Abstract: A technique for treatment of plaque deposits on the arterial wall of a patient. The technique employs a high pressure jet of sterile saline solution directed at the plaque deposit. The high pressure jet is located at the distal end of a guide wire or catheter which is advanced through the vascular system to the site of the plaque deposit. Optional removal of the debris is via an evacuation lumen within the catheter. This particular technique directs the high pressure jet of fluid distal to the distal tip of the guide wire or catheter. This permits treatment of arteries, which are totally occluded, because the device need not transit the lesion to be effective. Some applications will use the high pressure jet of fluid to open a sufficient passage within the occlusion to permit further dilatation using a balloon integral to or passed over the device. An ultrasonic transducer array located adjacent the high pressure jet permits the attending physician to monitor the procedure.

Abstract: A device for removing a thrombus or other tissue deposit from the cardiovascular system, or from a natural or synthetic tubule or cavity found in the human body of a patient without the need to surgically access the location of the thrombus or other tissue deposit via a cut-down or other surgical procedure. A flexible metal or high pressure plastic tube conveys an extremely high pressure stream of sterile saline or other physiologic solution to at least one orifice at the distal end of the catheter. At least one jet is directed at the opening of a large exhaust lumen or other target. The jet is responsible for providing a localized negative pressure which entrains tissue into the jet from break-up of the debris. This jet can also provide stagnation pressure in the exhaust lumen which drives the tissue or thrombotic debris out of the exhaust lumen.

Abstract: A catheter system facilitates blood treatments such as apheresis that require simultaneous withdrawal and return of blood to a patient at high flow rates. A multi-lumen catheter has an external coupling device connected to a pump and blood treatment device. All of the lumens are designed to be used in the blood treatment process. The catheter includes two or more lumens for withdrawing blood and a return lumen for returning treated blood. The combined flow resistance of the withdrawal lumens is less than or equal to the flow resistance of the return lumen so that the flow rate of blood through the withdrawal lumens does not require a pressure differential sufficient to collapse the lumens. High flow rates are achievable through the catheter by using a pair of withdrawal lumens instead of a single, large withdrawal lumen. The lumens may be used for general medical use when the catheter system is not being used for exchange treatments.

Abstract: A reverse flow pump comprising two concentric passageways and an interior compartment having cut out portions in communication with a pump passageway for the directional flow of fluid relative to the pump, and a rotor positioned within the interior compartment for reversing the directional flow of fluid through a region in communication with another pump passageway. A reverse flow pump and cannula system is further provided comprising an inner cannula adjoining a pump passageway, and an outer conduit adjoining another pump passageway for the reverse flow of fluid relative to the pump.

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

Abstract: A device for removing a thrombus or other tissue deposit from the cardiovascular system, natural or synthetic tubule or cavity found in the human body of a patient without the need to surgically access the location of the thrombus or other tissue deposit via a cut-down or other surgical procedure. A flexible metal or high pressure plastic tube conveys an extremely high pressure stream of sterile saline or other physiologic solution to at least one jet at the distal end of the catheter. At least one jet is directed at the opening of a large exhaust lumen or other target. The jet(s) is responsible for providing a localized negative pressure which entrains tissue into the jet from break-up of the debris. This jet(s) can also provide stagnation pressure in the exhaust lumen which drives the tissue or thrombotic debris out of the exhaust lumen. Operation of the device with tip pressure greater than 500 psi provides this device with the entrainment and exhaust characteristics which contribute to its effectiveness.

Abstract: A single instrument is provided for simultaneously enabling fluid inflow, fluid outflow and pressure sensing during endoscopic surgical procedures. The instrument comprises three concentric tubular members, each of which has a distal end and a proximal end and each of which has a port connected to its proximal end for providing access to the interior of the associated tubular member. Each of the tubular members is coaxially aligned with the others and the central most tubular member is adapted to enable an elongated endoscopic instrument to be inserted axially therethrough. The invention also resides in the method of sensing pressure within a body cavity by utilizing such an instrument which enables a user to perform fluid inflow, fluid outflow and pressure sensing simultaneously.

