Abstract: Disclosed herein are devices for minimally invasive vertebral augmentation and restoration of spinal lordosis using a steerable cannula assembly. When deployed, the articulating cannula, including an outer cannula and an inner cannula extending into a central lumen of the outer cannula and coupled to each other at their distal ends, can be manipulated to curve/bend the body of the articulating cannula. This manipulation is used to create a void within the interior body and may also be used to control delivery of a treatment element to the interior body.

Abstract: Described here are devices and methods for performing atherectomies. Generally, the atherectomy devices include a handle, a cutter assembly, and a catheter or catheter assembly therebetween. The cutter assembly includes a cutter housing and a cutter having a first cutting element and a second cutting element, each of which can be rotated relative to the atherectomy device to cut occlusive material.

Abstract: Embodiments of an expandable sheath can be used in conjunction with a catheter assembly to introduce a prosthetic device, such as a heart valve, into a patient. Such embodiments can minimize trauma to the vessel by allowing for temporary expansion of a portion of the introducer sheath to accommodate the delivery apparatus, followed by a return to the original diameter once the prosthetic device passes through. Some embodiments can include a sheath with inner and outer layers, where a folded portion of the inner layer extends through a slit in the outer layer and a portion of the outer layer overlaps the folded portion of the inner layer. Some embodiments include an elastic outer cover positioned outside the outer layer. Embodiments of the present expandable sheath can avoid the need for multiple insertions for the dilation of the vessel, thus offering advantages over prior art introducer sheaths.

Abstract: The present application relates to a molecular exchange device (1) for use with an analysis and control apparatus and a method of manufacturing a molecular exchange device.

Abstract: The intravascular catheter has a polymeric inner tube, a reinforcing inner jacket which is spirally wound over the inner tube and which becomes progressively softer from a proximal end to a distal end, and a polymeric outer sheath extruded over the inner jacket. The reinforcing jacket includes helical coiled wires wound over the inner tube in order to provide improved multi-axial mechanical properties.

Abstract: A hybrid cannula may comprise a first portion formed from a first material, a second portion formed from a second material overmolded to the first portion, a third portion formed from a third material and a fourth portion formed from a fourth material overmolded to the third material. The third portion is coupled to the first portion. The first portion may prevent the proximal end of the hybrid cannula from being pushed through a portal. The second portion may include a membrane and the fourth portion may include a dam, the dam defining interior spaces thereof between the proximal and distal ends of the hybrid cannula. The membrane and/or dam may prevent liquid from projecting during insertion or removal of instruments. The distal end of the hybrid cannula may comprise a variety of features.

Abstract: A catheter shaft and methods for making and using the same. The catheter shaft may include a core portion, a cap portion, and one or more lumens. The cap portion may be disposed on or over a section of the core portion and define a region with a different exterior or interior surface characteristic. For example, the cap portion may define a lubricious region along the catheter shaft. Manufacturing the catheter shaft may include a modified co-extrusion process that incorporates a flow valve on at least one of the material supply lines so that the supply line can be regulated by a user.

Abstract: A flexible tubular portion for an endoscope having a central axis includes a spiral tube, an outer layer covering the outside of the spiral tube, and an inhibiting portion. The spiral tube includes, along the longitudinal direction of the central axis, a closely wound portion to which an initial tension is applied, and sparsely wound portions provided on the distal side and the proximal side of the closely wound portion. The inhibiting portion inhibits the movement of at least a part of the sparsely wound portions relative to the outer layer in the longitudinal direction of the spiral tube.

Abstract: The present disclosure provides various embodiments of products for a tapered catheter tip and methods of forming a tapered distal tip for a catheter. An exemplary tapered catheter tip of the invention includes a proximal segment, a distal segment, and a midsection there between. The midsection includes at least two tip materials in an overlapping configuration and the distal segment includes one of the at least two tip materials.

