Abstract: Delivery devices for a stented prosthetic heart valve. The delivery device includes a spindle, at least one cord, and a covering feature associated with the spindle for selectively covering at least a portion of a stented prosthetic heart valve tethered to the spindle in a delivery state. In some embodiments, the covering feature includes a tip mounted to the spindle. The tip can include an overhang region for selectively covering a portion of the stented prosthetic heart valve. In other embodiments, the tip can include a tip body and a compressible foam bumper. In yet other embodiments, the covering feature includes an outer sheath arranged to selectively cover the stented prosthetic heart valve. The outer sheath can be elastic and stretchable for recapturing a partially expanded prosthesis, for example by including one or more windows covered by a stretchable covering layer.

Abstract: Disclosed herein are intrasacular aneurysm occlusion devices with nested proximal and distal meshes. A proximal mesh covers the aneurysm neck. A flexible distal mesh expands to fill even an irregularly-shaped aneurysm sac when it is expanded by the insertion of embolic members and/or material.

Abstract: A wire lock assembly for an access port of an elongate medical tube includes a body having an exterior surface, an interior surface, and a central opening disposed therethrough, an attachment mechanism disposed through the exterior surface of the body, the attachment mechanism having an open end and a closed end, at least one notch arranged on the body and positioned proximate to the central opening and at least one seal supported within the interior surface of the body in communication with the central opening, the seal comprising a passageway therethrough, where the interior surface of the body defines a non-linear pathway for securing one or more medical devices.

Abstract: Some embodiments are directed to a catheter system comprising an introducer having a main body, an introducer sheath projecting from the main body, and a first seal supported within the introducer and a catheter having a main body, an outer sheath projecting from the main body, a second seal supported within the catheter, and an inner core configured to be advanced axially through the main body, the second seal, and the outer sheath. The introducer can be configured to be selectively engageable with the catheter so that the catheter can be selectively and removably linked with the introducer in the axial direction. The catheter system can also be configured such that, when the introducer and the catheter are linked, the catheter can be rotatable relative to the introducer. The introducer can be configured to radially restrain an endoluminal prosthesis.

Abstract: Devices, systems and methods are described herein to provide improved steerability for delivering a prosthesis to a body location, for example, for delivering a replacement mitral valve to a native mitral valve location. The delivery system can include a number of advantageous steering and delivery features, in particular for the transseptal delivery approach.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes an elongate body having an axis and proximal and distal end portions spaced apart from one another along the axis. A tissue-removing element is mounted on the distal end portion of the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen. A motor operatively engages the elongate body for driving rotation of the elongate body and tissue-removing element mounted on the elongate body. A controller is operatively connected to the motor and configured to perform a torque response routine to control a speed of the motor based on a set PWM value of the motor and a detected current applied to the motor during rotation of the elongate body and tissue-removing element.

Abstract: A delivery system for delivering a stent to a body lumen. The delivery system includes a tubular member having an expandable stent disposed about the outer surface of the inner tubular member. The stent is maintained in a radially compressed configuration with a removable sheath. The sheath can be released using a variety of techniques.

Abstract: Delivery devices for a stented prosthetic heart valve. The delivery device includes a spindle, at least one cord, and a lateral control feature. The cord is tensioned to crimp the prosthesis to a compressed condition for delivery to a target site. Tension is lessened to allow the prosthesis to self-expand. In a tethered and expanded state in which the prosthesis has self-expanded and is connected to the spindle by the cord, the lateral control feature directs the spindle to a prescribed location relative to the prosthesis appropriate for a functional evaluation of the prosthesis. In some embodiments, the spindle is directed to a center of the prosthesis; in other embodiments, the spindle is held at a commissure of the prosthesis. The lateral control features of the present disclosure assume numerous forms.

Abstract: A replacement heart valve prosthesis is loaded onto a balloon mounted onto a balloon shaft of a catheter system. The balloon shaft is rotatably engaged with an actuator on the handle of the catheter system. Rotation of the actuator by a first amount in a first direction permits rotation of the heart valve prosthesis by a known amount during the procedure so that alignment of the commissures of the replacement valve with the commissures of the existing valve can be predictably achieved.

