Abstract: An anterior chamber maintainer (ACM) is fastened to the cornea of a patient's eye at one or more, or potentially two or more, points of contact. The ACM can be inserted through a first and second incision. The ACM can be fastened to each of the two incisions using, for example, friction surfaces, ridges, a malleable tip, magnets, a segmented tip, or other types of fasteners. The ACM includes openings to provide irrigation solution to maintain the volume of the patient's eye during cataract surgery. The shape of the openings can be customized to reduce the amount of turbulence caused by the irrigation solution. By fastening the ACM to the cornea, the ACM is less likely to shift around or become dislodged from the eye during surgery. The ACM can be integrated with iris retractors to hold the position of a floppy iris during surgery.

Abstract: Systems, methods, and computer-readable media for providing a decision support solution to medical professionals to optimize medical care through data monitoring and feedback treatment are provided herein. In another embodiment, a computer-implemented method for modeling patient outcomes resulting from treatment in a specific medical area includes receiving patient-specific data associated with a patient, determining a plurality of possible patient states under which the patient can be categorized, a current patient state under which the patient can be categorized and determining probabilities of the patient transitioning from any of the possible patient states to every other possible patient state.

Abstract: The present invention operates to significantly reduce over or under drainage of cerebrospinal fluid (CSF) from the brain or spinal cord using an extraventricular drain (EVD) in the brain or lumbar drainage device (LDD) and automated intracranial pressure (ICP) monitoring. The present invention attaches the drainage catheter of the EVD to a flow controller or valve which controls the flow of CSF from the drainage catheter and is electronically controlled by a stepper motor communicating with a pressure transducer receiving pressure signals indicating an ICP without the need for constant manual re-leveling.

Abstract: A spray nozzle chip comprising: a first layer provided with a first layer orifice, and a mechanically flexible nozzle layer provided with a nozzle orifice, wherein the first layer has a valve seat arranged aligned with the nozzle orifice, wherein the spray nozzle chip has a valve functionality obtained by movement of the nozzle layer relative to the valve seat due to pressure changes, and wherein the nozzle layer is arranged at a distance from the valve seat when the nozzle layer is in a default non-pressurised state, whereby a gap with a gap length (L) is formed between the nozzle layer and the valve seat, wherein the gap length (L) is smaller than a dimension of a specific bacterial type, to thereby seal against bacterial ingrowth through the nozzle orifice of the specific bacterial type.

Abstract: A circulatory support device includes a flexible cannula having a fluid outlet at a proximal end, and a pump assembly disposed at a distal end of the flexible cannula. The pump assembly includes a pump housing having a fluid inlet defined therein, a motor disposed within a distal end of the housing, and an impeller, driven to rotate by the motor, and configured to push blood toward the fluid outlet. A method of deploying the device to a subject's heart using an insertion manifold that prevents a protective tube from advancing with the device into a delivery shaft, is also disclosed. Pushing the device into and then out of the shaft expands and secures a cage at a location in the vasculature.

Abstract: Adjustable flow glaucoma shunts are disclosed herein. In one embodiment, for example, a variable flow shunt for treatment of glaucoma in a human patient includes an elongated outflow tube having (a) a proximal inflow portion configured for placement within an anterior chamber in a region outside of an optical field of view of an eye of the patient, and (b) a distal outflow portion at a different location of the eye. The variable flow shunt further includes a flow control mechanism positioned along the outflow tube between the inflow portion and the outflow portion. The flow control mechanism comprises one or more control elements transformable between an open position that allows fluid to flow through the outflow tube and resistance positions that partially obstruct or attenuate fluid flow through the outflow tube. During operation, the control element(s) are movable between positions in response to non-invasive energy.

Abstract: An illustrative endoluminal implant having an elongated tubular member. The elongated tubular member having a stent and a retrieval suture interwoven with the stent. The retrieval suture including a first suture loop extending about a circumference of the stent and adjacent to a suture retrieval loop and a second suture loop extending about a circumference of the stent and longitudinally spaced from the first suture loop. The first and second suture loops coupled via one or more interconnecting segments. At least one of the first or second suture loops has an arc length of less than 270° of the circumference of the stent.

Abstract: In a surgical drain system formed with two or more branches, exudate flow from a patient's wound is directed between two branches with the respective filling and emptying times determined in order to identify the presence of a blockage in the drain.

Abstract: A medical implant includes a primary tubular member having a first end and a second end and defining a primary longitudinal axis and a primary lumen. The primary tubular member is disposed in an arterial-venous connection. The medical implant also includes a baffle disposed transversely to the primary longitudinal axis within the primary lumen. The baffle defines at least one aperture therethrough.

