Abstract: The present invention relates to devices, systems, and methods for improving memory and/or cognitive function by brain delivery of compositions of small interfering RNA or vectors containing the DNA encoding for small interfering RNA. Such compositions can be administered using devices, systems and methods for direct delivery of the compositions to the brain, or using devices, systems, methods of delivery, and compositions that deliver small interfering RNA or vectors containing the DNA encoding the small interfering RNA across the blood-brain barrier. The present invention also provides valuable small interfering RNA vectors, and methods for reduction of BACE1 levels in the hippocampus, cerebral cortex, or other regions of the brain that have beneficial effects on improving memory and/or cognitive function in a subject.

Abstract: This invention provides novel active agents (e.g. peptides, small organic molecules, amino acid pairs, etc.) peptides that ameliorate one or more symptoms of atherosclerosis and/or other pathologies characterized by an inflammatory response. In certain embodiment, the peptides resemble a G* amphipathic helix of apolipoprotein J. The agents are highly stable and readily administered via an oral route.

Abstract: A liquid embolic delivery system is provided for trapping an injected liquid embolic composition to prevent the liquid embolic from solidifying or otherwise passing outside of an embolization area. The delivery system includes a catheter for delivery of a liquid embolic composition and a containment member positioned at a distal end of the catheter which is shaped to trap the liquid embolic composition delivered through the lumen of the catheter. The containment member is formed as a brush, nest, sponge, swab, flexible sack, or other shape into and around which the liquid embolic composition is injected. The liquid embolic composition is trapped or meshes with the containment member during solidification containing the liquid embolic and preventing the embolic composition from passing into the blood stream.

Abstract: A catheter for delivering a medical implant in a patient's vasculature includes an elongate catheter having a distensible and frangible cap mounted across the open distal end thereof. The cap is distendable by pressure within the catheter to provide a bumper tip for guiding the catheter through a patient's vasculature. At the desired site for deploying the medical implant, the cap is ruptured to permit the implant to be advanced through the distal opening. Methods of using the catheter are also disclosed.

Abstract: An infusion mechanism for treating an intraluminal site in a patient includes an infusion catheter having an elongate body with a proximal body end defining at least one fluid supply orifice, and a distal body end. The elongate body defines a high head loss lumen in fluid communication with a first set of side ports defining a proximal infusion zone. The elongate body further defines a low head loss lumen in fluid communication with a second set of side ports defining a distal infusion zone.

Abstract: Methods for more uniformly delivering drugs or other treatment agents locally to the vasculature of a mammal are disclosed. These methods use one or more strategies to facilitate rapid mixing with the blood flowing past a device or otherwise improve the uniformity of drug delivery. Some of these strategies employ medical devices with diffusion members.

Abstract: A drug delivery catheter suited for cardiac procedures. The catheter includes a distal helical coil or other fixation and penetrating element which can be operated from the proximal end of the catheter to engage and penetrate the myocardium. Once delivered to the inside of the heart, the catheter can be used to inject small doses of therapeutic agents to the myocardium. The drug delivery system of the catheter allows for precise control of the dose injected into the heart wall.

Abstract: The catheter is positioned within an obstruction so that the distal end is positioned distal to the obstruction and proximal openings are positioned proximal to the obstruction. Blood enters the proximal openings and passes through the lumen to the distal end to perfuse blood distal to the obstruction.

Abstract: A device (10,110,210) for the expression of liquids, such as for the maintenance treatment of vascular catheters. A syringe (16; 116a,116b; 216) has a support structure (15,215) and includes at least two separate compartments (11,12; 111,112; 211,212) in which liquids for treating the lumen (L,283) of a catheter (C,280) with which the device is associated. The syringe further includes a closure plug (13,213) to be associated with the lumen being treated, which is coupled, by virtue of a releasable securement arrangement, to support structure (15,215). At least one plunger (16; 116a,116b; 216) is also included for infusing, in preset order, the different treatment liquids into the lumen to be treated, and the syringe further includes a duct (17,217) which is in fluid communication with the two compartments and is arranged through a through hole through the closure plug (13,213) in order to allow access of the treatment liquid to the interior of the lumen (L,283) upon activation of the plunger.

Abstract: A dihydroxyphenyl cross-linked macromolecular network is provided that is useful in artificial tissue and tissue engineering applications, particularly to provide a synthetic macromolecular network for a wide variety of tissue types. In particular, artificial or synthetic cartilage, vocal cord material, vitreous material, soft tissue material and mitral valve material are described. In an embodiment, the network is composed of tyramine-substituted and cross-linked hyaluronan molecules, wherein cross-linking is achieved via peroxidase-mediated dityramine-linkages that can be performed in vivo. The dityramine bonds provide a stable, coherent hyaluronan-based hydrogel with desired physical properties.