Abstract: Delivery devices for delivering a stented prosthesis to a target site are disclosed. Certain disclosed delivery devices include a handle assembly including an actuator, a shaft assembly interconnected to the handle assembly, and are configured to releasably retain the stented prosthesis to the delivery device with at least one elongate tension member. The delivery devices further include a torque shaft that is configured to apply and adjust the amount of tension in the each tension member. For example, the torque shaft can be configured to wind and unwind each elongate tension member around the torque shaft to correspondingly compress and expand the stented prosthesis. The torque shaft can be controlled with an actuator provided in the handle assembly, for example. In some embodiments, the actuator is further configured to axially move the torque shaft.

Abstract: An attachment apparatus to an arthroscopic tool, comprising at one axial distal end of the attachment, a pushrod end collar of tubular cross section with a hook or fastening provision at one axial distal end of said pushrod end collar to connect to a force applicator and, rigidly attached at the other axial distal end of the pushrod end collar, are at least two pairs of pushrods, wherein each pair of said pushrods are tangentially situated at opposite ends of the pushrod end collar and extends away from the pushrod end collar into channels or grooves of a pushrod guide sleeve with tubular cross section, wherein one distal end of the pushrod guide sleeve is at least a pair of cutouts for a plurality of lifting tabs placed at opposite radial distal ends along the circumference of the pushrod guide sleeve.

Abstract: This disclosure provides a transnasal odontoid retractor that can retract tissue unilaterally or bilaterally, with the retractor including one or more retractor shafts that can be configured between a closed position and an open position, and controlled using, for example, a forcep.

Abstract: A medical device may include an introducer sheath, having a distal and a proximal end and a lumen extending from the distal end to the proximal end. The introducer sheath may also include a tab formed at the distal end and extending distal to the lumen, and a frangible portion extending between the distal end and the proximal end.

Abstract: A planning device that generates control data for an ophthalmological laser therapy appliance with a laser device and a control unit, includes a first interface for supplying various data and a second interface for transferring the control data to the control unit of the ophthalmological laser therapy appliance, which is embodied to generate control data for a scanning pattern for the ophthalmological laser therapy appliance from the supplied data, by application of which scanning pattern a structure can be produced in the cornea, the limbus, and/or the sclera of a patient's eye. The planning device is embodied to generate from the supplied data, control data for the scanning pattern of this structure and/or a structure for receiving the shunt implant.

Abstract: Surgical instruments and methods are disclosed including a tissue removal tool for treatment of endometrial tissue on a background tissue of a patient. The tissue removal tool can optionally comprise a graspable portion, a shaft and an end effector. The shaft can be coupled to the graspable portion. The shaft can have a proximal portion and a distal portion and can be configured to access an anatomic location of the endometrial tissue. The end effector can be coupled to the distal portion of the shaft. The end effector can be configured to lift the endometrial tissue relative to the background tissue to a lifted position. The end effector can be configured to cut the endometrial tissue from the background tissue with the endometrial tissue in the lifted position.

Abstract: A first positional information derivation unit derives three-dimensional positional information of at least one target point of a target structure in a subject as first positional information. A second positional information derivation unit derives three-dimensional positional information of at least one feature point on an insertion structure inserted to the target structure in the subject as second positional information. A display control unit displays a positional information screen indicating a positional relationship between the target point and the feature point on a display unit.

Abstract: Embodiments disclosed herein are directed to surgical cannulas and methods relating thereto. In some embodiments, a method includes cutting one or more lines in a tubular member to form a tubular body and a hinge of a surgical cannula. In some embodiments, a surgical cannula includes a fiber brag grating (FBG) reflector mounted to a tendon for deflecting a distal tip of the surgical cannula. A controller is coupled to the FBG reflector and is configured to determine a tension in the tendon based on reflected light from the FBG reflector. In some embodiments, a surgical cannula includes a tubular body including a plurality of apertures extending therethrough.

Abstract: A nerve block introducer for introducing a catheter and also administering an initial dose of local anesthetic, the introducer having an elongated body with a distal end and a proximal end, an inlet, and at least one discharge opening for the local anesthetic near the distal end. The introducer also includes a grasping member near the distal end of the elongated body, the grasping member operably coupled to a handle near the proximal end of the elongated body such that the grasping member can be used to releasably hold a catheter by operation of the handle. The catheter may thus be positioned and left in place following removal of the introducer.