Abstract: A technique is described for liquefying, or gelifying, a hardened, cataractous lens nucleus and aspirating the same. Heat or heated solution is delivered to the lens nucleus in vivo so that the heat or heated solution is placed in contact with the hardened nucleus in order to heat and liquefy the same. The lens nucleus is irrigated simultaneously with a cooled solution to thereby limit to a very small area where the heat or heated solution is present in the eye. This allows the surgeon precise control over which intraocular anterior segment structures are exposed to the heat or heated solution. The liquefied lens nuclear material is then aspirated from the eye. The above allows the removal of a lens nucleus through a 1 to 2 mm corneal or limbal incision which is smaller than the smallest incision allowable with previously known small incision cataract techniques. The above benefits the patient as it allows small incision cataract removal to be done in a way that is non-traumatic to intraocular structures.

Abstract: Suction control device intended to be fitted on an apparatus used in surgery, in particular in ophthalmic microsurgery, said apparatus comprising a handpiece (1) which may or may not be fitted with an ultrasound transducer for fragmenting a body which is to be extracted from the eye, and equipped with an orifice (17) for suctioning debris and connected to a system for pump-activated suctioning of liquid containing debris, characterized in that it includes means (18, 20) which, in the event of at least partial obstruction of the suction orifice (17) of the handpiece (1), are used for maintaining a continuous circulation of liquid between the active end of the handpiece and the pump-activated suctioning system of the apparatus.

Abstract: A needle for use with an apparatus for injecting fluid into a pierced body orifice has a hollow body having an axis and an internal bore along the axis, a blunt, closed first end, an open second end with an interface to a closure for attachment to a reservoir, and one or more side openings at substantially a right angle to the axis communicating from the internal bore to outside the hollow body. The needle may be curved or straight. A fluid injection system based on the needle uses such as squeeze bottles or syringes to express material through the needle.

Abstract: A sleeve apparatus for a phacoemulsification/irrigation and aspiration handpiece having an ultrasonic drive assembly attached to a hollow needle includes a compressible sleeve for establishing an annular passage around the needle and enabling the irrigation fluid to pass into an eye through a cornea/sclera wound while cooling the needle. The compressible sleeve includes a wall configuration for controlling compression of the sleeve in order to cause the compressible sleeve to shape and conform to the corneal/sclera wound and limit fluid egress from the wound. A hub is provided for attaching the compressible sleeve to the handpiece and enabling the needle to be angularly displaced within the compressible sleeve means during phacoemulsification.

Abstract: An apparatus having a pump reservoir and one or more microcatheters, for use in delivering and/or recovering fluid to and/or from a tissue site or for performing tissue engineering outside of the body. The apparatus can be used in a method to perform site specific microtherapy, including for the treatment of avascular necrosis, compartment syndrome, cerebral edema, and to improve skin flap survival in the course of reconstructive surgery.

Abstract: A pulsed irrigation handpiece comprises a pulsed irrigation liquid outlet for applying liquid pulses to a surgical site, a pump unit reciprocatingly driveable for pumping pulses of irrigation liquid through the outlet, an electric powered drive unit for reciprocatingly driving the pump unit, and a housing containing the pump and drive units. A irrigation inlet hose leads from the pump unit out of the handpiece housing and is connectable to a remote irrigation liquid source. An irrigation inlet hose adjacent the remote end thereof and electric conductors extending along the irrigation inlet hose transfer electric power from the supply unit to the drive unit in the handpiece. Removable tips are alternatively removably attachable to the irrigation liquid outlet adjacent the front end of the handpiece.

Abstract: A feedback controlled drug delivery system includes the automated sampling and analysis of a patient sample and dosing the patient based on the analysis. Automated sampling may be performed by direct analysis of the patient sample, such as for the measurement of a blood sample coagulation state or a glucose level. The drug delivery system includes a sample set that has a bidirectional patient tube that allows for delivery of the patient sample to an analyzer, and at another time, the infusion of a therapeutic drug. A controller receives a measurement from the analyzer, and based on that measurement, adjusts the delivery of the therapeutic fluid. The sample set has a quick--clear Leur fitting that allows for more effectively clearing a first fluid from a Leur fitting when starting a second fluid. The system also has a reagent cassette holder that protects, using a foam gasket, a reagent on a sample slide.

Abstract: To reduce damage to surrounding tissue while fragmenting some tissue such as for example not damaging the capsular wall while removing the lens during cataract removal surgery or not damaging artery or vein walls during bypass surgery while freeing the artery or vein to be transplanted, an incision is made for the insertion of surface--a handpiece tip. The tip is rotated and reciprocated ultrasonically at the same time so that tissue is fragmented by the combined motion of a fragmenting surface perpendicular to the surface and at an angle to the surface many times during a single revolution or part of a revolution.