Abstract: Methods, systems and devices for delivering a diagnostic or therapeutic treatment, substance or device to a target area located within the body of a human or animal subject. A tissue penetrating catheter is positioned within a body lumen near the target area. A hollow penetrator is then advanced from the tissue penetrating catheter and penetrated from the body lumen in which the penetrating catheter is positioned into tissue in the direction of the target area. Thereafter, an elongate optical device (e.g., an optically equipped guidewire or catheter) is advanced through the hollow penetrator and continues to advance through tissue, in the direction of the target area. The elongate optical device is connected to an optical processing device (e.g., a spectrometer) which provides optically determined data (e.g., spectral reflectance, pH, oxygen concentration, temperature) indicating when the elongate optical device has entered the target area.

Abstract: Procedures for the stabilization of vulnerable plaque can comprise identification of the vulnerable plaque and the delivery of a stabilization composition to the location of the vulnerable plaque. For example, the stabilization composition can be delivered to an isolated portion of the vessel with the vulnerable plaque and/or alternatively or additionally using a profusion balloon that delivers the stabilization composition at the vessel wall near the vulnerable plaque. Suitable stabilization compositions can comprise a collagen crosslinking agent, an elastin stabilization agent, VEGF or a combination thereof. Vascular endothelial growth factor (VEGF) can be used to encourage endothelialization of the vessel wall near the vulnerable plaque.

Abstract: The present invention relates to locking compositions, kits containing the locking compositions and methods for maintaining the patency of vascular access devices or intravascular delivery devices employing the locking compositions. The locking compositions contain water, an anticoagulant and a viscosity agent and are free of heparin and alcohol.

Abstract: A multi-lumen catheter assembly for use in the extracorporeal treatment of a body fluid of a patient. The catheter assembly includes an elongated catheter body having a pair of lumens extending therethrough, and a septum separating the lumens. The catheter body has an aspiration port in communication with a first lumen for transporting fluid withdrawn from a body vessel to a treatment unit, and an infusion port in communication with a second lumen for return of treated fluid to the vessel. The infusion port is positioned distal of the aspiration port along a length of the catheter body. A flexible member is provided, wherein the flexible member has an end receivable in the first lumen and another end engaged with the catheter body distal of the aspiration port. The flexible member is structured and arranged to maintain a spacing between the aspiration port and a wall of the vessel.

Abstract: Devices, systems, and methods for autoretroperfusion.

Abstract: Systems, devices, and methods for delivering treatment to the renal arteries are provided. Exemplary systems include a delivery catheter having a distal bifurcation, an introducer assembly comprising an introducer sheath in operative association with a Y-hub, wherein Y-hub includes a first port for receiving the delivery catheter and a second port for receiving a second catheter, and a constraint assembly for holding the distal bifurcation of the delivery catheter in a low-profile configuration when it is advanced distally beyond the introducer sheath.

Abstract: This invention relates to methods of enhancing the permeability of blood vessels to therapeutic agents.

Abstract: A device suitable for removing material from a living being is provided, featuring an infusate pump, and an aspiration pump, both powered by a motor. The aspiration pump and infusate pump preferably feature a helical pumping mechanism, and operate at a high rate of rotation, thereby ensuring adequate pumping performance and flexibility. Additionally, a narrow crossing profile is maintained, ensuring that the device may reach more tortuous regions of the vasculature. In one embodiment, the system comprises a wire-guided mono-rail catheter with a working head mounted on a flexible portion of the catheter that can laterally displace away from the guide wire to facilitate thrombus removal. The working head may be operated to separate and move away from the guide wire to come within a closer proximity of the obstructive material to more effectively remove it from the vessel.

Abstract: A liquid embolic delivery system is provided for trapping an injected liquid embolic composition to prevent the liquid embolic from solidifying or otherwise passing outside of an embolization area. The delivery system includes a catheter for delivery of a liquid embolic composition and a containment member positioned at a distal end of the catheter which is shaped to trap the liquid embolic composition delivered through the lumen of the catheter. The containment member is formed as a brush, nest, sponge, swab, flexible sack, or other shape into and around which the liquid embolic composition is injected. The liquid embolic composition is trapped or meshes with the containment member during solidification containing the liquid embolic and preventing the embolic composition from passing into the blood stream.

Abstract: Methods, compositions, and kits for repairing damaged myocardium and/or myocardial cells including the administration cytokines are disclosed and claimed. Methods and compositions for the development of large arteries and vessels are also disclosed and claimed. The present application also discloses and claims methods and media for the growth, expansion, and activation of human cardiac stem cells.