Abstract: A stent graft transport device includes a mounted state keeping wire that keeps a mounted state of a stent graft on a transport tube or a contracted state keeping wire that keeps a contracted state of the stent graft. The transport tube can be separated from the stent graft by pulling an operation end part of the mounted state keeping wire, and the stent graft can be in an expanded state by pulling an operation end part of the contracted state keeping wire. Furthermore, the operation end part of each of the wires is housed inside the transport tube. In order to draw the operation end part, a wire pulling-out string is provided, one end part of which is mounted on the mounted state keeping wire and the other end part of which is pulled out from a window arranged on a side peripheral surface of the transport tube.

Abstract: Apparatus (40) for compressing a transcatheter cardiac stent-valve (10) comprises: a first compressor stage (100) including a hollow channel (42) with a tapered interior surface configured for compressing a stent-valve in response to longitudinal advancement of the stent-valve within the channel; and a second compressor stage (102) comprising a crimper for compressing a portion of the stent-valve without longitudinal advancement.

Abstract: The present invention relates to an implant device for an eye disease for adjusting intraocular pressure. An implant device for an eye disease for adjusting the intraocular pressure according to an embodiment of the present invention comprises: a first tube into which the aqueous humor flows so as to adjust the intraocular pressure; and a second tube formed inside the first tube. The second tube is made of a biodegradable material configured to be degraded inside the eye over a predetermined period of time after being inserted into the eye. The first tube and the second tube may be divided into a first area and a second area according to the distance from the anterior chamber of the eyeball. The second area of the first tube and the second tube may have such a structure that the diameter thereof is larger than that of the first area of the first tube and the second tube, and the same can expand as the aqueous humor flows in.

Abstract: A method for extracting a lead from a patient comprising: providing a lead removal stylet; inserting the stylet into the lead; locking the stylet to a position inside the lead; and vibrating the stylet with tissue disrupting vibration to cause the lead to vibrate and to disconnect from binding tissue.

Abstract: A device for intra-vascular embolic-thrombolic protection, as well as embolectomy/thrombectomy and atherectomy interventional procedures and methods. At least a portion of the working end of the device may be formed monolithically from a single hypodermic tube, or may be formed of monolithic inner and outer tubes with fixed or movable guide wire elements and imaging modalities. The device may comprise structures enabling coring, expansion within a vascular structure and vascular wall shaving, as well as filtration, stabilization and capturing of thrombotic or embolitic material during an intervention procedure.

Abstract: An overtube assembly for use with an elongate medical tool includes an overtube including a flexible tubular body having a proximal end and distal end. The flexible tubular body includes a split extending from the proximal end to the distal end. The overtube assembly further includes an inflatable balloon coupled to a distal portion of the flexible tubular body. The flexible tubular body is disposable over a section of the elongate medical tool by inserting the elongate medical tool through the split.

Abstract: A system and method for intracranial access is disclosed. In particular, a drill stop is shown providing a way to control the penetration of a drill bit as an access hole into the brain is being formed. Access to a desired location is achieved using a catheter guide device. Also disclosed is a mechanism by which multiple diagnostic and treatment devices can be placed at a desired location in brain tissue without the need for more than one access hole. A drainage catheter is disclosed with a mechanism to allow both drainage and to allow intracranial pressure measurement.

Abstract: A flexible, polymer sleeve is provided that is everted into a body passageway in such a manner as to exert minimal rubbing friction on the internal walls of such passageway. The sleeve is housed within a tube assembly comprising a posterior tube that telescopingly slides into an insertion tube. The sleeve everts over the insertion tube, upon forward pressure applied thereon, as it extends forward into a body passageway, and consequently, causes the posterior tube to retract into the insertion tube. Multiple tubes can be telescoped to support the polymer sleeve and to keep a passageway open for the expelling of urine or body fluids, the insertion of tools, sanitation/antibacterial substances, or for the flow of liquids through the sleeve. The insertion tube can be locked in reference to the sleeve to prevent unintended removal of catheter assembly. Sleeve and tubing are removed by reversing the insertion and eversion movements.

