Abstract: This document provides methods and materials for improving arteriovenous fistula (AVF) maturation and/or maintaining AVF functionality. For example, methods and materials for using one or more senolytic agents to improve AVF maturation, to maintain AVF functionality, and/or to maintain the patency of an AVF are provided. Methods and materials for using one or more senolytic agents to maintain functionality and/or patency of a venous graft (e.g., a venous graft that bypasses an occluded artery) also are provided.

Abstract: A stent for use in the nasolacrimal duct of a patient's eye. The stent is used to maintain and improve the patency of the nasolacrimal duct. The stent uses a hollow shaft to create a fluid pathway from the punctum to the inferior meatus. Either the superior or inferior punctum can be selected for insertion of the stent. An inserter is used to position the flexible stent into position. A guidewire attached to the inserter is removed from the stent and it transforms from its collapsed state to its deployed state. A first anchor stabilizes the proximal end of the stent to the punctum and ampulla. A second anchor stabilizes the proximal end of the stent near the inferior meatus. The second anchor can take any of several deployed shapes, such as a pigtail or fins.

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: Devices and methods for deploying an anastomotic stent between portions of the gastro-intestinal (GI) tract are disclosed. The anastomotic stents are configured to atraumatically engage the tissue walls and to permit the flow of fluid, partially digested food, and food. The stents can be deployed using endoscopic catheter devices, laparoscopic tools, and combinations of both endoscopic tools and laparoscopic tools. Examples of anastomoses include anastomoses between the stomach and a portion of the intestines such as the jejunum. Anastomoses can also be formed between two closed ends of the intestines, such as two closed ends of the colon formed during a colon resection procedure. Anastomoses can also be formed between a fundal pouch formed during a gastric bypass procedure and the jejunum. Laparoscopic tools are disclosed to deploy a stent by selectively removing a radial restraint on a self expanding stent with the restraint removed through the laparoscopic access points.

Abstract: Disclosed herein are drug delivery devices and methods for the treatment of ocular disorders requiring targeted and controlled administration of a drug to an interior portion of the eye for reduction or prevention of symptoms of the disorder. The devices are capable of controlled release of one or more drugs and may also include structures which allows for treatment of increased intraocular pressure by permitting aqueous humor to flow out of the anterior chamber of the eye through the device.

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: This application discloses methods and tools for the treatment of chronic fatigue syndrome (CFS) and fibromyalgia and the use of retinal nerve fiber layer thinning as a biomarker for the treatment.

Abstract: An arterial cannula connects to a heart-lung machine for supplying a patient with oxygen-rich blood and includes a tubular body having a front end region for positioning at the aortic arch, a main region, and a rear end region for connection to the supply side. The length of the tubular body is dimensioned so that the cannula can be placed at the femoral artery and extends to the aortic arch. The tubular body is flexible and includes a lumen, and perforations in the front end region. The front end region is pre-curved, following the shape of the aortic arch. An insertion aid is located inside the tubular body for placing the cannula and is slidable into or withdrawable from the tubular body after the cannula has been placed. The curvature of the front end region adjusts automatically after the cannula is placed and the insertion aid withdrawn.

Abstract: An intravascular sensor device can be used to guide treatment of a diseased blood vessel in the body of a patient. In some examples, the intravascular sensor device includes a pressure sensor and an ultrasound transducer. The intravascular sensor device is used to measure a pressure within the diseased blood vessel and acquire an ultrasound image of the diseased blood vessel. The pressure may be measured during hyperemic blood flow that is caused by a pharmacologic vasodilator drug. The measured pressure can be used to calculate a fractional flow reserve value. The ultrasound image can be used to determine a physical dimension of the blood vessel, such as cross-sectional area. The fractional flow reserve value and physical dimensions of the blood vessel can be used to optimize patient treatment.

