to conventional crushing tips, and can efficiently crush and emulsify the crystalline lens. In the crushing tip, which is inserted into the crystalline lens of an eye of a patient at a time of an eye surgery for crushing, sucking, and discharging the crystalline lens by providing the ultrasonic vibrations, one or a plurality of partition walls is provided in such a way as to cross a through hole inside the through hole of a cylindrical tip main member. A tip of the partition wall may project from a tip of the tip main member, and a projecting portion may extend to an outer peripheral edge of the tip main member in a width direction as well.

Abstract: Catheters, vascular access devices using such catheters, methods of using such catheters and uses of such catheters are disclosed. The catheter comprises polymeric tubing including a composition that can be magnetized by application of an externally applied magnetic field, thereby magnetizing the tubing. Detection of the magnetic field provides location information for the catheter in the vasculature.

Abstract: According to one embodiment, a heart anchor tensioning device includes a main body and an elongate shaft. A tension member or tether may be inserted through a lumen of the elongate shaft to allow the shaft to be advanced over the tension member and within a body while the main body is positioned outside of the body. The device also includes an anchor coupling mechanism that is configured to engage a heart anchor and move the heart anchor into engagement with a first wall of the heart. The anchor coupling mechanism is able to lock the heart anchor to inhibit proximal movement of the heart anchor along the tension member. The device further includes a tension indicating mechanism that provides an indication of a force being applied to the heart anchor by the device.

Abstract: An imaging needle apparatus includes a body, a needle coupled to the body, a probe, and an imager. The needle includes a needle body and a sharp tip. The probe can be exposed from the needle or housed within the needle body according to an operation being performed with the image needle apparatus. The imager is disposed inside of the probe, and includes a plurality of photocells.

Abstract: An insertion tool having an insertion guide tube that maintains a perimodiolar or other pre-curved electrode assembly in a substantially straight configuration while preventing the electrode assembly from twisting in response to stresses induced by the bias force which urges the assembly to return to its pre-curved configuration. This generally ensures that when the electrode assembly is deployed from the distal end of the insertion guide tube, the electrode assembly and insertion guide tube have a known relative orientation.

Abstract: In some examples, a catheter includes an elongated body extending between a proximal end and a distal end, and defining an inner lumen, an outer body wall having a wall cross-sectional diameter, and a distal aperture at the distal end. A distal portion of the elongated body including a taper section that tapers from the outer body wall of the distal portion to the distal aperture, with the distal portion defining a plurality of slits open to the distal aperture. The distal aperture has an aperture diameter greater than zero and less than the wall cross-sectional diameter. The distal portion defining the plurality of slits is configured to substantially center the distal end around a guide member when the guide member is introduced in the inner lumen and extends through the distal aperture.

Abstract: Disclosed herein is a technique for insert-molding a tubular member to define a hollow portion. A circumferential portion of a circumferential wall of the tubular member is removed to expose the hollow portion to outside.

Abstract: Embodiments of the invention provide a system and method for accessing an internal body region using a catheter. The catheter includes a catheter body and a medication lumen positioned within the catheter body for delivering medication to the internal body region. An inflation lumen is positioned within the catheter body. A balloon is in fluid communication with the inflation lumen, and the balloon is configured to move between a collapsed position and an expanded position as fluid enters the balloon through the inflation lumen. An anchor covers at least a portion of the balloon on an outer surface of the catheter body and includes a movable section with a first retracted position and a second deployed position. Upon inflation of the balloon, the movable section of the anchor moves radially outward from the first contracted position to the second deployed position to secure the catheter in the internal body region.

Abstract: A stent is disclosed that has an elongated body composed of a bioabsorbable polymer having a proximal end, a distal end, two open spiral channels formed on the exterior surface of the body to provide fluid communication between the proximal end and the distal end. The stent also has a central lumen open at the proximal and distal ends of the stent for the passage of a guide wire. A method for using the stent and a kit containing the stent are also disclosed.

Abstract: A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. In this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion and by appropriately maneuvering each member, a continuous channel is created. Additional elements such as capture devices, dilators and injection catheters are also disclosed.

Abstract: A support apparatus for supporting a trocar while the trocar extends through a body wall of a patient includes an inflatable collar and a slidable abutment collar commonly connected for engagement onto the trocar following which the slide collar is released to slide along the trocar. The inflatable collar is inflated to a set size by a manually operable pump on the slidable collar operated by squeezing finger abutments together up to a latch so that threaded portion expels the inflation fluid. The abutment member is shaped to be received on an outer surface of the trocar and adjustable longitudinally of the trocar sleeve so as to be located at a selected position by a manually movable latch collar. The inflatable collar and slidably collar are held connected by a manually operable release.

Abstract: A method for delivering fluid to a brain of a subject is disclosed. This method includes the steps of: making one or more incisions in a subject; implanting one or more catheters in the brain of the subject; subcutaneously implanting a first part of a modular fluid delivery apparatus in the subject, the first part of the modular fluid delivery apparatus comprising a first length of tubing having a first end and a second end, the first end having a first fluid connector portion attached thereto and the second end being connected to the one or more catheters; and closing the one or more incisions such that the first part of the modular fluid delivery apparatus and the one or more catheters are entirely subcutaneously implanted within the subject.

Abstract: Provided is a ureteral stent (=50) including a bladder portion (=52) positioned in a bladder of a patient, a kidney portion (=54) positioned in a kidney and ureteral passageway of the patient, and one or more tethers (=56) coupling the bladder portion to the kidney portion. The ureteral stent allows urine to pass around a blockage, and allows a ureter orifice connecting the ureteral passageway to the bladder to move between a compressed state and an uncompressed state to prevent or minimize urinary reflux, flank pain, blood in the urine, etc., while allowing the bladder portion to move freely in the bladder to prevent the bladder portion from irritating the trigone muscle.

Abstract: A medical device is disclosed for delivering energy to a body lumen. The device includes an elongate member including a proximal portion and a distal portion adapted for insertion into a body lumen; and an energy delivery device disposed adjacent the distal portion of the elongate member, the energy delivery device including at least one elongate electrode arm, wherein the elongate electrode arm is configured to transition between a first configuration and a second configuration different than the first configuration. The at least one elongate electrode arm includes an active region configured to contact and deliver energy to the body lumen. When the elongate electrode arm is in the first configuration, at least a portion of the active region of the elongate electrode arm extends radially inward toward a longitudinal axis of the energy delivery device.

Abstract: In certain aspects, the present invention is directed to a device selected from (a) an operating microscope with an attached or attachable magnet and (b) a magnet that is configured for attachment to an operating microscope. In either case, the magnet is configured to allow a patient's tissue to be viewed through the operating microscope while at the same time permitting the creation of a magnetic field of sufficient magnitude and direction to move a magnetic therapeutic and/or diagnostic agent lying within the tissue to a preferred location in the tissue.

Abstract: A method of retrieving calculus in a renal pelvis of a living body involves positioning an enclosure in the renal pelvis, creating convection in the renal pelvis by introducing liquid into the renal pelvis from outside the living body to lift the calculus from a surface of the renal pelvis, retrieving the calculus in the renal pelvis by creating a vacuum in the enclosure while the enclosure is located in the renal pelvis so that the calculus are drawn into the enclosure, wherein the vacuum also draws the liquid into the enclosure, and withdrawing the enclosure from the renal pelvis while the calculus is in the enclosure.