Abstract: A surgical technique and device wherein an indwelling tube is placed in the eye of a patient having glaucoma. The tube diverts aqueous humor from the anterior chamber to the suprachoroidal space from which it is removed by blood flowing in the choroidal and uveal tissues. This decreases the intraocular pressure.

Abstract: Devices, systems, and methods for organ retroperfusion. In at least one embodiment of a method of organ perfusion of the present disclosure, the method comprises the steps of positioning at least part of a first catheter having a cannula within an artery of a patient, the first catheter configured to permit arterial blood to flow therethrough and further configured to permit a portion of the arterial blood to flow through the cannula, positioning at least part of a second catheter within a vein of the patient at or near a target organ, the second catheter configured to receive some or all of the portion of the arterial blood, and connecting the cannula of the first catheter to a portion of the second catheter so that some or all of the portion of the arterial blood flowing through the cannula is provided into the vein to treat a condition or disease of the target organ.

Abstract: One disclosed embodiment comprises a method for treating lesions in the carotid artery of a mammalian body. The method comprises transcervical access and blocking of blood flow through the common carotid artery (with or without blocking of blood flow through the external carotid artery), shunting blood from the internal carotid artery and treating the lesion in the carotid artery.

Abstract: A connector for fluidly coupling proximal and distal tubular segments of a fluid conduit is provided. In one embodiment, a system is provided for providing continuous flow of blood between two locations in a patient's cardiovascular system. A first blood conduit is provided that has a distal portion and a proximal portion. The distal portion is adapted to be inserted into a blood vessel at an insertion site and to be advanced therethrough to a location spaced apart from the insertion site. The system is provided with a connector that has a distal portion adapted to be engaged with the proximal portion of the first blood conduit and a tubular body extending proximally of the distal portion. The tubular body is adapted to be inserted into and/or attached to an end of a second blood conduit, such as a vascular graft or the like.

Abstract: A bio-compatible lumen bearing device such as a catheter formed of a polymeric material having a titanium surface bonded to the underlying exposed catheter surface. The titanium surface is employed in patients to improve bio-compatibility and enhance lubricity during insertion and removal.

Abstract: Devices and methods for gastrointestinal bypass are described. A gastrointestinal bypass device includes a gastrointestinal cuff and a gastrointestinal sleeve. The cuff may be configured to be attached in the esophagus, and may be sufficiently flexible to expand and collapse to conform with the inside of the esophagus to allow the esophagus to function substantially normally. The sleeve is configured to be coupled to the cuff, and may be made of a material that is floppy or flaccid but does not substantially expand radially.

Abstract: The invention relates to a device for use in glaucoma surgery intended for implantation in the eye. The device comprises a flat head region (8), a probe (6) which adjoins the head region (8), and a relief channel (7) which extends through the head region (8) and the probe (6) and is open at both sides. The design and dimensions of the head region (8) and of the probe (6) are such that the probe (6) can be inserted by its free end through the sclera (4) into the posterior chamber (10) of the eye in order to reduce an excessive intraocular pressure when the conjunctiva (3) is open, and such that, in the inserted position, the lower side of the head region (8) comes into abutment with the sclera (4), and the upper side of the head region (8) can be covered by closing the conjunctiva (3) such that drainage can be performed from the posterior chamber (10) into a gap (11) between the conjunctiva (3) and the sclera (4).

Abstract: A shunt rivet for implantation in the aorta and inferior vena cava to treat chronic obstructive pulmonary disease, and a method of treating chronic obstructive pulmonary disease. The shunt rivet may be formed to have a central section, a proximal clinch section, and a distal clinch section each having one or more clinch members. These one or more clinch members may be trained to be resiliently biased to bend radially outwardly from the central section.