Abstract: Described are methods, systems, devices for facilitation of intraluminal medical procedures within the neurovasculature. A catheter advancement device includes a flexible elongate body having a proximal portion coupled to a proximal end region of the flexible elongate body and extending proximally to a proximal-most end of the catheter advancement element. A hardness of the flexible elongate body transitions proximally towards increasingly harder materials up to the proximal portion forming a first plurality of material transitions. At least a portion of the flexible elongate body is formed of a plurality of layers including a reinforcement layer. An outer diameter of the flexible elongate body is sized to be positioned coaxially within a lumen of a catheter such that a distal tip portion of the flexible elongate body extends distally beyond a distal end of the catheter to aid in delivery of the catheter to an intracranial vessel.

Abstract: A pressure regulator includes a first chamber having an inlet opening for fluidly connecting to a first pressure source; a second chamber having an outlet opening for supplying a regulated pressure to a regulated site; a third chamber having a pressure opening for connecting to a second pressure source; and a flexible membrane fluidly isolating the third chamber from both of the first and second chambers, wherein the flexible membrane is movable by the pressure source between a first position in which the flexible membrane fluidly isolates the first chamber from the second chamber and a second position in which the first and second chambers are fluidly connected.

Abstract: Apparatus and methods are provided for treating diseases that produce elevated intraocular pressures, such as glaucoma, wherein the device includes a housing shell defining a cavity between a first end and a second end of the housing shell, and an elastic membrane disposed within the cavity to divide the cavity into a fluidic channel that permits a flow of fluid from the first end to the second end and a sealed cavity. The elastic membrane deforms to change the volume of the sealed cavity responsive to pressure fluctuations between the first and second ends, thereby varying the fluidic resistance of the flow of fluid through the fluidic channel.

Abstract: A device for occluding flow of materials is formed as a simple structure permitting a compact delivery configuration which may shift to an expanded deployment configuration. The device has at least one expandable portion formed of a plurality of elongated longitudinally extending frame elements. The frame elements may be spaced apart to define spaces therebetween, and a flexible occlusive material may be provided to block flow of material through such spaces. A flexible occlusive material may form one of two expandable portions of the device without the need for frame elements.

Abstract: The present disclosure relates generally to controlling a volume of fluid within a portion of a patient's body. For example, the present disclosure can relate to the addition or removal of cerebral spinal fluid (CSF) from a portion of the patient's brain. The amount of fluid can be controlled by a system that includes a dual chamber probe and a volume control. One channel can include a drain element to drain the fluid from the portion of a patient's body. The other channel can include a volume changing element to facilitate the drainage of the fluid by changing a volume of the portion of the patient's body. The volume changing element can be coupled to a volume control, which can control the change of the volume of the portion of the patient's body (e.g., based on passive oscillation or active oscillation).

Abstract: An apparatus for moving a fluid to or from a cavity on a body of a human or mammal patient. The apparatus comprising a fluid movement device, an energy source adapted to supply energy to said fluid movement device and at least one connecting tube having a tube end. The at least one connecting tube being connected to the fluid movement device. The apparatus further comprises, a flexible patch. The fluid movement device and the at least one connecting tube forms a fluid moving arrangement adapted to be implanted inside the body of the human or mammal patient. The fluid movement device is adapted to move fluid from a treatment area via the at least one connecting tube to a delivery area. The flexible patch comprises a net structure adapted to be overgrown by human fibrotic tissue hen implanted in the patient.

Abstract: Devices and methods are configured to allow transcarotid or subclavian access via the common carotid artery to the native aortic valve, and implantation of a prosthetic aortic valve into the heart. The devices and methods also provide means for embolic protection during such an endovascular aortic valve implantation procedure.

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 allow for treatment of increased intraocular pressure by permitting aqueous humor to flow out of the anterior chamber of the eye through the device.

Abstract: Systems, catheters, and methods for accessing and treating along the central nervous system are disclosed including sampling systems. An example sampling system may include a filter cassette designed to filter cerebrospinal fluid. The filter cassette may have an inlet region configured to be coupled to a catheter and configured to receive cerebrospinal fluid, one or more filters, and an outlet region configured to be coupled to an outlet of the catheter and to direct filtered cerebrospinal fluid to the catheter. A sampling port may be in fluid communication with the filter cassette. The sampling port may have a first end region configured to receive cerebrospinal fluid, a stopcock, a syringe port, and a second end region. The stopcock may be configured to shift between a first position where cerebrospinal fluid is directed from the first end region to the second end region and a second position where cerebrospinal fluid is directed from the first end region to the syringe port.