Abstract: A multilumen catheter (1) of a type comprising two inner lumens (2, 3) defined by a wall (2A, 3A) for guiding a fluid (4), and two opposite ends (5, 6), namely a distal end (5) and a proximal end (6), characterized in that the distal end is formed of two elongated and discrete end portions (13, 14) located beyond a so-called dividing point (12) at a predetermined distance D1 from the proximal end (6), wherein said end portions, in a rest position of the catheter, extend parallel to the longitudinal axis thereof, each over a predetermined length (L1, L2) measurable between a free end (13A, 14A) and the dividing point (12), are each made of a flexible material, contain a segment of at least one lumen (2, 3) and have at least one channel (7, 8) for delivering and/or sampling the fluid.

Abstract: A drainage catheter for selective positioning within the human vasculature which includes a catheter body defining separate pressure and discharge lumens. A connector means at a proximal end of the catheter connects the pressure channel to a source of liquid under pressure. An inlet opening is positioned in the side of the catheter adjacent the distal end thereof and communicates with the discharge channel. The pressure channel extends from the proximal end distally forward of the inlet opening and then curves rearwardly to join the discharge channel at said inlet opening. The pressure channel is shaped to form a spray nozzle to direct pressurized fluid in the pressure channel across said inlet opening and into the discharge channel to create a suction adjacent the inlet opening. A preformed distal tip portion extends from the distal end of the drainage catheter.

Abstract: A long-term dialysis catheter system for use in a body of a patient includes a guide catheter having a guide lumen defined therein, wherein the guide lumen defines a distal guide orifice. The system also includes a tissue ingrowth member secured to an outer surface of the guide catheter. The system further includes an original dialysis catheter positionable between an original inserted position and an original removed position, wherein (i) the original dialysis catheter has an original ingress lumen and an original egress lumen defined therein, (ii) the original ingress lumen defines an original distal ingress orifice, and (iii) the original egress lumen defines an original distal egress orifice.

Abstract: This invention provides a medical device for delivering volumetric quantities of a first and a second biochemically reactive fluid comprising a first container having an opening, the first container being adapted to contain the first biochemically reactive fluid; a second container having a second fluid opening adjacent the first fluid opening, the second container being adapted to contain the second biochemically reactive fluid; a spray unit for separately atomizing the first and second biochemically reactive fluids into an aerosol with at least one energy source of a liquid energy, a mechanical energy, a vibration energy, and an electric energy; a fluid pressurizer for pressurizing the first and the second biochemically reactive fluids for delivery under pressure through the spray unit onto a surface; and wherein the first and second biochemically reactive fluids first mix on the surface.

Abstract: A phacoemulsification handpiece for ophthalmic surgical procedures includes a needle having a tip and connected to a source of ultrasonic energy, for cutting and/or fragmenting eye tissue along with a conduit for introducing irrigation fluid proximate the needle tip. The handpiece also includes separate structure for introducing a viscous fluid, such as a viscoelastic material, proximate the needle tip as well as bore through the needle and handpiece for aspirating irrigation fluid, viscoelastic material end cut and/or fragmented eye tissue. An accumulator, connected to the housing is provided for containing a supply of viscous fluid. A diaphragm assembly and a manual valve are provided for delivering viscous material to the needle tip.

Abstract: A dual lumen catheter is provided having an elongate body defining coaxial intake and return lumens and a junction containing a proximal end of the body with parts of the lumens in the junction constrained in side-by-side relationship. First and second connecting tubes are engaged in the junction and extend generally longitudinally away from the main body. The junction provides fluid continuity between the first connecting tube and the intake lumen and between the second connecting tube and the return lumen to permit the catheter to be used for simultaneous dual flow. The distal end of the catheter includes a conical transition portion at which the exterior diameter of the dual lumen main catheter section is smoothly reduced to that of an open-ended, single lumen cylindrical tip section of lesser diameter.

