Abstract: Described here are systems and methods for accessing Schlemm's canal and for delivering an ocular device or fluid composition therein. The ocular devices may maintain the patency of Schlemm's canal without substantially interfering with transmural fluid flow across the canal. The fluid composition may be a viscoelastic fluid that is delivered into the canal to facilitate drainage of aqueous humor by disrupting the canal and surrounding trabeculocanalicular tissues. Tools for disrupting these tissues and minimally invasive methods for treating medical conditions associated with elevated intraocular pressure, including glaucoma, are also described.

Abstract: Disclosed herein are implantable dual-valve devices having first and second valve structures, a connector coupled to the structures, and first and second sealing members coupled on each side of the device, along with related methods of deploying such devices.

Abstract: Described here are devices, systems, and methods for improving blood flow in a vessel. Generally, the method may comprise advancing a catheter into a first vessel proximal to an occlusion in the first vessel and forming a fistula between the first vessel and a second vessel. This may deliver blood flow around an occlusion to ischemic tissues located in the peripheral vasculature.

Abstract: An arteriovenous (AV) graft is disclosed than includes portions for inserting hemodialysis needles. The AV graft includes two spaced portions that are each adapted for receiving needles. These portions may have a different shape or rigidity than other portions of the AV graft. A care giver may be able to palpate the location of the two spaced portions, thus facilitating hemodialysis by providing the needles to locations on the AV graft adapted to accept the needles. Methods of providing hemodialysis using the AV graft are also described.

Abstract: A method of providing retrograde perfusion of a patient's brain includes occluding a jugular vein of a subject at a jugular occlusion location, and passively shunting arterial blood from an artery of the subject to a location in the jugular vein distal to the jugular occlusion location.

Abstract: Devices and methods for treating intraocular pressure are disclosed. The devices include shunts for draining aqueous humor from the anterior chamber to the uveoscleral outflow pathway, including the supraciliary space and the suprachoroidal space. The shunts are preferably implanted by ab interno procedures.

Abstract: An implantable artificial bronchus (IAB) is provided that is used for the treatment of chronic obstructive pulmonary diseases, such as pulmonary emphysema. The implantable artificial bronchus can be made with silicone or nitinol, and has a tapered cylindrical shape. Additional embodiments of this apparatus may be further associated with a one-way valve, on the nozzle of the IAB.

Abstract: An apparatus (10) for controlling flow of fluid from a wound site of a patient may include a chamber (28) connectable to a wound site and a reservoir (16). The chamber (28) may have a first deformed state, and a second state in which it is not deformed or less deformed than in the first state. The chamber (28) may be adapted to manage fluid flow between the wound site and the reservoir (16) during transition of the chamber (28) between the first state and the second state. An actuator element (64) of the apparatus (10) may be adapted to operate on the chamber (28) to transition the chamber (28) from the second state to the first state.

Abstract: A microsurgical bipolar forceps may include an actuation structure, a hypodermic tube, a first electrical conductor, and a second electrical conductor. The actuation structure may include an actuation structure distal end, an actuation structure proximal end, and a plurality of actuation limbs. The hypodermic tube may be disposed in the actuation structure. The first electrical conductor may be disposed in the hypodermic tube and the actuation structure wherein the first electrical conductor is electrically connected to a bipolar cord. The second electrical conductor may be disposed in the hypodermic tube and the actuation structure wherein the second electrical conductor is electrically connected to the bipolar cord. A compression of the actuation structure may be configured to decrease a distance between a first jaw of the first electrical conductor and a second jaw of the second electrical conductor.

Abstract: A device for implanting in a gastrointestinal system of a patient may include an elongate flow modulator configured to be inserted in an intestine, wherein the flow modulator defines an enclosed interior space to hold a fill material.

Abstract: Systems and methods for implanting an endovascular shunt in a patient is disclosed. The system having an expandable anchor configured for being deployed in a dural venous sinus of a patient at a location distal to a curved portion of a wall of an inferior petrosal sinus (IPS) of the patient; an elongate guide member coupled to, and extending proximally from, the anchor; a shunt delivery catheter having a first lumen configured to receive the guide member, and a second lumen extending between respective proximal and distal openings in the shunt delivery catheter, the shunt delivery catheter further having a penetrating element coupled to a distal end of the catheter; and the system further having a guard at least partially disposed over, and movable relative to, the penetrating element.