Abstract: A catheter assembly employs an outer catheter with a pre-formed distal end and an open lumen. An inner catheter having an open lumen and a pre-formed distal end is movably disposed within the outer catheter. Relative rotation and extension of the inner and outer catheters provides the distal end of the catheter assembly with an adjustable range of two- and three-dimensional shapes. The inner catheter can include sections of varying stiffness, such that extension of the inner catheter within the outer catheter modifies the shape of the outer catheter's pre-formed distal end. One or both of the outer and inner catheters includes an occlusion balloon attached to the distal end thereof. The adjustable shaping of the catheter assembly's distal tip provides an improved system for locating and cannulating cardiac venous structures, particularly the coronary sinus via the right atrium.

Abstract: A medical device for advancement over a guidewire includes a number of lumens therein including a working channel lumen, one or more control wire lumens, and a guidewire lumen. A flexible support within the device includes a number of interlocking elements that resist longitudinal compression, transfer rotational torque, and can bend side to side. The flexible support also includes a slot that is aligned with the guidewire lumen. An outer jacket includes a perforation, slot, slit, or thinned area that is aligned with the slot in the support member and the guidewire lumen in order to allow a device such as a guidewire to be removed from the guidewire lumen and through the support member.

Abstract: An anastomosis device that includes a catheter body is provided. A distal end portion of the catheter can include a spring device to prevent the formation of blood clots and to improve the flow of urine out of the catheter. The device may be used, for example, in performing procedures such as a vesico-urethral anastomosis in association with a radical prostatectomy, or with an end-to-end urethral anastomosis.

Abstract: The present application relates to method of arresting telescopic endwise relative movement in a medical device between an end portion of an elongate member, preferably being a cylinder, and an end portion of a tube, preferably being a cylindrical tube, that receives the end portion of the elongate member. The method is of particular use in the construction of stent delivery systems. In one embodiment, the method comprises providing a length of deformable blocking material; imparting relative endwise movement to draw the blocking material, into the gap and reversing the direction until the blocking material length suffers deformation.

Abstract: A catheter includes a proximal shaft, a distal shaft including a proximal end portion having an inner cavity into which a distal end portion of the proximal shaft is fitted, and a core wire extending through the inner cavity of the distal shaft. The core wire has a proximal end portion that is joined to a cutout portion formed in the distal end portion of the proximal shaft. Joining means are formed along a joint surface between the proximal end portion of the core wire and the cutout portion. When the joining means are divided into first joining means and second joining means along a longitudinal axis of the catheter, a length of one of the first joining means and the second joining means is larger than a length of the other of the first joining means and the second joining means.

Abstract: The present disclosure describes endoluminal devices, such as stents and stent grafts capable of being bent smoothly, with various benefits resulting therefrom.

Abstract: A deflectable catheter including an outer member having a proximal portion and a distal portion, an elongated column member extending distally from the outer member and an inner member positioned coaxial with the outer member and attached to the column member. The inner member extends distally of the outer member and has a distal tip portion. A reinforcement member is positioned over the column member to restrict axial movement of the column member such that when one of the inner member or outer member is moved with respect to the other, axial compression of the column member is restricted by the reinforcement member causing the distal tip portion of the inner member to deflect laterally.

Abstract: A catheter has a deflection beam and a single continuous puller wire to effectuate bi-directional deflection. A joint between a catheter body and a deflectable distal section effectively transmits torque from a control handle. The joint includes two open-shaped brackets, each affixed to a respective side of the flat deflection beam to form a closed-shaped hollow body that bridges and circumferentially encircles the beam. Each bracket has through-holes into which thermoplastic material of the catheter body and the deflectable distal section can melt and migrate to form interlocking nodes.

Abstract: An agent delivery catheter that includes an anti-whipping feature, improved assembly of distal parts and/or accuracy/repeatability of needle delivery to a target tissue. Additional features include fitting a catheter with a pneumatic delivery device for delivery of a therapeutic agent without using a needle.

Abstract: A neuromodulation catheter includes an elongate shaft and a neuromodulation element. The shaft includes two or more first cut shapes and two or more second cut shapes along a helical path extending around a longitudinal axis of the shaft. The first cut shapes are configured to at least partially resist deformation in response to longitudinal compression and tension on the shaft and torsion on the shaft in a first circumferential direction. The second cut shapes are configured to at least partially resist deformation in response to longitudinal compression on the shaft and torsion on the shaft in both first and second opposite circumferential directions.