Abstract: A device and method for achieving hemostasis and leakage control in vascular structures and other body ducts or vessels in an emergency room or trauma situation. The device has at least one shunt that contains an obturator on an end of the shunt. The shunt is inserted into a damaged vessel or lumen for sealing the leak or hemorrhage. Two shunts that both contain obturators on one of their ends can be inserted into two different vessels or lumens when the vessel or lumen has been severed. The obturators allow for the improved ease of insertion into the vessel or lumen. The two shunts are then releasably attached to restore fluid communication through the vessel or lumen. The shunt is placed temporarily within the patient and then removed when definitive repair can be achieved by a qualified physician.

Abstract: Glaucoma can be treated by implanting an intraocular shunt into the eye. Such procedures can employ various deployment devices, shunts, and implantation techniques.

Abstract: The present application is directed to devices and methods that can treat dementia or other brain disorders via electrical stimulation. Embodiments disclosed herein utilize brain stimulation of brain areas involved in memory and cognition through an intraventricular approach. Brain stimulation is combined with CSF flow in an intraventricular electrode having one or more passageways to permit fluid to flow therethrough. For example, an intraventricular electrode shunt catheter can be safely placed in any part of the ventricular system and through any foramen or aqueduct of the ventricular system without fear of obstruction to CSF flow.

Abstract: An apparatus for cleansing and promoting tissue growth in wounds, in which irrigant fluid optionally containing cell nutrients and/or other physiologically active material from a reservoir connected to a conformable wound dressing and wound exudate from the dressing are recirculated by a device for moving fluid through a flow path which passes through the dressing, a biodegradable scaffold in contact with the wound bed and a means for fluid cleansing and back to the dressing. The apparatus has means for supplying thermal energy to the fluid in the wound. The cleansing means (which may be a single-phase, e.g. micro-filtration, system or a two-phase, e.g. dialytic system) removes materials deleterious to wound healing, and the cleansed fluid, still containing materials that are beneficial in promoting wound healing, is returned to the wound bed. The dressing and a method of treatment using the apparatus.

Abstract: A shunt rivet for implantation between a first body space and a second body space in a patient, such as to treat chronic obstructive pulmonary disease.

Abstract: An implant may be used for implantation into tissue of a body. The implant includes an elongated conduit and a loop. The elongated conduit has an interior passageway for conducting fluid. The loop has an interior circumference with a fluid conducting channel formed therein. The channel is interconnected with the interior passageway for delivery of fluid between the channel and the interior passageway.

Abstract: Implanting an intraocular shunt into an eye can involve creating an opening in the cornea and positioning a shunt in the anterior chamber of the eye such that the shunt terminates between layers of Tenon's capsule, thereby facilitating fluid flow out of the anterior chamber into a space between the layers of Tenon's capsule.

Abstract: A patient is provided with an increased sense of satiety by increasing resistance to the outflow of food from the stomach and through the intestines. Stomach emptying may be slowed with devices implantable within the gastrointestinal tract below the stomach. Implants are preferably removable and can include artificial strictures that may be adjustable to vary the rate of stomach emptying. Slowing gastric emptying may induce satiety for a longer period and may therefore reduce food consumption. Many of the embodiments include intestinal liners or sleeves, but they need not. The resistor concept may be applied to a simple anchor and resistor without a long liner.

Abstract: Treating glaucoma utiilizing a shunt having an elastormeric plate and a non-valved elastomeric drainage tube. The plate is positioned over a sclera with an outflow end of the elastomeric drainage tube open to an outer surface of the plate. An inflow end of the drainage tube tunnels through the sclera and cornea to the anterior chamber of the eye. The drainage tube collapses upon initial insertion within an incision in the sclera and cornea, or at a kink on the outside of the incision, but has sufficient resiliency to restore its patency over time. The effect is a flow restrictor that regulates outflow from the eye until a bleb forms around the plate. The plate desirably has a peripheral ridge and a large number of fenestrations, and a longer suturing tab extending from one side of the plate to enhance visibility and accessibility when suturing the shunt to the sclera.

Abstract: Intestinal devices and methods for facilitating weight loss. In at least one embodiment of a method of patient treatment of the present disclosure, the method comprises the step of positioning a device, that is configured to reduce or limit localized intestinal distension, around a portion of an intestine of a patient.