Abstract: A medical fluid suctioning device for selectively applying varied levels of suction pressure at a device-tissue interface includes a direct "trumpet"-type control mechanism in conjunction with a "venturi"-type control. A valve manifold is adapted to couple a vent pathway and a suction pathway simultaneously to the vacuum conduit adapted for connection to a vacuum source. The amount of resistance to flow due to vacuum pressure is adjusted simultaneously in both the vent pathway and the suction pathway in order to achieve controlled, selected levels of suction. Similarly shaped valve apertures are provided in inverse and reciprocal orientation along an axis of motion of a valve manifold. The apertures translate across ports to the suction and venting pathways simultaneously to vary applied suction to those pathways inversely.

Abstract: A double lumen tubing which is adapted for use as a catheter. The tubing accommodates multiple sized guidewires and has increased resistance to kinking. A lumen wall divides the outer tubular wall into the two lumens and has a central arcuate portion shaped to allow insertion of relatively large guidewires through one of the lumens, while still leaving space for smaller guidewires through the other lumen. Resistance to kinking is increased by varying internal diameters or axes of the interior lumen walls to increase the wall thickness of the tubing in selected areas, and by varying the thickness of the wall that divides both lumens in the middle or where the dividing wall meets the outer tubular wall.

Abstract: A assembly for use in performing a medical procedure within a region in a body of a patient having a vessel therein comprising a multi-port introducer adapted to be inserted into a vessel of the patient. The multi-port introducer includes an elongate body having proximal and distal extremities and has spaced-apart lumens extending from the proximal extremity toward the distal extremity. The elongate tubular body has ports therein at the proximal extremity in communication with the lumens and openings in the distal extremity in communication with the lumens. The elongate tubular body has a length so that it can extend from the exterior of the body to said region in the body. A plurality of catheters is provided. Each of the catheters is slidably disposed in a separate lumen in the multi-port introducer and has a distal extremity adapted to be disposed in the vessel of the patient.

Abstract: Blood is circulated through a multiple lumen catheter which connects between a vein of a patient and the blood treatment device. The catheter and the lumens thereof each define distal ends which are positioned within the vein. By this invention, one withdraws blood from the vein through one of the lumens at a flow rate of at least about 200 ml./min. while also inserting blood into the vein through another of said lumens at a similar flow rate. The distal ends of the lumens are longitudinally spaced from each other by no more than about 5 mm. It has been found that the following advantages can be achieved by this method: less clot formation coupled with low direct blood recirculation and longer catheter survival. Also, the catheter of this invention works well in either direction of blood flow through the respective lumens.

Abstract: The invention provides a dual lumen catheter comprising outer and inner tube materials. A main portion extends axially and has a selected first cross-section. The main portion includes main portions of the respective outer and inner tube materials which together define an annular intake lumen and a main part of a return lumen contained inside the intake lumen. A tubular transition portion is made up integrally of both the outer and inner tube materials and has a second cross-section smaller than the first cross-section. The transition portion extends axially from the distal end of the main portion and this can be extended to include a tip portion made up only of outer tube material and which extends axially from the transition portion. The transition portion on its own, or with the tip portion, defines a tip section which is a continuation of said main part of the return lumen to complete the return lumen.

Abstract: A method for manufacturing an irrigation/aspiration (I/A) handpiece for use during cataract eye surgery and the I/A handpiece so manufactured are provided. The I/A handpiece comprises an aspiration cannula which extends through a hollow, inseparable housing assembly to an aspiration port, and an irrigation cannula concentrically surrounding a portion of the aspiration cannula outside the housing assembly. The irrigation cannula is in fluid communication with a hollow interior region of the housing assembly, including an irrigation port. The I/A handpiece is manufactured by insert molding the irrigation cannula within a front housing. The aspiration cannula is inserted through the irrigation cannula and the front housing and within a rear housing which contains the aspiration and irrigation ports. An interconnecting member is molded to fill the gap between the front housing and the rear housing, thereby providing an integral, inseparable housing assembly.

Abstract: A multiple lumen catheter assembly and methods for inserting the same are provided. The assembly includes a splittable membrane joining a first catheter and a second catheter for allowing the catheters to be at least partially longitudinally split from each other. Each catheter has at least one lumen extending longitudinally through the catheter. One method for inserting the assembly includes making an incision near the area to be catheterized, at least partially splitting the distal end regions of the catheters from each other by splitting apart the splittable membrane, and inserting the distal end regions of the catheters in a juxtaposed relation through the incision and into the area to be catheterized. In another method, the catheters are first tunnelled subcutaneously by pulling the distal end regions of the catheters in the assembly through a tunnel and outwardly from the tunnel near the area to be catheterized, leaving proximal end regions at least partially within the tunnel.