Abstract: A method for replacing a stenotic native aortic valve of a patient can include inserting a delivery apparatus into a femoral artery of the patient, the delivery apparatus having a first shaft extending from the handle, a second shaft disposed around the first shaft, a third shaft extending through the second shaft, and a valve cover coupled to the first shaft. The valve cover can be in a first state housing an entirety of a prosthetic heart valve and retaining the prosthetic heart valve in a radially compressed state during the act of inserting. The method can further include advancing the delivery apparatus through the aorta of the patient to position the valve cover and the prosthetic heart valve within the native aortic valve, and moving the valve cover longitudinally from the first state to a second state in which the entirety of the prosthetic heart valve is uncovered.

Abstract: A retention mechanism for a surgical access assembly is provided. The retention mechanism includes a planar base having first and second extensions each with a free end, a first locking member disposed on the free end of the first extension, and a second locking member disposed on the free end of the second extension. The first locking member includes a U-shaped body having a first set of opposed, inwardly facing teeth. The second locking member includes a U-shaped body having a first set of opposed, outwardly facing teeth configured engage the first set of opposed, inwardly facing teeth when the retention mechanism is in a locked condition. The first set of opposed, inwardly facing teeth and the first set of opposed, outwardly facing teeth are configured to be spaced apart from each other when the retention mechanism is in an unlocked condition.

Abstract: Disclosed herein are sealing devices configured for improving sealing functionality with an engaged extension member of an apparatus. More specifically, disclosed herein are trocar sealing devices configured for improving insufflation gas containment in relation to trocars (and/or other related type of devices) that are used for enabling a surgical instrument such, for example, a laparoscope, to gain access to an abdominal cavity (or other body cavity). By providing for such improved insufflation gas containment, sealing devices as disclosed herein are particularly advantageous, desirable and useful in view of long-standing reasons for limiting insufflation gas leakage and in view of newly recognized reasons stemming from outbreak of COVID-19 disease for limiting insufflation gas leakage.

Abstract: Aspects of the instant disclosure relate to an elongated medical device. In particular, the instant disclosure relates to apparatuses for sensing contact force. In various embodiments, a force sensing element including a tip and a catheter shaft, wherein the tip is configured to move relative to the shaft when an external force is applied to the tip comprising a transmitter configured to transmit a transmitter signal when external force is applied to the tip, a first plurality of sensors and a second plurality of sensors positioned proximate the transmitter, wherein each of the sensors is configured to receive the transmitter signal and the first plurality of sensors is longitudinally offset from the second plurality of sensors.

Abstract: A protective sleeve for a urinary catheter includes a sleeve configured to extend over an outer surface of the urinary catheter shaft from a proximal insertion end of the catheter shaft to a distal end of the catheter shaft. The protective sleeve includes a protective sleeve tip defining the proximal end portion of the sleeve. The sleeve and the protective sleeve tip are of a single unitary construction and the sleeve and protective sleeve tip are formed of the same thin, flexible film.

Abstract: A guide tube is used for guiding an instrument through a hole within tissue of a patient. The guide tube includes a cannula member defining a passage extending therethrough along an axis. The passage is operable to receive the instrument and guide the instrument through the hole within the tissue of the patient. The guide tube also includes an expansion member that is moveably coupled to the cannula member to selectively move radially between a retracted position and an expanded position relative to the axis of the cannula member. The expansion member is at least partially insertable into the hole when the expansion member is in the retracted position. The expansion member is operable to engage with a surface of the hole when the expansion member is in the expanded position.

Abstract: An stent delivery system may include a delivery device and a tubular body having a lumen sized to slidably fit about an outer diameter of the delivery device and a drainage stent having an anchoring mechanism, wherein the delivery device includes a constraining member configured to engage an external portion of the tubular body at the proximal end of the delivery device. A method of delivering a stent may include inserting a tubular body into the port of an endoscope, inserting a stent delivery device and a stent having an anchoring mechanism into the tubular body, wherein the delivery device includes a constraining member configured to engage and retain the tubular body at the proximal end of the delivery device, advancing the drainage stent distally through the tubular body, sliding the tubular body proximally, and engaging an external portion of the tubular body with the constraining member.