Abstract: Methods and devices are adapted for implanting into the eye. An incision is formed in the cornea of the eye and a shunt is inserted through the incision into the anterior chamber of the eye. The shunt includes a fluid passageway. The shunt is passed along a pathway from the anterior chamber through the scleral spur of the eye into the suprachoroidal space and positioned in a first position such that a first portion of the fluid passageway communicates with the anterior chamber and a second portion of the fluid passageway communicates with the suprachoroidal space to provide a fluid passageway between the suprachoroidal space and the anterior chamber.

Abstract: A suprapyloric anchor assembly includes an antral cap having at least three stabilizing members configured to reside in an antrum and engage tissue circumscribing a pyloric valve. A duodenal member is configured to reside at least partially in a duodenal bulb, and one or more tethers connect the antral cap to the duodenal member. The tether(s) is/are configured to allow passage of stomach contents through the pyloric valve. Optionally, one or more gastric balloon(s) may attached to the suprapyloric anchor and be inflated with the gastric cavity.

Abstract: In one aspect, the present invention provides an implant device for use in an eye with elevated intraocular pressure or glaucoma. In another aspect, the present invention provides a method for lowering intraocular pressure and/or treating a condition associated with elevated intraocular pressure using the implant device of the present invention.

Abstract: A tubular body portion lining assembly adapted for insertion into a tubular body portion of a patient, the assembly including a flexible tubular liner including at least one generally circumferentially disposed attachment portion on its outer surface adapted to face the internal walls of the tubular body portion and to attach the liner thereto, and liner placing functionality adapted to place at least a portion of the tubular liner between first and second locations within the tubular body portion.

Abstract: An inserter is provided for inserting a tubular medical implant device into tissue. The inserter includes a rigid rod extending along a longitudinal axis. The rod has a distal portion that defines an open slot. The open slot extends diametrically through the rod along the longitudinal axis to a base. The open slot is configured to receive and release the tubular medical implant device.

Abstract: A digestive tract device is configured to reduce the burden on a living body associated with the adjustment of the length of a tubular portion retained inside the living body and simplify a retention operation after introducing the digestive tract device into the living body. The digestive tract device includes a tubular portion provided with a main body having a through hole extending in the longitudinal direction and a tip opening continuous with the through hole and a folded-back portion formed by folding back the main body in the longitudinal direction, a holding unit which holds the folded-back portion in a folded-back state with the tip opening open, and a retention unit which is provided on the base end side of the tubular portion and retains the tubular portion inside a living body.

Abstract: The present invention provides systems and methods for treating and controlling obesity and/or type II diabetes. In one aspect of the invention, an internal bypass device includes gastric and duodenal anchors coupled to each other and positioned on either side of the pylorus and a hollow sleeve designed to extend from the pylorus through at least a proximal portion of a patient's small intestine. The gastric and duodenal anchors are movable between collapsed configurations for advancement through the esophagus and an expanded configuration for inhibiting movement of the anchors through the pyloric sphincter. Thus, the bypass device can be placed and removed endoscopically through the patient's esophagus in a minimally invasive outpatient procedure and it is “self-anchoring” and does not require invasive tissue fixation within the patient's GI tract, thereby reducing collateral tissue damage and minimizing its impact on the digestive process.

Abstract: A system includes a scleral prosthesis and an insert. The scleral prosthesis includes an elongated body having a first free end and a second free end opposite the first end. A maximum width of the body at each end is wider than a maximum width of the body between the ends. The body includes multiple first portions that form the first end of the body and a part of the body between the ends. The first portions are separated lengthwise along a substantial portion of a total length of the body. The first portions are biased so that they maintain separation from one another without external interference but are configured to be pushed towards each other. The insert is configured to be placed between the first portions to maintain a separation of the first portions. The body and/or the insert could be formed using one or more magnetic materials.