Abstract: A neuromodulation catheter includes an elongate shaft and a neuromodulation element. The shaft includes two or more first cut shapes and two or more second cut shapes along a helical path extending around a longitudinal axis of the shaft. The first cut shapes are configured to at least partially resist deformation in response to longitudinal compression and tension on the shaft and torsion on the shaft in a first circumferential direction. The second cut shapes are configured to at least partially resist deformation in response to longitudinal compression on the shaft and torsion on the shaft in both first and second opposite circumferential directions.

Abstract: A turbulator for promoting mixing of fluids passing through a body lumen includes an elongate flow perturbing component and an elongate shape controlling component freely slidable within the flow perturbing component. The turbulator is adjustable from a low profile, lumen access configuration to a deployed configuration via sliding the shape controlling component within the flow perturbing component. Adjusting the turbulator within a body lumen of a patient induces turbulence within a flow of fluid passing through the body lumen to increase mixing of a treatment fluid with the body fluid by way of the induced turbulence.

Abstract: An endovascular sheath apparatus 2 is provided. The endovascular sheath apparatus 2 includes an inner tube 12 that includes a lumen 26 for introducing medical fluids or devices and an outer surface. The apparatus 2 further includes an outer tube 22 with an interior surface. The outer and inner surfaces define a cavity 28 therebetween. The apparatus 2 still further includes a stiffening component 20 which in one embodiment includes a braided material that is at least partially received in at least part of the cavity 28. An actuating mechanism 18 cooperates with the stiffening component 20. A method of providing intravascular delivery of a sheath includes the steps of providing an inner tube 12; positioning a stiffening component 20 around the inner tube 12; and deploying an actuating mechanism 18 that cooperates with the stiffening component 20, a stiffness characteristic of which being adjustable extra-corporeally by movement of the actuating mechanism in combination with the stiffening component.

Abstract: An infusion sleeve has a flexible tube enclosing a lumen. The tube has a plurality of wall segments, each wall segment located between the lumen and an exterior surface of the tube and extending parallel to a central axis of the tube. The plurality of wall segments includes at least two thick wall segments and at least two thin wall segments alternately arranged such that each thick wall segment is adjacent to two thin wall segments, and each thin wall segment is adjacent to two thick wall segments.

Abstract: Medical devices and methods for making and using the same are disclosed. An example medical device may include a guidewire. The guidewire may include a core wire having a distal portion. A tubular member may be disposed over the distal portion. The tubular member may have a plurality of slots formed therein and may have a longitudinal axis. The tubular member may include a variably spaced slot section that has a flexural rigidity that varies from a first flexural rigidity to a second flexural rigidity. The transition from the first flexural rigidity to the second flexural rigidity may be a function of a fourth power equation. The first flexural rigidity may be in the range of about 1×10?6 to about 9×10?5 lbs-inches2. The second flexural rigidity may be in the range of about 1×10?3 to about 5×10?3 lbs-inches2.

Abstract: Distal access aspiration guide catheter system and methods for delivering implantable devices, catheters, or substances in or near and/or restoring flow through body lumens, such as blood vessel lumens are described. A Distal access aspiration guide catheter having a proximal, medial, and distal possessing high flexibility, high resistance to kinking and a large lumen to wall thickness ratio.

Abstract: A catheter includes a first opening portion positioned at a distal end; a first curved portion positioned proximally of the first opening portion, and is curved in a first direction; a second curved portion positioned proximally of the first curved portion, and is curved in a second direction; an intermediate portion provided between the first curved portion and the second curved portion; and a second opening portion formed in the intermediate portion. In a transverse sectional view of the intermediate portion, the first direction and the second direction are directions directed towards a first side of the intermediate portion. In addition, in the transverse sectional view of the intermediate portion, the second opening portion opens in a third direction directed towards a second side of the intermediate portion that is opposite to the first side.

Abstract: A low cost, flexible, torqueable structure for use as at least a portion of a medical device comprises a coil formed of a wound element. The coil includes a plurality of adjacent windings. Connected portions of a region between the adjacent windings are formed (by, for example, laser welding) such that torque can be transmitted between adjacent windings.