Abstract: An antimicrobial urinary catheter device comprising a circumferential array of safe, antimicrobial lights around a urinary catheter directed for disinfecting the distal urethra, urethral meatus, and adjacent indwelling urinary catheter.

Abstract: Systems, methods, and apparatuses for relieving upper airway obstructive breathing in a patient are disclosed. In some implementations, the apparatus comprises first and second pivot devices anchored to a mastoid bone and a mandible bone, respectively; an implant positioned between the first and second pivot device, the implant comprising a first end coupled to the first pivot device and a second end coupled to the second pivot device; an inactive position, the inactive position enabling a posterior displacement of the second end relative to the first end; an active position, the active position preventing posterior displacement of the second end relative to the first end, and anteriorly positioning the second end relative to the first end; and an activation mechanism enabling transition between the inactive position and the active position, and vice versa.

Abstract: Methods and systems are disclosed for using a feature hierarchy with multiple levels with a different number of features at different levels to segment a dataset. The mechanism may use the first level of the hierarchy to segment a dataset into multiple datasets and then generate a timeseries dataset for each segment. Those timeseries datasets may be input into an anomaly detection model to identify a number of anomalies detected within those segments. Based on the number of anomalies not reaching a threshold, a second level of the hierarchy may be used to segment the dataset. Those segments may be input into the anomaly detection model to determine a number of anomalies for the second level. This process may continue until a level of the hierarchy is determined such that the number of anomalies reaches the threshold. The mechanism may then generate a security rule to deal with the anomalies.

Abstract: The present disclosure provides a system for ablation of uterine fibroid(s), said system comprising: an ultrasound scanner configured to perform a volume scan of a uterus of a patient; a display coupled with the ultrasound scanner, configured for displaying image and alphanumeric characters; a device comprising an electrode for ablating the uterine fibroid; a controllable energy source coupled with the electrode and configured to supply energy to the electrode.

Abstract: A docking unit for use in a modular mammalian body implantable device. The docketing unit comprising an elongated body. The body has: a longitudinal axis, at least one receiving surface extending parallel to the longitudinal axis, a distal end and a proximal end, and at least one proximal guide hole. Each receiving surface has at least one proximal guide hole associated therewith. The docking unit is dimensioned and shaped to be deliverable to an implantation site within a conduit of a conduit system of the mammalian body via a catheter.

Abstract: An ocular implant including a drug releasing element and having an inlet portion and a Schlemm's canal portion distal to the inlet portion, the inlet portion being disposed at a proximal end of the implant and sized and configured to be placed within an anterior chamber of a human eye, the Schlemm's canal portion being arranged and configured to be disposed within Schlemm's canal of the eye when the inlet portion is disposed in the anterior chamber.

Abstract: A system for producing a graft device for a patient may comprise: an imaging device configured to produce image data of a tubular conduit; and a processing unit configured to receive the image data from the imaging device. The processing unit may comprise an algorithm configured to process the image data, and produce a construction signal based on the image data. A material delivery device may be configured to receive the construction signal from the processor, and deliver material to produce a 3D covering based on the construction signal. The graft device may comprise the 3D covering positioned about the tubular conduit. Graft devices and methods of producing graft devices may also be provided.

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: 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: An end effector for use by a surgeon to staple an anatomical structure of a patient during a surgical procedure includes an anvil and a cartridge. Each of the anvil and the cartridge has a face that is positionable on the anatomical structure. The anvil is coupled to the cartridge at first and second ends. The anvil is movable relative to the cartridge to define a first gap between the faces at the first ends that is different from a second gap between the faces at the second ends.

Abstract: Provided herein are methods and materials for improving arteriovenous fistula (AVF) maturation and/or maintaining AVF functionality. For example, methods and materials for using one or more senolytic agents to improve AVF maturation, to maintain AVF functionality, and/or to maintain the patency of an AVF are provided. Methods and materials for using one or more senolytic agents to maintain functionality and/or patency of a venous graft (e.g., a venous graft that bypasses an occluded artery) also are provided.