Abstract: An implantable ophthalmological device (10) in the form of a punctal plug or canalicular implant is configured for use at or near the nasolacrimal drainage system. In a deployed state, the device (10) may include an elongated body (25), an anchor (15) operably connected to the elongated body (25), a radially expanding occlusive feature disposed on an outer circumference of the elongated body (32), and a flange (30). The elongated body (25) may define a lumen (35) configured to receive a pharmacological treatment (55). The device (10) is made of a shape memory material such as a shape memory polymer.

Abstract: A satiation device is described which includes a sheath or liner extending from the proximal or middle stomach to the distal antrum. Food ingested by the patient passes through the sheath or liner, thereby minimizing contact between the ingested food and the stomach. It is believed that over time, reduced contact between food and the stomach will result in decreased Ghrelin production by the patient and a consequent decrease in appetite. In some embodiments, the satiation device may also include a proximal pouch and/or a distal bypass tube.

Abstract: The invention relates to a method and a device for treatment of glaucoma, wherein by means of an elongated catheter provided with a distal portion and a proximal portion, a tube-shaped implant is inserted and released in a Schlemm's canal with two opposite openings exposed by an incision and a folded up scleral flap. In a first phase, the distal portion inserted into the Schlemm's canal through the first opening, while a fluid or gaseous medium is injected at the same time, and exited through the second opening, which is, in circumferential direction, oppositely located. The implant detachably disposed at the protruding distal portion and, in a second phase, inserted, in circumferential direction, into the expanded Schlemm's canal up to the first opening. Subsequently, the distal portion, which protrudes from the first opening, is detached from the implant and, together with the catheter, removed.

Abstract: Disclosed are devices and methods for treatment of eye disease such as glaucoma. Implants are described herein that create a flow field, such as between the anterior chamber and either the supraciliary space or suprachoroidal space. In addition, the implant can be treated with one or more treatments, including plasma treatments, for creating a variety of surface features and characteristics. Some of the surface features and characteristics can assist in controlling tissue responses to the implanted implant, including promoting or preventing tissue proliferation.

Abstract: A lacrimal duct tube (31) includes an integrated tube that is placed in a lacrimal duct and capable of insertion of an insertion aid (36) in a detachable manner. The tube (31) has a terminal end opening (33) at a terminal end. In the vicinity of the terminal end opening (33), a stopper part (32a, 32b, 32c, and 32d) for stopping the insertion aid (36) is inserted in the tube (31). The stopper part (32a, 32b, 32c, and 32d) is opened at both ends in an axial direction of the tube and has a cylindrical structure including an inner wall surface (37a, 37b, 37c, and 37d) to guide and stop the insertion aid (36).

Abstract: An artificial blood has a trunk portion with both ends connected to blood vessels, and access branch portions and a shunt branch portion branched from the trunk portion. The access branch portions are disposed with a solid column-shaped access port that plugs these branch portions. The access port has a solid center portion and a tube-shaped peripheral portion disposed to surround the center portion. The peripheral portion is harder than the center portion and prevents the needle from deviating from the inside of the center portion. This enables a puncture to be easily made in a therapy in which a puncture is highly frequently made in a blood vessel.

Abstract: A cardiovascular conduit system may comprise a connector. The connector may comprise a proximal end adapted to attach to a cardiovascular organ. The proximal end may comprise a first plurality of expandable members, and each member in the first plurality of expandable members may be deployable from a delivery position to a deployed position. The first plurality of expandable members may be dimensioned to deploy inside the cardiovascular organ to secure the connector to the cardiovascular organ. The connector may comprise a distal end adapted to attach to a conduit and an opening extending through the connector. Connectors for cardiovascular conduit systems may also include expandable stents. Connectors may be rotatably secured to a conduit, and the conduit may be reinforced. Methods for forming and using cardiovascular conduit systems are also disclosed.