Abstract: Apparatus for cleaning a vessel having a stenosis therein comprising first and second balloon catheters. Balloons are disposed on opposite sides of the stenosis in the vessel and form a closed chamber in the vessel. A therapeutic catheter having a distal extremity is disposed in the chamber. Irrigation liquid is supplied to the chamber and liquid is aspirated from the chamber to form an aspirate. The distal extremity of the therapeutic catheter is moved to cause the material forming the stenosis to be removed from the wall of the vessel and to be broken into particles which are removed with the aspirate.

Abstract: The invention relates to a suction/rinsing instrument comprising a suction channel for removing fluid and a rinsing channel for supplying rinsing fluid. The suction channel is provided for receiving an auxiliary instrument. Via a grip part of the instrument, the auxiliary instrument, for example a forceps, may be controlled. The auxiliary instrument is fixed on the suction/rinsing instrument by way of a receiver. The receiver can be traversed in the axial direction of the shank, the traversing is effected via operating means provided on or near the grip part, so that the operator, without having to let go of the grip part, may selectively, with only one hand, push forward the auxiliary instrument an thus operate or also retract the auxiliary instrument and clear the suction/rinsing channel.

Abstract: A drainage catheter comprises a tubular basic catheter body defining separate catheter lumens respectively comprising a pressure channel and a discharge channel. Connectors are provided at the proximal end of the catheter for respectively connecting the pressure channel to a source of liquid under pressure and the discharge channel to a discharge receptacle. An inlet opening is positioned in the side of the catheter adjacent the distal end thereof. The discharge channel communicates with the inlet opening, while the pressure channel extends from the proximal and distally forward of the inlet opening and then curves rearwardly to join the discharge channel at the inlet opening.

Abstract: An endoscopic surgical instrument for aspiration, irrigation, and blowing gas adjacent a surgical site is provided. The instrument includes a handle portion and a cannula member extending distally from the handle portion. First and second connection ports are supported by the handle and are in fluid communication with the cannula member. An insertion port is also supported by the handle portion and is preferably axially aligned with the cannula member. A blow tube is removably positioned within the cannula member via the insertion port. The first and second connection ports are adapted to communicate with a source of irrigation fluid and a vacuum source and the blow tube is adapted to be connected to a source of pressurized gas such that irrigation fluid, aspiration, and/or pressurized gas can be selectively provided via the cannula member at the surgical site.

Abstract: The outer cannula of an ophthalmic irrigator-aspirator has rigid tip and butt sections and a more flexible central section. The central section can be an elastomeric sleeve that extends between the tip and butt sections. The outer cannula includes reinforcement members that prevent the elastomeric sleeve from becoming completely closed by compression caused by a tight fit in an incision in a patient's cornea. The reinforcement members may be rigid or somewhat flexible.

Abstract: A protective positionable flexible cover or sleeve for suction apparatuses where a suction catheter or other suction device is covered prior to and subsequent to suction procedures to prevent contamination of the suction catheter or other suction device for subsequent use, and for prevention of contamination transfer to medical workers and health facility environs.

Abstract: An improved system for removing thrombus from blood vessels comprising a catheter shaft having proximal and distal ends, designed to be advanced through a hemostasis valve and guide catheter and over a guidewire for placement of its distal end at a point proximal to a thrombus, the catheter shaft defining at least one longitudinally-extending lumen, the catheter having a guidewire retainer which retains the guidewire within the catheter in a peripheral or non-centered part of the catheter cross-section, the distal tip of the catheter being angled back from the guidewire retainer to allow the catheter to follow the guidewire around tight bends and across restrictions easily; a suction device in fluid communication with the proximal end of the catheter for providing vacuum down the catheter lumen to the distal tip, for drawing thrombus into the lumen; and the lumen terminating in an angled tip at the distal end, the angled tip improving the removal of thrombus adhering to the vessel wall and reducing clogging o

Abstract: A partially collapsible catheter is formed as a substantially-flattened tube of flexible, collapsible plastic; a spacing member disposed within such tube allows the tube to substantially flatten and collapse in the absence of infusion fluid, but maintains at least one channel open within the tube for allowing fluid to be aspirated therethrough. During infusion, infusion fluid expands the catheter to a generally rounded configuration. The spacing member can be incorporated within a single lumen catheter; alternatively, the spacing member can divide the tube into first and second lumens for providing a dual lumen catheter.