Abstract: A joint-ring for an endoscope-bending-tube that fits with and is fixed to a rigid-member on a distal end side, the joint-ring being formed by plastically deforming a tube-material, the joint-ring including a joint-ring-convex portion provided in the tube-material before the plastic deformation, configured to fit with distal end rigid concave portions of the distal end rigid-member to perform positioning, and protrudingly provided to the distal end side, a plastically deformed shape portion provided in the joint-ring such that an axial direction position thereof overlaps the joint-ring-convex-portion and formed by force of stretching along a circumferential surface in the plastic deformation, and joint-ring-convex-portions provided in the tube-material before the plastic deformation near both sides in the circumferential direction of the joint-ring-convex-portion to interrupt the force of stretching along the circumferential surface to keep the force from reaching the joint-ring-convex-portion to thereby preve

Abstract: A stiffenable structure is made of longitudinal beams that are positioned around a longitudinal axis. In one state, the longitudinal beams are bendable so that the structure is bendable. As the structure bends, the longitudinal beams slide longitudinally with reference to one another. In a second state, the beams are clamped in a fixed position relative to one another so that the structure is stiffened. In some aspects the longitudinal beams are made of two or more longitudinal laminar elements. As each beam bends, the laminar elements slide longitudinally with reference to one another. Each beam, and accordingly the structure, is stiffened by preventing the laminar elements from sliding longitudinally relative to one another.

Abstract: An introducer assembly (10) includes a sheath (18) having a proximal portion (26) with a greater wall thickness and a distal portion (30) with a smaller wall thickness. A transition portion (28) may be provided to give a gradual transition between the proximal and distal portions (26, 30). The outer surface (32) of the sheath (18) has a substantially smooth and preferably even form and preferably constant diameter. The sheath (18) can thus have a greater flexibility at its distal end that at its proximal end, to improve trackability and thus to facilitate deployment of an implantable medical device (16) carried by the introducer (10). The smooth outer surface (22) prevents snagging of the introducer assembly (10) during and after the deployment procedure.

Abstract: Ultrasound catheter devices and methods provide enhanced disruption of blood vessel obstructions. Ultrasound catheter devices generally include an elongate flexible catheter body with one or more lumens, an ultrasound transmission member extending longitudinally through the catheter body lumen and a distal head coupled with the transmission member and positioned adjacent the distal end of the catheter body for disrupting occlusions. Improved features of ultrasound catheters include catheter bodies and ultrasound transmission members with increasing distal flexibility, guidewire tubes allowing contact between a guidewire and an ultrasound transmission member, distal heads with improved guidewire lumens, and torquable proximal housings for enhancing disruption of blood vessel occlusions.

Abstract: An endoscopic device has a longitudinal member having a longitudinal axis, a bending portion formed on a distal end side of the longitudinal member, a lumen formed along the longitudinal axis of the longitudinal member, and an opening portion that communicate with the lumen, and opens toward the inner side of a bend of the bending portion when the bending portion is bent.

Abstract: High flow rate catheters, and related methods, are useful in dialysis and other procedures. A catheter according to the invention comprises a hub and a generally elongated conduit. The conduit has a substantially continuous and smooth wall. The conduit also defines at least one lumen and has a length extending from a proximal end to a distal end of the conduit. The proximal end is coupled to a hub and the distal end has an opening in communication with the lumen. The conduit has a conical shape which tapers along the length.

Abstract: The present invention provides a silicone rubber-based hardening composition which can produce a silicone rubber having excellent tensile strength and tear strength, a molded article which is made using the silicone rubber-based hardening composition, and a medical tube which is obtained by using the molded article, and the silicone rubber-based hardening composition according to the present invention contains linear organopolysiloxane having a vinyl group (A); linear organohydrogen polysiloxane (B); and silica filler (C) of which the surface is treated with a silane coupling agent having a trimethylsilyl group.