Abstract: Disclosed herein are elongate flexible medical devices which are capable of axial elongation through the mechanism of eversion or toposcopic expansion. In general, this may be accomplished by providing a flexible tubular device having a proximal end and a distal end. Retraction of the distal end in a proximal direction through the tubular body inverts the tube upon itself, causing an axial shortening of the overall length of the device. The original length of the device can be restored by coupling a pressurized media to the proximal end of the sleeve. If the distal end of the sleeve is temporarily restricted or closed, the pressurized media causes the distal end of the sleeve to travel distally until the full length of the sleeve has been restored.

Abstract: An implant includes a collapsible anchor to be deployed within a lumen and a protrusion coupled to the anchor. The protrusion, in a constrained state, extends a distance from an exterior surface of the anchor and, in an unconstrained state, extends further from the exterior surface of the anchor. Also included is a biodegradable constraint, such as a biodegradable tube or suture, configured to maintain the protrusion in the constrained state until the constraint releases. The implant may include additional biodegradable constraints, each constraint configured to maintain the protrusion in a different constrained state and to degrade over a different predetermined period after the implant has been deployed within the lumen. The protrusion may include a bi-directional barb or an open loop. The protrusion may be configured to penetrate a wall of the lumen and to allow tissue to grow about the protrusion.

Abstract: An intraluminal sleeve system is provided, which generally includes an intraluminal sleeve capable of dispensing an active agent to a patient, for example, a metabolic agent or satiety inducing agent. The intraluminal sleeve may be structured to contain the active agent and permit controlled release of the active agent to the patient while the intraluminal sleeve is positioned within the patient's intestine. Methods for treating obesity are also provided which include positioning an intraluminal sleeve in a patient's intestine, the intraluminal sleeve being capable of dispensing an active agent to the patient. In one embodiment, the active agent may be contained in a reservoir and dispensed to a portion of the patient's body.

Abstract: A covered radially-expansible stent, capable of being advanced along a bodily lumen, and capable of performing as an arteriovenous shunt, and with a covering that stops short of one end of the stent at a line that slants to the longitudinal axis of the stent at an angle intermediate between 0° and 90°.

Abstract: A self adjusting venous equalizing graft (SAVE graft) which provides a self regulating stenosis is provided herein. The SAVE graft responds to increases or decreases in blood pressure which allows a higher pressure at the graft's arterial end and a lower pressure at the graft's venous end. This is ideal in that it mimics the natural pressure of a patient's circulatory system. A dialysis machine may draw blood at the arterial end, dialyze the blood, and return the blood to the patient at the graft's venous end. The lower pressure at the venous end prevents damage to the patient's vein. The SAVE graft may comprise a deformable stenosis control diaphragm or a venous controlled pressure nozzle which may expand or contract in response to blood pressure to self regulate the stenosis provided by the SAVE graft.

Abstract: Disclosed are lacrimal inserts and their method of use for delivery of medication to the eye. The plug includes a body portion sized to pass through a lacrimal punctum and be positioned within a lacrimal canaliculus of the eyelid and includes means for directional release of medication into the lacrimal fluid. The plug may contain a core, or reservoir, at least partially within the body portion comprising a therapeutic agent that is configured to controlled release into the eye.

Abstract: A system for measuring quantitative CSF flow in shunt tubing implanted under the skin. The system includes an array of thermosensors clustered in three sections, cooling device, placed on the skin surface and an associated data acquisition and analysis device. Two sensor sections are placed over the shunt on the skin and measure real time temperature responses related to CSF movement. One array placed adjacent the cooling device collects data on thermal properties of skin including skin thermal condictivity, specific heat, diffusivity, perfusion, and thermal inertia. The method involves assessing thermal properties of skin and measuring CSF flow in shunt tubing. The method is useful for shunt patency assessment, CSF valve adjustment procedures and CSF flow measurements related to CSF over drainage. Alternatively, only one section of sensors need be used when determining relative CSF flow, without the need to determine thermal skin properties and by applying the cooling device continuously.