Abstract: Techniques for infusing drugs into the brain to treat neurodegenerative disorders by system of an implantable pump and catheter. The drugs are capable of altering the level of excitation of neruons in the brain. A sensor is used to detect an attribute of the nervous system which reflects the hyperexcitation of the nerve cells projecting onto the degenerating nerve cells. A microprocessor algorithm analyzes the output from the sensor in order to regulate the amount of drug delivered to the brain.

Abstract: Vascular access catheters that include a catheter body having one or a plurality of lumens longitudinally extending therethrough. The lumens have cross-sectional shapes that enhance kink resistance, support reliable slit valve operation, and couple securely with the outlet stem of a multiple reservoir implantable access port. In a dual lumen catheter disclosed, each of the lumens are defined by a plurality of longitudinally extending generally linear inner wall surfaces. The inner wall surfaces when viewed in a transverse cross section of the catheter body taken normal to the longitudinal access have trapezoidal shapes. Other cross-sectional shapes are also illustrated. A generally planar septum separates the pair of lumens. The lumens effect a fluid-tight mechanical engagement between the D-shaped outlet prongs of a conventional outlet stem of an implantable dual reservoir access port, highly reliable two-way, three-position slit valves may be associated with each of the lumens.

Abstract: A multiple-lumen catheter includes a first generally-cylindrical flexible lumen extending between a first distal end and a second proximal end; the first lumen is sufficiently rigid to maintain its generally-cylindrical shape when negative pressure is applied thereto for aspirating fluid from the blood vessel. A second flexible lumen also extends between a first distal end and a second proximal end alongside the first lumen. The first distal end of the second lumen is sufficiently pliable to collapse and flatten in the absence of any positive fluid pressure applied to the second lumen; upon the application of a positive fluid pressure to the second lumen, the collapsible first, distal end of the second lumen expands and assumes a generally-cylindrical shape for introducing fluid into the blood vessel.

Abstract: A multi-lumen percutaneous introducer for introducing a catheter and fluids into a body lumen includes an introducer sheath having a first lumen for receiving a catheter and a second lumen within the sheath having a proximal opening for receiving fluids and a distal opening for delivering fluids into the body lumen. A port in alignment with the first lumen receives the catheter when the catheter is inserted through the first lumen into the body lumen.

Abstract: The invention provides a cylindrical elongate body extending from a proximal to a distal end, the body defining two similar longitudinally extending lumens separated by a septum and a further lumen defined within the septum, a tip extending from the distal end of the body defining a part of the further lumen, a connector at the proximal end, tubes coupled to the connector and in fluid communication through the connector one with each of the respective lumens, the body defining openings providing access one to each of the longitudinally extending lumens, the openings being spaced from one another longitudinally of the body and the further lumen extending longitudinally beyond the longitudinally extending lumens and through the tip, the further lumen terminating at an opening at the distal end of the tip and the tip being convergently tapered as it extends longitudinally from the body and the longitudinally extending lumens being blocked immediately adjacent and distally of the openings.

Abstract: A double lumen tubing which is adapted for use as a catheter. Both lumens of the double lumen tubing have equal cross-sectional areas to provide equivalent flow volumes through each lumen. The lumen wall which divides the outer tubular wall into the two lumens has a central arcuate portion which is shaped to allow insertion of relatively large guidewires through the lumen while at the same time maintaining equivalent cross-sectional areas for each lumen. Resistance to kinking is increased by varying external diameters of each lumen to increase the wall thickness of the tubing in selected areas and by varying the thickness of the wall that divides both lumens at the two joints where the wall meets the tubular wall.

Abstract: A drainage catheter comprises a tubular basic catheter body defining separate catheter lumens respectively comprising a pressure channel and a discharge channel. Connectors are provided at the proximal end of the catheter for respectively connecting the pressure channel to a source of liquid under pressure and the discharge channel to a discharge receptacle. An inlet opening is positioned in the side of the catheter adjacent the distal end thereof. The discharge channel communicates with the inlet opening, while the pressure channel extends from the proximal and distally forward of the inlet opening and then curves rearwardly to join the discharge channel at the inlet opening. In one embodiment of this invention the pressure channel defines a distal portion that is of rigid and fixed dimension to define a spray nozzle of precise, unchanging dimensions.