Abstract: The invention relates to a stainless steel device for permanent insertion into the sclerocorneal limbus, with different drainage and anchorage systems, enabling the aqueous humour to discharge through one or more virtual spaces from the anterior chamber to an intrascleral space in cases of simple glaucoma or to the equatorial episclera in cases of complex glaucoma, such as neovascular glaucoma. The space is virtual, not real, as in the case of the tubular device. It enables the aqueous humour to discharge slowly and continuously, minimizing the possibility of the chamber being flat or of germs penetrating through the device. Furthermore, the anchorage system is less aggressive, thus reducing the possibility of bleeding.

Abstract: An implantable device for treatment of glaucoma of the eye. In one aspect, the device includes an elongate duct for diverting aqueous humor from the anterior chamber of the eye, the elongate duct having a central axis with a proximal end and distal end opposite one another. A least one element is spaced apart from the proximal end and the distal end of said elongate duct and extends radially outward beyond an outer surface of said elongate duct in at least two directions transverse to the central axis of said elongate duct, wherein the at least one element has a distal portion with a tapered profile facing the distal end of said elongate duct. The at least one element is configured to deform in a tissue passage leading into the anterior chamber of the eye as it is inserted into the tissue passage in response to forces applied by surrounding ocular tissue of the tissue passage. Other aspects are also described and claimed.

Abstract: A system for preparation of an implant and ab interno insertion of the implant into an eye including a handle having one or more actuators and an elongated shaft having an outer sheath and an elongate member positioned within a lumen of the tubular outer sheath. The system includes a recess sized for holding a patch of material fixed relative to the handle and a cutting member movable relative to the handle and to the recess. The cutting member cuts the patch of material into an implant as the cutting member moves towards a cutting configuration. The implant, once cut, is axially aligned with the lumen of the tubular outer sheath. The inner elongate member is movable relative to the tubular outer sheath to advance the implant into a deployment position in the lumen of the tubular outer sheath for delivery into the eye. Related devices and methods are provided.

Abstract: The present invention relates to an implant, to an instrument for implantation of the latter and to a method for manufacturing this implant which includes an elongated body (10) between a free end and a head (18) along a longitudinal axis on the one hand and turns (12) of at least one threading on at least one portion of said body (10) in proximity to the free end, along the longitudinal axis on the other hand, characterized in that the body (10) includes a longitudinal internal conduit (11) in at least one portion along the longitudinal axis, obtained by at least one first central machining operation parallel to the longitudinal axis and at least one second machining operation in a so-called transverse plane, not parallel to the longitudinal axis and crossing the wall of the body (10) as far as the longitudinal internal conduit (11) by making windows (15) communicating between said longitudinal internal conduit (11) and the outside of the body (10).

Abstract: A delivery system for delivering an implant to a first space within a body of a patient including an elongate delivery member having a proximal portion, a distal portion, a lumen and a receiving area, the receiving area dimensioned for receipt of the implant. A deforming member is movable with respect to the delivery member from a first position to a second position to apply a force to the implant to deform the implant positioned in the receiving area of the delivery member.

Abstract: The present invention relates to a connection stent and a method of manufacturing the stent. The connection stent includes: a body configured to form a plurality of cells through the intersection of wires, and provided in a hollow cylindrical shape; an upper head formed to extend from one end of the body to have a diameter larger than that of the body; and a lower head formed to extend from a remaining end of the body to have a diameter larger than that of the body. The upper head and the lower head are respectively placed to come into contact with insides of heterogeneous tissues. Accordingly, according to the present invention, there can be manufactured a stent which can connect heterogeneous tissues and form a bypass and which can provide sufficient expansion force and minimum axial force for the maintenance of the bypass formed as described above.

Abstract: A high-flow luer lock connector is disclosed. A high-flow luer lock connector comprises a connector body defining an interior region, a lumen, and an extended passageway. The interior region is bounded by a cylindrical side wall and a base wall. The lumen is defined at the base wall of the interior region and extends no more than 0.274 of an inch into the interior region. The extended passageway comprises a first and second end and passes through the connector body and the lumen. The extended passageway is in communication with the interior region to allow insufflation gas to flow through the interior region and extended passageway.