Abstract: An apparatus for delivering an implant to an eye using a ratchet drive. Some embodiments of an apparatus for delivering an implant to an eye may comprise a gear rack configured to be coupled to the implant, a forward gearwheel, an input gearwheel meshed with the forward gearwheel, an idler gearwheel meshed with the input gearwheel, and a reverse gearwheel meshed with the idler gearwheel. An actuation lever may be configured to rotate the input gearwheel. Some embodiments may additionally comprise a pivot arm that may be operable to selectively engage the forward gearwheel and the reverse gearwheel to the gear rack.

Abstract: Methods and devices that prevent stasis in the LAA by either increasing the flow through the LAA or by closing off or sealing the LAA. Increasing the flow is accomplished through shunts, flow diverters, agitators, or by increasing the size of the ostium. Closing off the LAA is accomplished using seals or by cinching the LAA.

Abstract: The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to delivering a variable length stent within a patient. In one example, a stent may include a body comprising coils about a longitudinal axis of the stent and along the length of the stent between a proximal end and a distal end in a substantially helical pattern. The coils may define a lumen along the longitudinal axis through the center of the body. A distal tube may have a wall extending from the distal end of the body. A first aperture may extend through the wall of the distal tube into the lumen. A distal retention member may extend from the distal tube. A distal suture may have a mid-portion. The mid-portion may extend through the first aperture.

Abstract: Various exemplary methods, systems, and devices for joint to pump elevation level user interfaces, autocalibration for joint elevation, and joint pressure estimation are provided. In general, an arthroscopic pump can be configured to estimate fluid pressure at a surgical site, e.g., at a joint, to provide an accurate indication of fluid pressure to users. In an exemplary embodiment, the fluid pressure estimation is based on a fluid pressure measurement at the pump that is adjusted at the pump, e.g., by a processor at the pump that executes instructions stored in a memory at the pump, using one or more control algorithms that adjust for one or more factors, such as pressure loss in tubing and sheath through which fluid flows between the pump and the surgical site and elevation difference between the pump and the surgical site.

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: The present disclosure provides a fluidic device including (a) a first channel including a first inlet and a first outlet, (b) a second channel including a second inlet and a second outlet, wherein the second inlet of the second channel is in fluid communication with the first outlet of the first channel, and (c) a sensor positioned between the first outlet and the second inlet, wherein the sensor includes a sensor configured to deflect in response to a flow between the first channel and the second channel.

Abstract: A prosthetic heart valve and delivery system adapted to facilitate transapical or transfemoral implantation of a prosthetic heart valve, the delivery system comprising an elongated sheath or shaft have one or more loop stabilization wires adapted to circumscribe and crimp a metallic stent, the loop stabilization wires releasable with retraction of an engagement pin to expand the metallic stent and anchor the same in native tissue within the circulatory system of a patient.

Abstract: An apparatus for shunting blood includes a flow-indication chamber shaped to define an entry port and an exit port, and one or more moveable objects disposed within the flow-indication chamber and configured to move in response to a flowing of the blood from the entry port to the exit port. At least a portion of a wall of the flow-indication chamber is transparent so as to expose the moveable objects to sight. Other embodiments are also described.

Abstract: Implantable occlusion devices that include one or more flanges extending from a tubular body are disclosed. The flange or flanges may assist in retention of the device within a vessel, cavity, appendage, etc. At least one flange on the occlusion device may include a concave surface proximate one end of a body. Because of the shape of the flange, e.g., its concavity, the occlusion device may resist dislocation due to e.g., the forces generated within the left atrial appendage during atrial fibrillation.

Abstract: Described is a system for affecting intestinal microbial flora. The system includes an intestinal sleeve that is implanted in a patient and bypasses a section of the intestine; and probiotics, prebiotics or pharmacologic therapy used in combination with the intestinal sleeve. Also described are related methods.