Abstract: A catheter that comprises a hub, an elongated conduit, and at least one lumen therein. The lumen includes a proximal lumen section, a distal lumen section, and an intermediate lumen section extending between the proximal and distal lumen sections. The cross-sectional dimension of the intermediate lumen section is less than the cross-sectional dimension of the distal lumen section. In one embodiment, the cross-sectional dimension of the intermediate lumen section is less than the cross-sectional dimension of the proximal lumen section. In certain embodiments, the lumen tapers from the distal and/or proximal lumen sections to the intermediate lumen section.

Abstract: Ureteral access sheaths can have a nonuniform axial-stiffness. A nonuniform axial-stiffness ureteral access sheath can have an inner liner defining a longitudinally extending and generally uniform bore. A non-uniform axial-stiffness outer jacket can define a longitudinally tapered outer surface, and a reinforcement layer can be encapsulated between the inner liner and the non-uniform axial-stiffness outer jacket. The reinforcement layer can have a non-uniform axial-stiffness. For example, a proximal portion of the reinforcement layer can be thicker than a distal portion of the reinforcement layer. A coil of wire can be included in the reinforcement layer, and a diameter of the wire in a proximal portion of the reinforcement layer can be larger than a diameter of the wire in a distal portion of the reinforcement layer. In some instances, the diameter of the wire tapers from the proximal portion to the distal portion.

Abstract: A catheter shaft including a metallic tubular member including a plurality of apertures formed in the tubular wall of the metallic tubular member to provide a desired degree of flexibility to the metallic tubular member. The metallic tubular member includes a tapered region intermediate a region and a second, reduced diameter region relative to the first region.

Abstract: The invention relates to a medico-technical device for at least partially introducing into a body passage. Said device comprises an elongate, tubular, flexible internal body (2), an elongate exterior enveloping body (3) which surrounds, at least partially, said internal body (2) on the periphery thereof, and a device (4) for transferring the device (1) from a flexible state to a rigid state and vice-versa. The invention is characterized in that the internal body (2), which is in the form of a double tube (5), comprises an inner tube (6) which forms an inner wall (8) of the internal body (2) and an external tube (7) which forms an external wall (9) of the internal body (2), said external tube (7) surrounding the inner tube (6) in a concentric manner on the periphery thereof.

Abstract: Distal access balloon guide catheter system and methods for delivering implantable devices, catheters, or substances in or near and/or restoring flow through body lumens, such as blood vessel lumens, or inflating balloons affixed to the distal end of the guide catheter system are described. A Distal access balloon guide catheter having a proximal region, an optional medial region of intermediate flexibility, and distal region possessing high flexibility, high resistance to kinking and a large lumen to wall thickness ratio. The balloon is inflated by means of a kink-resistant secondary lumen embedded within the walls of the balloon guide catheter system tubing.

Abstract: A catheter a first sheath having a proximal end and a distal end, and a length extending between the proximal end and the distal end. The first sheath being devoid of any bonds between the proximal end and the distal end, and a flexural modulus of the first sheath varying along the length. A method of making a catheter having more than one flexural modulus.

Abstract: A catheter body includes a hollow coil whose outer and inner surfaces are coated with outer and inner resin layers. A resin tip is provided at a distal end of the catheter body. The tip has a tapered section at a distal end of the tip. Also, an axially extending braid is embedded in the catheter body and the tip to extend from the catheter body to the tip.

Abstract: A catheter body having a variable stiffness along its longitudinal length and a method for manufacturing same is disclosed wherein an inner layer having an uninterrupted length serves as a backbone for segments of coextrusion of, e.g., Pebax or nylon and a tie layer which are then bonded to the backbone to create a multi-stiffness catheter body.

Abstract: Ureteral access sheaths can have a nonuniform axial-stiffness. A nonuniform axial-stiffness ureteral access sheath can have an inner liner defining a longitudinally extending and generally uniform bore. A non-uniform axial-stiffness outer jacket can define a longitudinally tapered outer surface, and a reinforcement layer can be encapsulated between the inner liner and the non-uniform axial-stiffness outer jacket. The reinforcement layer can have a non-uniform axial-stiffness. For example, a proximal portion of the reinforcement layer can be thicker than a distal portion of the reinforcement layer. A coil of wire can be included in the reinforcement layer, and a diameter of the wire in a proximal portion of the reinforcement layer can be larger than a diameter of the wire in a distal portion of the reinforcement layer. In some instances, the diameter of the wire tapers from the proximal portion to the distal portion.