Abstract: An implantable device for treatment of glaucoma of the eye. In one aspect, the device includes an elongate duct for diverting aqueous humor from the anterior chamber of the eye, the elongate duct having a central axis with a proximal end and distal end opposite one another. A least one element is spaced apart from the proximal end and the distal end of said elongate duct and extends radially outward beyond an outer surface of said elongate duct in at least two directions transverse to the central axis of said elongate duct, wherein the at least one element has a distal portion with a tapered profile facing the distal end of said elongate duct. The at least one element has a hardness within a range between Shore 30A and Shore 80A. Other aspects are also described and claimed.

Abstract: A prosthesis has a tubular body having a proximal end, a distal end, and a lumen extending through the tubular body and open at each of the proximal end and the distal end. The tubular body defines a longitudinal axis and has a first width in a direction perpendicular to the longitudinal axis. The prosthesis also includes a first flange at one of the proximal end and the distal end with the lumen extending through the first flange. The first flange has a second width in the direction perpendicular to the longitudinal axis that is greater than the first width. The tubular body and the first flange form a structurally self-supporting, body compatible, and body absorbable device. The device is formed of a composite structure and is adapted for insertion into an opening through a tympanic membrane.

Abstract: A self-sealing vascular graft, including a substrate with a sealant layer and several optional additional layers, is described. The substrate can be ePTFE and the material used for the sealant and additional layers can be polyurethane. The sealant layer and additional layers may include one or more base layers, one or more foam layers, beading of different sizes and shapes, and ePTFE tape. A flared cuff may be integral to one or both ends of the substrate or may be attached to one or both ends. Various methods of making a self-sealing vascular graft are also described, including methods of disposition, methods of forming, methods of bonding and methods of attaching.

Abstract: Shunt devices and a method for continuously decompressing elevated intraocular pressure in eyes affected by glaucoma by diverting excess aqueous humor from the anterior chamber of the eye into Schlemm's canal where post-operative patency can be maintained with an indwelling shunt device which surgically connects the canal with the anterior chamber. The shunt devices provide uni- or bi-directional flow of aqueous humor into Schlemm's canal.

Abstract: A fluid jet is directed at tissue to erode tissue with a controlled amount of ablative energy of a jet. Embodiments as described herein can provide controlled removal of ocular tissue, and can remove a pre-defined volume having a pre-determined shape, for example. The accurate tissue removal as described herein can have many applications, such as removal of the lens for cataract surgery to more completely remove the cortex and nucleus of the lens and to separate layers of the lens. The length of an ablation depth extending from an opening that releases the jet can be controlled, and the angle and longitudinal position of the opening can be controlled together, in order to ablate a pre-determined volume of tissue having the surface profile.

Abstract: A ventricular assist device includes a pump including a housing having an inlet, an outlet and a moveable element disposed in the housing for urging blood from the inlet to the outlet. An outflow cannula having a proximal end attached to the pump housing, a distal end remote from the pump housing, an interior bore in communication with the outlet of the pump housing, and at least one outlet aperture communicating with the interior bore remote from the pump housing is included. At least one sensor mounted to the outflow cannula and configured to detect a parameter of blood flowing at least one from the group consisting of through the outflow cannula and about an exterior of the outflow cannula is included.

Abstract: An endovascular catheter combination configured to have multiple capabilities is disclosed. These capabilities include proximal and distal occlusion of a segment of a target blood vessel (such as the carotid artery) thus excluding the segment of the blood vessel from circulation for purposes such as surgical consideration. Another capability includes intravascular shunting of the blood through the excluded portion of the artery during a procedure such as an endarterectomy. Additionally, a microsensor provides a measurement of the rate/volume of blood flow through the distal end of the catheter. In one embodiment, a guidewire is provided with a filtration mesh as an anti-embolic mechanism both at the time of initial positioning of the catheter and after reversing the occlusion.