Abstract: The disclosure provides example shunt apparatus and methods for deploying the apparatus. The apparatus includes (a) an inner catheter having first and second ends, where the inner catheter has a plurality of fenestrations extending along a portion of the inner catheter, (b) an outer catheter, where the inner catheter is positioned at least partially within a lumen of the outer catheter, (c) a deployment wire moveably arranged in a lumen of a conduit that is coupled to the outer catheter, and (d) a mesh arranged surrounding at least the first end of the inner catheter, where the mesh has a first end coupled to the inner catheter and the mesh has a second end coupled to the deployment wire, where the mesh is configured to move between a first position in an unexpanded condition having the form of a sheath to a second position in an expanded condition.

Abstract: A cerebral spinal fluid shunt plug includes a shunt plug housing having a recess formed therein and a shunt valve shaped and dimensioned for positioning within the recess of the shunt plug housing.

Abstract: A system for bypassing a portion of a small intestine. The system includes an occlusion device and a bypass device. The occlusion device includes a tubular body, an occlusion member at a distal end portion of the tubular body, and an anchor member at a proximal end portion of the tubular body. The bypass device includes a liner, and an anchor member at a proximal end portion of the liner.

Abstract: Systems and methods are adapted for treating the carotid artery. The systems include interventional catheters and blood vessel access devices that are adapted for transcervical insertion into the carotid artery. Embodiments of the systems and methods can be used in combination with embolic protection systems including blood flow reversal mechanisms, arterial filters, and arterial occlusion devices.

Abstract: Disclosed herein are systems, devices, and methods for accessing a subdural space. In some embodiments, an apparatus may comprise a shaft configured to be slidably disposed within a lumen of a catheter. The shaft may be configured to be advanced distally from a distal end of the catheter and into a blood vessel of a subject. The shaft may include a perforating tip including an energy element configured to generate radiofrequency energy to form an opening through a wall of the blood vessel and dura of the subject and into an extravascular space of the subject. A curved section may be configured to be radially constrained within the lumen of the catheter and to curve toward the wall of the blood vessel and the dura upon exiting the lumen of the catheter such that the energy element is positioned to form the opening.

Abstract: The present invention relates to an implantable apparatus and methods of use thereof for treating congestive heart failure. An apparatus of this invention may be anchored by implantation of a section of the apparatus within in a branch pulmonary artery, for example the left pulmonary artery, which then positions and anchors another section, for example a device frame section of the apparatus within the main pulmonary artery. A medical device may be attached to the anchored device frame.

Abstract: An example magnetically activated implantable valve according to the present disclosure includes an implantable valve, the implantable valve including a first set of passive magnets, and an actuator configured to actuate the implantable valve. The actuator includes a second set of passive magnets corresponding to the first set of passive magnets. The first set of passive magnets is configured to interact with the second set of passive magnets to actuate the valve. Another example magnetically activated implantable valve and an implantable valve for controlling flow of an active fluid are also disclosed.

Abstract: A medical device comprising an implantable subcutaneous access port having a septum penetrable by a needle; the septum having a cavity located between an outer wall and an inner wall, the cavity containing a flowable media comprising a plurality of displaceable particles arranged to move in response to the needle being inserted through the outer wall and into the cavity and reposition around the needle.

Abstract: An apparatus (10) for controlling flow of fluid from a wound site of a patient including a cavity (28) connectable to a wound site and a reservoir (16). The cavity (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 cavity (28) may be adapted to manage fluid flow between the wound site and the reservoir (16) during transition of the cavity (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 cavity (28) from the second state to the first state.

Abstract: Devices and methods for treatment of bodily lumens and sphincters are disclosed. Some embodiments include methods and devices for inducing an inflammatory response and development of fibrosis, collagen, and/or scar tissue. In some embodiments, scaffolds may be composed of a matrix of filaments. Application of the methods and devices disclosed herein to treat Gastroesophageal Reflux Disease (GERD) and other sphincter disorders are discussed. Biodegradable scaffolds configured to induce an inflammatory response are also disclosed.

Abstract: An implantable medical device configured to selectively permit access to a medicament reservoir or fluid pathway by way of at least one contactless key, including an implantable medical device having a medicament reservoir fluidly coupled to an access port via a first conduit and a second conduct via an access valve, and at least one contactless key configured to impart a magnetic field upon a portion of the implantable medical pump to manipulate the access valve between a first position fluidly coupling the medicament reservoir to the access port via the first conduit, and a second position fluidly coupling the medicament reservoir to the access port via the second conduit, and a third position isolating the medicament reservoir from the access port.