Abstract: A mesh for repair/prevention of a parastomal hernia during ostomy treatment is disclosed. More specifically, a pre-molded mesh having a unique shape to provide support to the abdominal wall adjacent a stoma formed during an ostomy procedure to prevent/repair formation of a parastomal hernia is disclosed which also provides a clearance channel through which the bowel can pass in a manner that prevents collapse or obstruction of the exposed segment of the bowel.

Abstract: The present disclosure concerns embodiments of an implantable perfusion device that can be implanted in an injured blood vessel to control bleeding without occluding the vessel. In one specific implementation, the perfusion device can be implanted percutaneously into a patient's descending aorta to control bleeding at the site of a ruptured portion of the aorta (known as torso hemorrhage) while still allowing for the antegrade flow of blood from a location upstream of the ruptured portion of the aorta to a location downstream of the ruptured portion of the aorta. The perfusion device can be left inside the patient as the patient is transported to a medical facility where the injury can be repaired. Following repair of the vessel, the perfusion device can be withdrawn from the patient.

Abstract: The present disclosure relates generally to stents, systems, and methods for anchoring devices within a body lumen by cooperation between the device and the body musculature. A device comprising an elongate tubular member may be deployed within a body lumen, where the body lumen includes a sphincter that regulates flow through the body lumen. The elongate tubular member includes a sleeve formed from a flexible membrane and one or more stents disposed at either or both ends of the sleeve. In some embodiments, the stents may be treatment stents configured to treat a portion of the body lumen. The elongate tubular member may be deployed within the body lumen such that the flexible membrane aligns with and moves in coordination with the sphincter, thereby increasing retention forces acting upon the elongate tubular member when the sphincter is closed to minimize treatment stent migration.

Abstract: Junction assemblies for joining intravenous (IV) devices to tubing are provided. A junction assembly includes a component connector and a shaped memory polymer (SMP) member formed of a shape changing material. The junction assembly allows movement of the tube along the component connector when the SMP member is in an expanded state and the junction assembly retains the tube securely against the component connector when the SMP member is in a contracted state. The shape changing material changes to one of the expanded state and the contracted state upon being subjected to an external stimuli. Methods of assembling junction assemblies are also provided.

Abstract: Disclosed are devices and methods for delivering a sheet of tissue into the eye in such a way that damage to the tissue is minimized, damage to the eye during insertion and manipulation of the tissue is minimized, and the tissue is released and delivered in a precise and controlled fashion.

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

Abstract: A disposable device for treating a condition of a ureter or kidney having a cylindrical body about 1-2 mm in diameter by about 5 to 10 mm in length and having a top and bottom end. The body is made of absorbent material that expands upon contact with pharmaceutical agent and bodily fluids and includes a string connected to the bottom end of the body for removing the device. The device can be used to treat a condition of the ureter or kidney by inserting into the ureter or kidney, delivering a pharmaceutical agent, and removing the device after it has been impregnated with fluid. The device can be included in a kit with an insertion device and/or appropriate pharmaceutical agents.

Abstract: The embodiments disclosed herein relate to a ureteral stent having two stent bodies and a tether. The stent can minimize or prevent migration of the device out of the bladder of the patient while also reducing patient discomfort associated with such stents.

Abstract: Methods and devices that prevent stasis in the LAA by either increasing the flow through the LAA or by closing off or sealing the LAA. Increasing the flow is accomplished through shunts, flow diverters, agitators, or by increasing the size of the ostium. Closing off the LAA is accomplished using seals or by cinching the LAA.

Abstract: A surgical instrument comprising a first jaw, a second jaw rotatable relative to the first jaw, and a closure system for closing the second jaw is disclosed. The closure system comprises a multi-stage closure system. In at least one instance, the closure system comprises a first closure member which closes the second jaw quickly, but with low force, and a second closure member which closes the second jaw more slowly, but with a higher force.