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: Apparatus (200) for use with pancreaticobiliary secretions that enter a gastrointestinal tract at an anatomical location. A secretion-diversion guide (370) comprises: a proximal portion (124); a distal portion (126); first and second anchors (36/38) coupled to the proximal and distal portions which apply pressure to the tract to maintain guide (370) in place; a collection-facilitation tube (280), between the anchors, having an inner surface (245) and an outer surface (246), the inner surface defining a lumen for passage of food. The outer surface inhibits contact of the secretions with food and defines a space (7) between the outer surface and the tract. A diversion tube (290) is in communication with the space and passes secretions from the space distally, and inhibits food-secretion contact. An intragastric anchor (170/171/172) coupled to guide (370), located in the stomach, maintains the guide in place. Other applications are also described.

Abstract: Methods and devices for diagnosing, monitoring, and/or treating tissue through an opening or port through an airway wall. A passageway is created extending from the airway to the target tissue. The passageway provides local access to the target tissue for treatment instruments and for delivering agents.

Abstract: An ocular implant comprising a shunt and a fluid absorbing conduit for reducing intraocular pressure, and optionally comprising a biodegradable ring.

Abstract: Methods of treating ocular disorders are disclosed, such as a method that includes inserting an implant in eye tissue, using a delivery instrument, such that an inlet portion of the implant is in an anterior chamber of an eye and an outlet portion of the implant is in a physiological outflow pathway; removing the delivery instrument from the eye without removing the implant; and conducting fluid comprising a therapeutic substance through the implant and into the physiological outflow pathway. Another method includes inserting an instrument into a physiologic outflow pathway through which aqueous humor drains from an anterior chamber of an eye; separating first and second walls of tissues which comprise the physiologic outflow pathway by injecting a fluid comprising a drug from the instrument while the instrument remains in the physiologic outflow pathway; and withdrawing the instrument following the injection with said fluid remaining within the eye such that the drug has a therapeutic effect on the eye.

Abstract: Systems, devices, methods, and compositions are described for providing an actively controllable shunt configured to, for example, monitor, treat, or prevent an infection.

Abstract: A device for implantation a patient may include a tubular fiber wall that defines at least one opening and at least one lumen continuous with the one opening and adapted to allow the passage of fluid. The tubular fiber wall typically contains a porosity gradient that is adapted to permit passage of different size substances at different locations along the gradient. In one aspect, a second tubular fiber wall substantially encircling the tubular fiber wall.

Abstract: The present disclosure relates to a method and a device for treating heart failure by normalizing elevated blood pressure in the left and right atria of a heart of a mammal The present disclosure includes methods for creating and maintaining an opening in the atrial septum. Tools for making an opening and enlarging the opening are also disclosed. Use of the techniques and tools described herein prolongs the patency of an intra-atrial pressure relief opening.

Abstract: An apparatus for cleansing and applying therapy or prophylaxis to wounds, in which irrigant fluid containing a physiologically active material from a reservoir connected to a conformable wound dressing and wound exudate from the dressing are recirculated by a device for moving fluid through a flow path which passes through the dressing and a means for fluid cleansing and back to the dressing. A biodegradable scaffold underlies the dressing on the wound bed to promote tissue growth. The cleansing means (which may be a single-phase, e.g. micro-filtration, system or a two-phase, e.g. dialytic system) removes materials deleterious to wound healing, and the cleansed fluid, still containing materials that are beneficial in promoting wound healing, is returned to the wound bed. The dressing, an assembly comprising the dressing and scaffold, and a method of treatment using the apparatus.

Abstract: Method and apparatus for limiting absorption of food products in specific parts of the digestive system is presented. A gastrointestinal implant device is anchored in the pyloric portion of the gastrointestinal system and extends beyond the ligament of Treitz. All food exiting the stomach is funneled through the device. The gastrointestinal device includes an anchor for anchoring the device in the pyloric portion and a flexible sleeve that extents into the duodenum. The anchor is collapsible for endoscopic delivery and removal.