Abstract: A method of and apparatus for removing a thrombus deposit from the cardiovascular system of a patient without the need to surgically access the location of the thrombus deposit via a cut-down or other surgical procedure. A catheter is inserted percutaneously into the patient at a convenient location either directly or over a previously positioned guide wire. The distal end of the catheter is advanced under fluoroscopy to the site of the thrombus deposit. A balloon is inflated to stabilize the position of the distal end of the catheter within the center of the vessel lumen. A flexible metal tube conveys an extremely high pressure stream of sterile saline solution to at least one jet at the distal end of the catheter. At least one jet positions the thrombus deposit for emulsification by at least one other jet. By directing the jets toward the orifice of the large evacuation lumen of the catheter, a stagnation pressure is induced which propels the emulsion proximally for disposal.

Abstract: A cannula system for a biventricular cardiac support system or a cardiopulmonary bypass system wherein a first cannula having a pair of side-by-side lumens is adapted to be positioned within the left atrium and left ventricle and aorta of a patient. Blood from the left atrium and left ventricle drains into one of the lumens in the first cannula and is conveyed to the inlet of a pulsatile flow cardiopulmonary bypass pump from where it is pumped through the other lumen into the aorta of the patient. An inflatable balloon is provided at the distal end of the first cannula for holding the distal end of the cannula in the aorta above the aortic valve. The first cannula includes an axially extending bore communicating with a space in the aorta between the inflated balloon and the aortic valve for conveying cardioplegic solution to the space communicating with the left and right arteries of the patient.

Abstract: A surgical suction cutting instrument includes a tubular outer member defining a cutting chamber with an opening, an inner member with a distal cutting edge movably received in the outer tubular member and a flushing mechanism for supplying fluid to the cutting chamber via an outlet communicating with the cutting chamber. The cutting edge of the inner member is disposed within the cutting chamber adjacent the opening to engage bodily tissue through the opening, and a lumen is preferably defined through the inner tubular member in communication with the cutting chamber for aspirating cut bodily tissue. In one embodiment, the flushing mechanism includes a tubular member disposed alongside the outer tubular member and having an outlet communicating with the cutting chamber for supplying fluid to the cutting chamber to prevent and clear clogging of the passage without the need of having to remove the cutting instrument from the surgical site.

Abstract: A dual lumen vascular catheter with expanding side portal includes a cylindrical tubing with one or more lumens inside. An effusion portal is located on the side of the tubing at an end of one lumen. The portal is oval-shaped, with an open-ended slit connected to an end of the oval opening. The slit is thereby expandable, allowing for vacuum relief during aspiration of blood in the event that the catheter is lodged with the portal pressed against an inner wall of the vein.

Abstract: A surgical access device comprises an introducer with a main endoscopic channel and an auxiliary or secondary instrument channel. The introducer exhibits an extremely narrow cross-sectional profile in order to minimize the size of the portal or other entry point necessary to gain access into the patient's body, thereby minimizing pain and discomfort to the patient and allowing a wide variety of endoscopic procedures to be performed on an out-patient basis. The narrow profile of the introducer is maintained upon introduction by a guide channel which can be stored in a first position so as to closely conform to the profile of the introducer. The guide channel is provided with a set in order to maintain its stored position upon introduction; however, post introductively, the set in the guide channel can be readily released in order to deploy the guide channel and allow insertion of a secondary surgical instrument.

Abstract: A process for the filling of the pumping chamber of a gas pressure driven medicine pump. A pillow filled with the propellant is formed which consists of a material permeable to the propellant. The pillow filled with the propellant is inserted into the propellant chamber which is evacuated. Then, the propellant chamber is sealed gas tight. Subsequently, the propellant diffuses through the wall of the pillow into the propellant chamber. The process according to the invention offers the possibility of filling the pumping chamber in a simple manner without allowing the penetration of foreign gases.

Abstract: Described is a closed chest intravascular catheter system for a simultaneous biventricular approach to 1) intravascular cardiopulmonary surgery and 2) acute or prolonged mechanical circulatory support.