Abstract: It has been determined that gamma sterilization of biodegradable polymer stents does not cause significant polymer cross-linking and collapse. Using sufficient spacing can lead to stents that display little if any detrimental effects from the procedure. In certain embodiments, using structures in the general region of about 100 micron spacing between the struts leads to highly functional stents that do not fuse. Further, the resulting stent has radially homogenous mechanical properties. Therefore, the stent has a uniform expansion within the lumen.

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: Steering engagement catheter devices, systems, and methods of using the same for accessing tissue, including the internal and external tissues of the heart, are disclosed. In at least one embodiment, a steering engagement catheter is provided, comprising an elongated tube having a proximal end, a distal end, and a first wall positioned circumferentially along a length of the elongated tube, the elongated tube configured such that a delivery catheter is capable of at least partial insertion into the elongated tube, at least one steering wire having a proximal end and a distal end, the distal end of the steering wire coupled to the first wall of the elongated tube at or near the distal end of the elongated tube, and a controller operably coupled to the at least one steering wire at or near the proximal end of the at least one steering wire.

Abstract: A pain management system for the infusion of drug to a wound site includes a pump connected to medical tubing which is connected to an improved infusion catheter for providing uniform delivery of fluid throughout an anatomical region. One method by which the infusion catheter is advanced to the wound site includes a guide needle that is placed within an introducer tubing. The needle is pierced through the patient's skin, after which the guide needle is withdrawn and discarded, leaving the introducer tubing in place partially under the patient's skin. The infusion catheter is then threaded through the introducer tubing and advanced to the wound site. The introducer tubing is then withdrawn and the infusion catheter remains in place to provide drug to the wound site. The introducer tubing is preferably peeled off of the infusion catheter and discarded.

Abstract: An electrosurgical apparatus for coagulating tissue used in combination with an endoscope which includes an elongated flexible tube having a plurality of side-ports located therethrough. The tube extends through a working channel of the endoscope and an ionizable gas is supplied to the tube at or near the proximal end of the tube. A diffusing member directs the ionizable gas from the proximal end of the tube through each of the side-ports towards the tissue. An electrode is used for ionizing the gas prior to the gas exiting the side-ports.

Abstract: Devices, systems, and methods for accessing the internal and external tissues of the heart are disclosed. At least some of the embodiments disclosed herein provide access to the external surface of the heart through the pericardial space for localized delivery of leads to the heart tissue. In addition, various disclosed embodiments provide devices, systems, and methods for closing a hole in cardiac tissue.

Abstract: Described herein are methods and devices for selectively applying fluids (particularly anesthetics) to a target tissue from within a blood vessel while minimizing the amount of fluid applied to non-target tissue. The injection catheters described herein may include an elongate body, a directional injector, and one or more holdfasts for securing the catheter before extending the injector. The methods of selectively applying anesthetic to a target structure generally include the steps of inserting an injection catheter into a body vessel, positioning the injection catheter within the body vessel near the target structure, anchoring the injection catheter before extending a directional injector from the injection catheter, and applying anesthetic from the injection catheter to the target structure.

Abstract: A therapeutic medical article is provided which comprises a medical article, a precursor compound and an activator compound. The medical article is adapted, upon administration to a patient, to release the precursor compound and the activator compound such that the activator compound interacts with the precursor compound and converts the precursor compound into activated form for local delivery. Specific examples of precursor and activator compound pairs include: (a) a nitrosothiol precursor and a nitric oxide donor, (b) plasminogen and plasminogen activator, and (c) fibrinogen and thrombin.

Abstract: The disclosure is directed to a sterilized medical device including a non-polymerized blend including a silicone matrix material and a radiation resistant component.

Abstract: The disclosure is directed to a method of treating a medical device. The method includes providing the medical device. The medical device has an opening defined by two contacting surfaces in a polyalkylsiloxane based portion of the medical device. The method further includes irradiating the medical device free of externally applied lubricant to sterilize the medical device.

Abstract: Heat transfer catheter apparatus and methods of making and using same are disclosed wherein fluid connection means is provided between the distal portions of two adjacent, thin-walled, high strength fluid lumens to define a closed loop fluid circulation system capable of controlled delivery of thermal energy to or withdrawal of thermal energy from remote internal body locations.

Abstract: The present invention provides a cardiac vascular occlusion system which includes inner and outer guide catheters and an occluding member disposed on the inner catheter. The occluding member may be deployed from a compressed to an expanded position to limit retrograde blood flow in a body lumen. The occluding member may be used when injecting a contrast agent into the body lumen.