Abstract: The present invention is a carotid sheath that has a proximal portion that is stiffer than the distal portion of the sheath as a result of the proximal portion having a higher durometer of the outer plastic coating of the sheath's proximal portion with a lower durometer for the plastic coating on the more flexible distal portion of the sheath. Another means to increase the flexibility of the sheath's distal portion compared to a stiffer proximal portion is by having a slightly smaller outside diameter for the outer plastic coating of the distal portion of the sheath. A more flexible distal portion of the sheath allows easier access for angiography, angioplasty or stenting when the sheath is used to access the tortuous path encountered when entering the carotid arteries.

Abstract: Methods and apparatuses for manipulating an elongated flexible shaft of a catheter provide ease and reliability of positioning electrodes against or near tissue. Dual-bend flexible distal tips may be used in combination with flat wires. In some embodiments, flat wires which are free to rotate upon initial bending of shaft segments are employed. In some embodiments, one or more transition segments are used to relocate the satellite lumen-to-main lumen transition of pull wires away from a change in shaft stiffness.

Abstract: A catheter comprising a sheath to be inserted into a living body, wherein the sheath includes a tubular reinforcement layer of at least one layer, which is formed with a spiral slit continuous from the distal side to the proximal side thereof; a termination end of the spiral slit is provided on the proximal side of the slit proximal portion at the site of the proximal side of the spiral slit; and at the same time, there is formed a slit termination portion in which inclination angle of the spiral slit with respect to the circumferential direction of the reinforcement layer is larger than that of the slit proximal portion.

Abstract: The invention relates to a guide device (1), in particular for positioning catheters in a body duct. The guide device (1) has an extended first thread (2) and at least one extended second thread (3) made from wire, which runs close to the first thread (2). According to the invention, the guide device (1) has a device (8), provided for one of the threads (2, 3) by means of which it is possible to actively control a relative movement between the threads (2, 3) or at least make the same difficult. The control device (8) is for example embodied such that the first thread (2), prepared from a flexible material, exerts a pressure, preferably acting a radial direction, on the several second threads, or that magnetic fields (4) of differing polarities along the first thread (2), prepared from a flexible material and along the second thread (3), may be generated for the selective introduction of an opposing attraction of the threads (2, 3) for reinforcing the guide device (1).

Abstract: A surgical suction instrument is provided that is flexible enough to bend in any direction creating a custom shaped suction device. The surgical suction device reduces surgeon fatigue and is rigid enough for use as a retractor. The surgical suction device preferably has the exit suction port below the handle to create a more ergonomic device and reduce user fatigue during surgery.

Abstract: An elongate shaft of a medical catheter including a thermoset polymeric tubular member including a skived distal portion. The skived distal portion includes a distally extending trough having a convex surface and a concave surface. A thermoplastic tubular sleeve may be positioned over at least a portion of the skived distal portion of the thermoset polymeric tubular member. In some instances, the thermoplastic tubular sleeve includes a crescent-shaped tubular portion defining a crescent-shaped lumen. The trough of the skived distal portion may extend through the crescent-shaped lumen. The thermoplastic tubular sleeve is thermally bonded to the inner and outer tubular members of a distal section of the elongate shaft at a guidewire port joint.

Abstract: A steerable catheter sheath for use in directing a catheter into a desired position is provided. The sheath includes an elongated member configured to receive the catheter therein. The distal end of the elongated member is steerable in two directions, each direction having a different bent configuration, e.g., a sharp curve in one direction and an open arching curve in the other direction. A resilient structure having different bending properties in each of its lateral sides is carried in the distal portion of the elongated member and causes the asymmetric bending. In one embodiment, the resilient structure includes a hypotube with a plurality of notches and slits in the sides. In another embodiment, the resilient structure is covered in an outer coating having different durometer portions. The sheath is particularly useful for accessing left and right pulmonary veins when a transeptal entry approach is used into the left atrium.