Abstract: Disclosed herein are systems and methods for aiding a surgeon to perform a surgical procedure on an eye. The surgical procedure includes inserting an elongate probe from an opening into the eye across an anterior chamber to a target tissue region comprising a trabecular meshwork and a Schlemm's canal. Exemplary systems include an optical microscope for the surgeon to view the eye with a microscope image during the procedure; an optical coherence tomography (OCT) apparatus configured to perform an OCT scan of a target location in the target tissue region during the procedure; and an image processing apparatus configured to generate an augmented image by overlaying an OCT image of target location and a graphical visual element identifying the locations, wherein the graphical visual element is registered with the microscope image to aid the surgeon in advancing a distal end of the elongate probe to the target location.

Abstract: Methods and systems for performing an ophthalmic surgical treatment procedure include one or more wicking members to secure a volume of treatment fluid to a distal end of a surgical instrument. Such a surgical instrument may include an elongate tubular member having a proximal end, a distal end, and a lumen extending therebetween, the elongate tubular member being configured to penetrate a body cavity of a patient. The instrument may further include a wicking member extending beyond the distal end of the elongate tubular member. The wicking member may be configured to secure a volume of treatment fluid delivered through the lumen to the wicking member for application from the wicking member to target tissue in the body cavity.

Abstract: Various embodiments of the present invention provide a conduit system including an outer lumen, an inner lumen, and an attaching device. In other embodiments, a multiple access port device adapted for communication with at least one of an outer lumen, an inner lumen, or an attaching device of a conduit system is provided. In yet other embodiments, a system including an inner lumen that is collapsible is provided. Means for closing a conduit system are also provided, including a plug for insertion through an attaching device and a variable radius coiled member associated with an attaching device.

Abstract: Shunt devices and a method for continuously decompressing elevated intraocular pressure in eyes affected by glaucoma by diverting excess aqueous humor from the anterior chamber of the eye into Schlemm's canal where post-operative patency can be maintained with an indwelling shunt device which surgically connects the canal with the anterior chamber. The shunt devices provide uni- or bi-directional flow of aqueous humor into Schlemm's canal.

Abstract: Systems and methods are provided herein that generally involve shunting fluid, e.g., shunting cerebrospinal fluid in the treatment of hydrocephalus. Self-cleaning catheters are provided which include split tips configured such that pulsatile flow of fluid in a cavity in which the catheter is inserted can cause the tips to strike one another and thereby clear obstructions. Catheters with built-in flow indicators are also provided. Exemplary flow indicators include projections that extend radially inward from the interior surface of the catheter and which include imageable portions (e.g., portions which are visible under magnetic resonance imaging (MRI)). Movement of the flow indicators caused by fluid flowing through the catheter can be detected using MRI, thereby providing a reliable indication as to whether the catheter is partially or completely blocked.

Abstract: Surgical methods and related medical devices for treating ocular disorders are disclosed. Some methods relate to delivering an implant within an eye, and involve providing an elongate guide device, such as, a flexible guide member or a guide wire. A distal end of the guide device can be advanced into an anterior chamber of an eye, or through at least a portion of a site of resistance along a physiologic outflow pathway of the eye, or from an anterior chamber of the eye to a location proximate a physiologic outflow pathway of the eye. The implant is advanced along the guide device toward the guide device distal end, and is positioned to conduct aqueous humor between the anterior chamber and the physiologic outflow pathway.

Abstract: An inserter for treating glaucoma can comprise a housing, a needle, a plunger, a slider component, and a drive component. The drive component is disposed within a cavity of the housing and rotatable within the cavity to result in movement along a longitudinal axis of the inserter to the needle and the plunger upon rotation of the drive component. The slider component is coupled to the housing and slidable along an elongate groove of the drive component such that movement of the slider component along the axis rotates the drive component within the housing.

Abstract: Lacrimal implants for treating diseases or disorders are disclosed. More particularly, lacrimal implants, methods of making such implants, and methods of treating ocular, respiration, inner ear or other diseases or disorders using such implants are disclosed.

Abstract: A gastroplasty method involves a staple line that terminates prior to reaching the gastroesophageal junction such that the bypassed portion of the stomach does not require resection. Additionally, bougies are taught that assist a physician in following the improved staple line of the present invention.

Abstract: A device for forming a fistula between blood vessels includes a tubular body having a central lumen, a flange attached to the tubular body and projecting outwardly from an outer body surface, and one or more vanes projecting inwardly into the lumen so as to induce helical flow in blood passed through the lumen between first and second vessels joined via the fistula.