Abstract: A system for preventing air from entering a first catheter of a multi-catheter system. Air is prevented from entering the proximal end of the first catheter by an axially elongate chamber having an impeller, the chamber being affixed to the proximal end of the first catheter. The air is removed through a port near the centerline of the chamber. Liquid removed with the air is returned to the chamber to minimize liquid loss during the procedure. A second catheter inserted through the chamber and into the first catheter is unable to entrain gas into the first catheter because any gas that enters the chamber is routed to the centerline of the chamber where it is removed. Inflow of fluid from an external pump scrubs the second catheter shaft of air bubbles attached by surface tension.

Abstract: A syringe assembly comprises a syringe barrel having an elongated body defining a chamber for retaining fluid, an open proximal end, a distal end and a frusto-conically shaped tip extending from the distal end and having a passageway therethrough in fluid communication with the chamber. The chamber has an inside diameter of at least 13.5 mm. A stopper is in fluid-tight engagement inside the barrel. An elongated plunger rod extends proximally from the stopper through the open proximal end of the barrel. A flange is positioned at the proximal end of the plunger rod. The flange is shaped and positioned to limit the distal motion of the plunger rod in the barrel by contacting the proximal end of the barrel. A tip cap is releasably connected to the tip for sealing the passageway and the chamber contains injectable liquid.

Abstract: The invention relates to a catheter system. The system comprises a catheter body having a chamber containing a low acoustic impedance medium. The catheter body includes an elongated body with an external surface and an ultrasound transducer having an external side between a first end and a second end. The ultrasound transducer is positioned over the external surface of the elongated body such that the first end is adjacent to the chamber.

Abstract: A multi-lumen catheter assembly with a two-piece hub is disclosed. The catheter includes a distal portion having a plurality of catheter lumens, wherein each of the plurality of catheter lumens includes a distal tip and a proximal lumen portion. The distal portion further includes a distal hub portion slidably disposed over the proximal lumen portion, wherein the distal hub portion includes a pivoting locking member. The catheter assembly further includes a proximal portion having a plurality of catheter extensions, wherein each of the plurality of catheter extensions fluidly communicates with at least one of the plurality of catheter lumens. The proximal portion also includes a proximal hub portion having a locking receiver, wherein the pivoting locking member is releasably engaged with the locking receiver.

Abstract: A system for moving particles suspended in a first fluid, and for infusing them into the stream of a second fluid, includes a catheter with a multi-lumen distal tip. The tip is formed with a plurality of parallel lumens, wherein each lumen has a predetermined diameter. Importantly, the diameter of each lumen is dimensioned to sequentially receive particles therethrough, to prevent the particles from flocculating before they enter the stream of the second fluid. A valve, affixed to the outside of the catheter, can be provided to regulate flow of the second fluid and thereby facilitate entry of the particles into the stream of the second fluid.

Abstract: An embolization system having a high packing fraction of embolic particles for use in occluding the flow of body fluid through a body vessel and a method for using such an embolization system are described. The embolic particles, which are made from a shape memory material, exhibit both a collapsed state and an expanded state. The embolic particles exhibit at least a bimodal particle diameter distribution in the collapsed state and expanded state with a particle packing fraction of at least about 0.85. The mixture of embolic particles is delivered into the body vessel in the collapsed state. The particle packing fraction of the mixture in its expanded state causes the occlusion of the flow of body fluid through the body vessel.

Abstract: Methods and devices for at least reducing the mass of, if not dissolving, renal calculi in situ are provided. In the subject methods, a renal calculus is contacted, e.g. flushed, with an acidic dissolution solution in situ, where the acidic dissolution solution is a solution of a strong, inorganic acid, e.g. hydrochloric acid. In many embodiments, the renal calculus is first enclosed in an isolated local environment of a device prior contact with the dissolution solution. Also provided are novel devices and kits for practicing the subject invention.

Abstract: A catheter for implantation into a patient having a catheter tube having a distal end, a means for trimming the distal end of the catheter tube after subcutaneous insertion of the tip of the catheter lumen into a desired position within the patient to form a trimmed end portion, and a means for selectively positioning each respective lumen of the trimmed end portion of the catheter tube into fluid communication with the respective first end of one attachment tube. The attachment tube is select fluid communication with a desired medical device.

Abstract: Methods for restoring blood flow in occluded blood vessels using an apparatus having a self expandable distal segment that is pre-formed to assume a superimposed structure in an unconstrained condition but can be made to take on a volume-reduced form making it possible to introduce it with a microcatheter and a push wire arranged at the proximal end, with the distal segment in its superimposed structure assuming the form of a longitudinally open tube and having a mesh structure of interconnected strings or filaments or struts. In a preferred embodiment, the distal segment has a tapering structure at its proximal end where the strings or filaments or struts converge at a connection point.