Abstract: Glaucoma treatment systems are disclosed. In various example, the glaucoma treatment systems include a body and a fluid conduit configured to facilitate an evacuation of fluid, such as aqueous humor, from a fluid-filled body cavity, such as an anterior chamber of an eye. In some examples, the fluid conduit is soft and compliant, and the glaucoma treatment system includes one or more stiffening members coupled with the fluid conduit to temporarily stiffen the fluid conduit and help aid in the delivery of the glaucoma treatment device. In some examples, the stiffening members are removable from the fluid conduit after the glaucoma treatment system has been implanted.

Abstract: Delivery devices, systems and methods are provided for inserting an implant into an eye. The delivery or inserter devices or systems can be used to dispose or implant an ocular stent or implant, such as a shunt, in communication with a suprachoroidal space of the eye. The implant can drain fluid from an anterior chamber of the eye to a physiologic outflow path of the eye, such as, the suprachoroidal space or other portion of the uveoscleral outflow path. The delivery or inserter devices or systems can be used in conjunction with other ocular surgery, for example, but not limited to, cataract surgery through a preformed corneal incision, or independently with the inserter configured to make a corneal incision. The implant can be preloaded with or within the inserter to advantageously provide a sterile, easy-to-use package for use by an operator.

Abstract: In general, medical sheath systems that include a curved support sheath are described. In one embodiment, the support sheath includes a curved tube includes a distal portion fixed in an orientation perpendicular to the proximal end during advancement of an interventional tool through the support sheath.

Abstract: An adjustable length medical device, such as a drainage stent, and delivery device for placing within the body, having an elongate tube and retention members at each end portion for anchoring the device in the body. The proximal portion of the device including the proximal retention member may be segmented in incremental portions so that the length of the device can be adjusted for placement.

Abstract: A method may include positioning a first device within an internal carotid artery of a subject and impeding antegrade blood flow in the internal carotid artery. Additionally, the method may include delivering a pharmaceutical agent through an external carotid artery for passage into an ophthalmic artery of the subject.

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: A shunt system used to treat excess cerebrospinal fluid (CSF) accumulation is described. In some embodiments, the system utilizes various mechanical, electrical, or electromechanical concepts designed to either clean a portion of the shunt system, or customize CSF drainage.

Abstract: The present disclosure discloses a nephrostomy tube and a nephrostomy tube with curved drainage. The nephrostomy tube with curved drainage includes a bending head, a balloon element, and an elongated main body integrally connected with each other, wherein the nephrostomy tube with curved drainage has an guiding channel adapted for a guiding member to penetrate through, wherein the bending head has a first inner channel and at least two drainage bending channels located on the outer side of the first inner channel, wherein the balloon element has an air chamber and a second inner channel, wherein the at least two drainage bending channels are communicated with the second inner channel, wherein the elongated main body has a third inner channel communicated with the second inner channel of the balloon element, wherein the first inner channel, the second inner channel and the third inner channel from the guiding channel.

Abstract: Apparatus and associated methods relate to a lead that includes metallic traces sandwiched between layers of polymers to form a ribbon (e.g., similar to a flex circuit). In an illustrative example, areas on both ends of the traces may be exposed, forming stimulation electrodes on one end and electrical contacts on the other. The ribbon may be formed such that it fits down a small diameter needle. When the needle is removed, the formed ribbon may relax and engage the tissue providing a means of retention. The lead may advantageously: (1) be minimally invasive to implant, (2) be inexpensive, (3) stay in place a temporary/trial medical procedure setting, and (4) be easy to remove.

Abstract: The present invention provides materials and methods for using electrical stimulation to treat a mammal having a proteinopathy (e.g., neurodegenerative diseases) or at risk of developing a proteinopathy are provided. For example, the present invention provides materials and methods for modulating glymphatic clearance (e.g., enhancing glymphatic clearance) of pathogenic proteins.