Abstract: Some embodiments of the invention advantageously leverage the expansion, dilation or by-pass of the Schlemm's canal using adjustable reversible self-expanding eye stents (SES) or eye tension rings (ETRs) of desired sizes to control and improve aqueous flow throughout the range of the uveolymphatic canal. As such, some embodiments include tension ring(s) or cylinders that sits either inside or outside the Schlemm's canal wall and is at least partially within the canal and/or is partially or fully anchored, attached, adhered, or otherwise held in place with respect to the wall and/or elsewhere in the canal. The partial or complete expansion of the canal can be pre-configured based on pre-operative metrology of the Schlemm's canal to a customized and adjustable fit across the various zones within the uveolymphatic canal and based on the patient specific and evolving needs.

Abstract: The present application relates to novel intraocular devices and their use in surgical techniques, as well as the novel surgical methodology achieved from their use.

Abstract: A device for use in pressure sensing has a housing enclosing a chamber and having at least one port that communicates with the chamber. A pressure sensor receives fluid pressure from the chamber. The chamber has a compliance that exhibits a marked change in volumetric stiffness repeatably at a fixed pressure.

Abstract: A subcutaneous arteriovenous graft system includes an arteriovenous graft having an arterial end, a venous end opposite to the arterial end and an internal volume between the arterial end and the venous end, and a valve device that can be arranged in an open state, in which fluid flow through the graft is possible and a closed state in which the fluid flow through the arteriovenous graft is blocked. The valve device is constructed to decrease, in the closed state of the valve device, the internal volume of the complete graft to substantially zero.

Abstract: Disclosed is a system including a flow control assembly. The system may include a flow regulating shunt system, for various purposes. The flow control assembly may be controlled according to selected parameters and methods.

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: An ocular electrolysis device is described that may include a diverting tube configured for insertion into an eye. The ocular electrolysis device may include an electrolysis chamber mechanically attached to the diverting tube such that aqueous from the eye enters the electrolysis chamber through the diverting tube. The ocular electrolysis device may include a pressure sensor located in the electrolysis chamber. The ocular electrolysis device may include a pair of electrodes located in the electrolysis chamber. The ocular electrolysis device may include a controller electrically connected to the pair of the electrodes and the pressure sensor, where the controller regulates electrolysis of the aqueous in the electrolysis chamber based on input from the pressure sensor through power levels at the pair of the electrodes.

Abstract: Provided herein is a glaucoma drainage implant assembly. The assembly may include a drainage implant tube defining a lumen there through defining a fluid channel between an anterior chamber of an eye and a region outside of the sclera of the eye; a closure disposed at a position outside the anterior chamber of the eye, the closure configured to preclude fluid flow from the anterior chamber of the eye to the region outside of the sclera of the eye; and a shunt received within the drainage implant tube, between the end of the drainage implant tube in the anterior chamber of the eye and the closure, where the shunt is configured to permit fluid flow from the anterior chamber of the eye, through the drainage implant tube, and out of the drainage implant tube external to the sclera of the eye through the shunt.

Abstract: An endovascular shunt implantation system includes a guide member configured for being deployed in an inferior petrosal sinus, and a delivery catheter movably coupled to the guide member, wherein a distal end of the delivery catheter includes a tissue penetrating element. A guard is disposed over the tissue penetrating element, the guard having an open distal end portion including an inner surface feature configured to deflect the tissue penetrating element away from the guide member when the tissue penetrating element is translated distally relative to the guard. A shunt delivery shuttle is positioned within, and is movable relative to, the delivery catheter, the shunt delivery shuttle having a distal portion configured to collapse around an elongate shunt body to thereby transport the shunt body through the delivery catheter, wherein the distal portion self-expands to release the shunt body when the distal shuttle portion is advanced out of the delivery catheter.

Abstract: The present disclosure describes devices, systems, and methods for intravascularly delivering an implantable device to a targeted anatomical site such as the mitral annulus. A delivery system includes a delivery member coupled to a handle assembly and extending distally from the handle assembly. A delivery catheter is concentrically positioned within an outer member and configured to advance the intravascular device relative to the outer member. The delivery catheter includes a distal can structure configured to house at least a portion of the intravascular device in a compressed, pre-deployed position.