Abstract: An ocular implant is provided. In some embodiments, the ocular implant includes a body that is curved about a longitudinal central axis and a distal body portion that defines a longitudinal channel including a channel opening. The implant is sized and configured such that the ocular implant assumes an orientation in which the channel opening is adjacent a major side of Schlemm's canal when the ocular implant is disposed in Schlemm's canal. Methods for delivering ocular implants into Schlemm's canal are also provided. Some methods include covering openings in the ocular implant, advancing the implant into Schlemm's canal while at least some of the openings are covered, and uncovering the openings while the distal portion of the implant is disposed in Schlemm's canal.

Abstract: Devices, methods and kits are described for reducing intraocular pressure. The devices include a support that is implantable within Schlemm's canal and maintains the patency of the canal without substantially interfering with transmural fluid flow across the canal. The devices utilize the natural drainage process of the eye and can be implanted with minimal trauma to the eye. Kits include a support and an introducer for implanting the support within Schlemm's canal. Methods include implanting a support within Schlemm's canal, wherein the support is capable of maintaining the patency of the canal without substantial interference with transmural fluid flow across the canal.

Abstract: The multi-material stent includes a renal portion and a bladder portion with respective, different hardness. A valve is disposed within the stent to guide liquid from the renal portion of the stent to the bladder portion of the stent. The present invention relates towards systems and method for stents. More particularly, the invention relates to a stent designed to increase patient comfort by minimizing irritation and reflux through the use of a stent that incorporates one or more flexible elements, which may involve materials with varying degrees of hardness, and a valve disposed therein.

Abstract: A shunt catheter system and method of use thereof. The system generally includes an open-ended ventricular catheter with drainage apertures and safety flap valves, a reservoir with inline filter, and a peritoneal catheter. After insertion, for example into the ventricles of the brain, cerebrospinal fluid would pass into the ventricular catheter, through the inline filter in the reservoir, and into the peritoneal catheter, subsequently exiting the shunt catheter system. During insertion of the ventricular catheter, a catheter stylet or wire/string and plug stylet can be positioned therein to occlude the open end. The ventricular catheter may be positioned perpendicular to the peritoneal catheter and can be coupled to one another through the reservoir and inline filter or valve.

Abstract: A system for reduced scarring of wounds; said system comprising: means (1) for creating an enclosed volume (3) over a wound site (2). The system further comprises: means (6, 10, 11, 12) for actively reducing the oxygen concentration within the enclosed volume at the surface of the wound to a first oxygen concentration level while maintaining an environment within the enclosed volume which is healthy for wound healing, means (4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14) for ensuring that the oxygen concentration of the gas composition of the gas within the enclosed volume at the surface of the wound is maintained below a second oxygen concentration level and above a third oxygen concentration level, and where said system is arranged such that said first, second and third oxygen concentration levels are between 1 and 16 volume percent.

Abstract: Methods and devices for providing a gas pathway between the nasopharynx and the Eustachian tube are provided. One device may include a lumen with a valve. A portion of the valve may be tethered to adjacent muscle. Another portion of the valve may be tethered to adjacent cartilage. When the muscle contracts the valve may open through movement of the tethers, and provide a gas pathway between the nasopharynx and the Eustachian tube.

Abstract: The present invention relates to a connection stent and a method of manufacturing the stent. The connection stent includes: a body configured to form a plurality of cells through the intersection of wires, and provided in a hollow cylindrical shape; an upper head formed to extend from one end of the body to have a diameter larger than that of the body; and a lower head formed to extend from a remaining end of the body to have a diameter larger than that of the body. The upper head and the lower head are respectively placed to come into contact with insides of heterogeneous tissues. Accordingly, according to the present invention, there can be manufactured a stent which can connect heterogeneous tissues and form a bypass and which can provide sufficient expansion force and minimum axial force for the maintenance of the bypass formed as described above.

Abstract: An apparatus for reducing/stabilizing intraocular pressure is provided. A tube extends from an inlet end in fluid communication with an anterior chamber of the eye, to direct an aqueous humor flow from the anterior chamber to an outlet end in fluid communication with a cavity, defined by a housing, for receiving the aqueous humor. A flow control device is operably engaged with the housing, and is configured to control the flow of the aqueous humor, via a conduit defined thereby and extending from the cavity, to a location away from the anterior chamber. The conduit is dilatable in response to the intraocular pressure being above a preselected pressure, to increase the flow or to decrease resistance to flow of the aqueous humor through the conduit to the drainage site and to reduce the intraocular pressure to no greater than the preselected pressure. Associated apparatuses and methods are also provided.