Abstract: A method of using an imaging catheter for activating a photodynamic agent is provided. The method generally includes four steps. First, an imaging catheter including a fiber optic cable is inserted within a body cavity or vessel. The fiber optic cable has a first end (e.g., proximal end) and a second end (e.g., distal end), and is configured to transmit electromagnetic irradiation from its first end to its second end and to transmit an image from its second end to its first end. Second, an image of a site of interest (e.g., the location of an aneurysm) within the body cavity or vessel is observed using the fiber optic cable. Third, a suitable photodynamic agent is applied to the site of interest. Fourth, the fiber optic cable is used to deliver a selected wavelength or wavelength range of electromagnetic energy to the site to thereby activate the photodynamic agent.

Abstract: A catheter may include a multiple lumen catheter tube, a hub attached to the catheter tube, and a first extension leg and a second extension leg attached to the hub. The multiple lumen catheter tube may include a longitudinal axis, an end, a first lumen, and a second lumen. The first lumen and the second lumen extend through the catheter tube along the longitudinal axis and each having an opening. The end of the catheter tube and the openings of the lumen may be disposed within the hub so that the opening of the first lumen is axially spaced with the end of the catheter tube. The first extension leg may be coupled to the first lumen and the second extension leg may be coupled to the second lumen for the separate delivery of fluids to the lumens.

Abstract: Clot disruption and dissolution are achieved using a catheter having the ability to infuse a thrombolytic agent, aspirate clot and fluid, and allow passage of a guidewire. Optionally, the catheter may also include a mechanical agitator for further disrupt clot in the presence of the thrombolytic agent. A flow resistor in the catheter provides for infusion and/or aspiration to be concentrated primarily at a clot treatment area in a blood vessel while also providing optional infusion and/or aspiration distal to the treatment area. In some embodiments, infusion, aspiration and guidewire passage occur through a common lumen. The thrombolytic agent, such as tPA, streptokinase, or urokinase, is directly released into the clot at the point where the agitator is engaging the clot. In this way, the thrombolytic activity of the agent is enhanced and the dissolution of the clot is improved.

Abstract: Improved methods of administration of thiol-based agents, such as NAC (N-acetylcysteine) and STS (sodium thiosulfate), are provided that protect against renal and other organ injury caused by diagnostic or therapeutic intra-arterial procedures which employ radiographic contrast agents.

Abstract: An apparatus and method is provided for preventing biofilm formation associated with an indwelling medical device. The method involves applying nanovibrational acoustic waves to surfaces of a medical device utilizing a piezo resonator to generate the waves.

Abstract: An endoluminal medical access device (1) is disclosed that is devised for endoluminal delivery to an extravascular target site (5) at a vasculature site of a human or animal body vasculature, such as the microvasculature.

Abstract: A method and apparatus for prevention and reduction of myocardial infarct expansion and heart remodeling by infusion of fluid into the pericardial space of the heart to created a hydraulic heart constraint. As a result of the constraint ventricular stress and dilation is reduced. Pressure in the pericardial sac is maintained at a safe level for the duration of treatment. Apparatus consists of a catheter and a fluid infusion system.

Abstract: Structurally supportive material is implanted or injected into cardiac veins as discrete masses at various sites in the cardiac venous system to reinforce the myocardium for the purpose of preventing, moderating, stopping or reversing negative cardiac remodeling due to various adverse cardiac conditions, both acute and chronic, or for the purpose of treating localize anomalies of the heart, or for both purposes. The sites may be arranged in a pattern about one or more chambers of the heart such that the masses cooperatively reduce stress in the chamber wall and reduce chamber size. Some patterns also cause a beneficial global reshaping of the chamber. These changes occur quickly and are sustainable, and have a rapid and sustainable therapeutic effect on cardiac function.

Abstract: An improved apparatus and method to catheterize passages is disclosed. The present invention provides a catheter having a soft flexible pre-formed distal tip, that when used in combination with commercially available guidewires of variable stiffness, results in the ability to control the direction and angle of wire advancement allowing cannulation of body passages, including those that arise at acute angles. The catheter can have a longitudinal axis, a proximal section and a distal section having a soft flexible pre-formed tip having a curvature of ninety degrees or greater and shape retention. The catheter can have an inner wall that defines a lumen that runs along said longitudinal axis forming a single continuous tube, a reinforcement braid disposed over the inner wall, and an outside covering disposed over the reinforcement braid. A spacer can be added between said wall liner and said reinforcement braid in the proximal end.