Abstract: The present invention discloses indicator fluids, reference indicator fluid, and usage thereof, and systems and methods for assessing movement of molecular substances within, to or from a cerebrospinal fluid, brain or spinal cord compartment of a human cranio-spinal cavity. Indicator fluid moving from the cerebrospinal fluid compartment enables measurements of levels of indicator fluid in blood or urine and assessment of the cranio-spinal cavity's ability to remove molecular substances. The indicator fluids may be contrast agents used for imaging, such as by computed tomography imaging, and magnetic resonance imaging, or imaging utilizing radioactive substances by positron emission tomography, single-photon emission computed tomography or scintigraphy.

Abstract: Disclosed is a valve assembly operable to selectively control a flow or passage of a fluid. The valve assembly may be applied to any appropriate mechanism such as a hydrocephalus shunt, fluid draining sewage system, or tank holding system. The valve assembly disclosed may include a selected profile for various applications.

Abstract: An arteriovenous graft (AV graft) and method of using the AV graft to facilitate dialysis is described. The AV graft includes a tube having two or more embedded reinforcing elements that each extend along a length of the tube and extends circumferentially along a portion of the tube. The reinforcing element is positioned in the patent distal to the skin and assists by minimizing slippage of a hemodialysis needle that might happen to attempt to pierce the back side of the AV graft. The method includes providing the AV graft to the patient and providing hemodialysis to a patient provided with the AV graft.

Abstract: An ocular implant 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: An implantable medical pump system configured to selectively permit access to a medicament reservoir by way of at least one contactless key, including an implantable medical pump having an medicament reservoir fluidly couple to an access port via a conduit including an access valve, and at least one contactless key configured to impart a magnetic field upon a portion of the implantable medical pump to manipulate the access valve between a closed position isolating the medicament reservoir from the access port, and an open position fluidly coupling the medicament reservoir to the access port.

Abstract: The application relates to a hydrocephalus valve for draining CSF from the ventricle systems of patients. The valve has a housing with a housing interior and at least one first passage for admission and/or discharge. The valve has at least one body provided in the housing interior. The body is designed to move in at least one direction. At least one adjusting unit is provided. The application aims to improve tried-and-tested existing valves. To achieve this, the adjusting unit is designed to adjust at least one drainage rate in the passage, and to allow the drainage rate to be adjusted between 1 ml per hour and 1000 ml per hour at a pressure at the hydrocephalus valve of 20 cm water column, in order to slow or accelerate, by means of this adjustment, a change in pressure in the ventricle system that results from the drainage.

Abstract: A device (100) is provided for treating diseases that produce elevated intraocular pressures, such as glaucoma, wherein the device (100) includes a housing shell (101) defining a cavity (107) between a first end (102) and a second end (104) of the housing shell (101), and an elastic membrane (110) disposed within the cavity (107) to divide the cavity (107) into a fluidic channel (106) that permits a flow of fluid from the first end (102) to the second (104) end and a sealed cavity (112). The elastic membrane (110) deforms to change the volume of the sealed cavity (107) responsive to pressure fluctuations between the first and second ends (102, 104), thereby varying the fluidic resistance of the flow of fluid through the fluidic channel (106).

Abstract: A device for regulating blood pressure in a heart chamber is provided. The device includes a shunt positionable within a septum of the heart. The shunt is designed for enabling blood flow between a loft heart chamber and a right heart chamber, wherein the flow rate capacity of the device is mostly a function of pressure in the left heart chamber.

Abstract: Systems, catheters, and methods for accessing and treating along the central nervous system are disclosed. An example method may control operation of a pump of pump/filtration system to facilitate removing cerebrospinal fluid from a patient, filtering the cerebrospinal fluid with a filter module to remove waste product, and returning the filtered cerebrospinal fluid to the patient. Operation of the pump may be adjusted based on a value related to a measure sensed by a sensor in communication with a lumen carrying cerebrospinal fluid through the filtration system.

Abstract: Various systems, devices, components and methods are disclosed for controllably and selectively occluding, restricting, and/or diverting flow within a patient's vasculature. The flow restriction systems can include an implant having a flow restrictor and an implantable controller having an actuator for actuating the flow restrictor. The flow restriction systems can also include an external device for controlling operation of the implant via the implantable controller.

Abstract: A cannula includes a tube having a proximal end, a distal end, and a tubular sidewall extending between the proximal end and the distal end. The cannula further includes an extendable member provided on a portion of the sidewall. The extendable member is configured to extend radially outward from the sidewall. The sidewall defines an aperture located between the proximal end and the distal end of the main tube.