Abstract: An intestinal barrier sleeve and corresponding treatments using the sleeve are provided herein. The sleeve generally includes an expanding section coupled to a tubular section at an interface there between. The expanding section is expandable from at least a first collapsed position to at least one expanded position, where the expanding section has a conical shape that when expanded retains the sleeve in the subject gastrointestinal tract. The expanding section may further include a plurality of petal-like elements extending radially from the narrow end of the conical shape and the petal-like elements may be interconnected with a webbing to form the conical shape.

Abstract: An implant container for containing an ocular implant is described herein. The implant container can releasably couple to an implant delivery device and provide at least partial alignment of the delivery device with an ocular implant during loading of the ocular implant onto the delivery device.

Abstract: Devices, methods and kits are described for reducing intraocular pressure. The devices include a support that is implantable within Schlemm's canal and maintains the patency of the canal without substantially interfering with transmural fluid flow across the canal. The devices utilize the natural drainage process of the eye and can be implanted with minimal trauma to the eye. Kits include a support and an introducer for implanting the support within Schlemm's canal. Methods include implanting a support within Schlemm's canal, wherein the support is capable of maintaining the patency of the canal without substantial interference with transmural fluid flow across the canal.

Abstract: Systems and methods for implanting an endovascular shunt in a patient is disclosed. The system having an expandable anchor configured for being deployed in a dural venous sinus of a patient at a location distal to a curved portion of a wall of an inferior petrosal sinus (IPS) of the patient; an elongate guide member coupled to, and extending proximally from, the anchor; a shunt delivery catheter having a first lumen configured to receive the guide member, and a second lumen extending between respective proximal and distal openings in the shunt delivery catheter, the shunt delivery catheter further having a penetrating element coupled to a distal end of the catheter; and the system further having a guard at least partially disposed over, and movable relative to, the penetrating element.

Abstract: Methods for treating hydrocephalus using a shunt, the shunt having one or more CSF intake openings in a distal portion, a valve disposed in a proximal portion of the shunt, and a lumen extending between the one or more CSF intake openings and the valve, the method comprises deploying the shunt in a body of a patient so that the distal portion of the shunt is at least partially disposed within a CP angle cistern, a body of the shunt is at least partially disposed within an IPS of the patient, and the proximal portion of the shunt is at least partially disposed within or proximate to a JV of the patient, wherein, after deployment of the shunt, CSF flows from the CP angle cistern to the JV via the shunt lumen at a flow rate in a range of 5 ml per hour to 15 ml per hour.

Abstract: Described here are systems and methods for accessing Schlemm's canal and for delivering an ocular device, tool, or fluid composition therein. The ocular devices may maintain the patency of Schlemm's canal without substantially interfering with transmural fluid flow across the canal. The fluid composition may be a viscoelastic fluid that is delivered into the canal to facilitate drainage of aqueous humor by disrupting the canal and surrounding trabeculocanalicular tissues. Some systems described here may be configured to cut or tear the trabecular meshwork with the body of an elongate member located within Schlemm's canal. Other tools for disrupting these tissues and minimally invasive methods for treating medical conditions associated with elevated intraocular pressure, including glaucoma, are also described.

Abstract: According to aspects described herein, there is disclosed an improved hot balloon catheter delivery system for shape memory tubular stents. An outer sheath is provided on the delivery system that facilitates stent placement on a balloon during delivery through an endoscope. In one embodiment, the stent may be positioned between radiopaque markers/electrodes and the balloon may be heated. The stent may be prevented from moving proximally relative to the catheter as the delivery system is tracked through the patient's anatomical passageways. The outer sheath may be positioned to ride over the proximal cone of the hot balloon catheter and abut the proximal end of the stent to facilitate proper alignment of the balloon for deployment. Upon deployment of the stent in an appropriate position, the sheath may be pulled away from the stent to expose the proximal cone of the balloon and thereby allow balloon and stent expansion.