Abstract: A stent delivery system is described. The system includes an outer sleeve assembly with an outer sleeve body, an outer sleeve handle fixed to one end of the outer sleeve body, and an outer sleeve tip connected to an opposing end of the outer sleeve body. The system also includes an inner sleeve assembly, which has a push tube sleeved in the outer sleeve body, an inner sleeve handle fixed to the rear end of the push tube, a stent placing tube connected to the front end of the push tube, and an inner sleeve tip set at the front end of the stent placing tube. The system also includes a snap ring fixed on an outer wall of the push tube and provided between the outer sleeve handle and the inner sleeve handle. The outer sleeve tip includes a stepped surface.

Abstract: The present application discloses a covered stent and a method for navigating the covered stent to a branch vessel, the covered stent including a main body and at least one lateral side branch connected to the main body. A system of covered stents and a method for implanting, including interconnecting the covered stents is also disclosed.

Abstract: A lead removal system includes a lead removal device comprising a sheath. The sheath includes a distal separating member configured to separate an implanted lead from adjacent tissue. The sheath also includes a sheath lumen configured to receive a lead engagement device and the implanted lead. A traction applying device is coupled to the lead removal device. The traction applying device is configured to be secured to the lead engagement device and apply traction to the lead engagement device and the implanted lead as the distal separating member of the sheath separates the implanted lead from adjacent tissue.

Abstract: A medical device may include an ablation device configured to deliver ablation energy to a treatment site. The medical device may further include a probe device configured to deliver excitation radiation to the treatment site. Further the medical device may include a radiation-receiving device configured to receive photoluminescence radiation emitted from the treatment site in response to the treatment site being illuminated by the excitation radiation and to generate a detection signal in response to the received photoluminescence radiation. Additionally, the excitation radiation may be different from the ablation energy.

Abstract: A delivery system for percutaneously deploying a prosthetic heart valve. The system includes an inner shaft assembly, a delivery sheath capsule and a handle maintaining a first actuator and a second actuator. The capsule is configured to compressively retain the prosthetic heart valve over the inner shaft assembly. The first actuator is operated to proximally retract the delivery sheath capsule and expose the prosthetic heart valve relative to the capsule. The second actuator is operated to proximally retract the prosthetic heart valve by transmitting forces to the inner shaft assembly.

Abstract: Various embodiments for a stent delivery device or catheter system that includes a stent disposed between an inner shaft and an outer sheath. A housing is coupled to the inner shaft and outer sheath with a rotary reel disposed in the housing and configured for rotation with respect to the housing. A hypotube is disposed in the housing and fixed thereto with the inner shaft extending into the opening of the hypotube and the outer sheath enshrouding a portion of the hypotube. Rotation of the rotary reel in a first direction pulls the outer sheath over the hypotube along the generally circular path to retract the outer sheath from the stent. In some embodiments, a rapid deployment mechanism allows for retracdtion of the outer sheat at an increased rate.

Abstract: Delivery devices and methods for delivering a stented prosthesis to a target site are disclosed. Disclosed delivery devices include a handle assembly including an actuator, an inner shaft assembly interconnected to the handle assembly, and are configured to releasably retain the stented prosthesis to the delivery device with at least one elongate tension member. The delivery devices further include a tension management device that is configured to limit the amount of tension that can be applied via the actuator to the at least one tension member. Certain embodiments are configured to apply different tension limits to different tension members that are controlled by a one or more actuators. Other various embodiments include one or more tension adjustors to selectively adjust one or more tension limits.

Abstract: A balloon comprising: a center portion having a proximal end, a distal end opposite the proximal end, and a length between the proximal end and the distal end. The center portion comprises: a first nominal diameter and a first radial modulus at the proximal end; a second nominal diameter and a second radial modulus at the distal end; further wherein, the first nominal diameter is equal to the second nominal diameter, such that, when the balloon is inflated to a nominal pressure, the center portion has a constant diameter over the length; and further wherein, the first radial modulus is smaller than the second radial modulus, such that, when the balloon is inflated above a nominal pressure, the center portion adopts a tapered shape in which the proximal end has a first stretched diameter and the distal end has a second stretched diameter, the first stretched diameter being larger than the second stretched diameter.

Abstract: A stent delivery system includes a core member and a coupling assembly rotatably coupled to the core member distal segment. The coupling assembly includes first and second plates and first and second spacers. The first plate is rotatably coupled to the core member and includes an outer surface having three or more projections separated by recesses. The first spacer is coupled to the core member and disposed between the first plate and a proximal restraint. The second plate is rotatably coupled to the core member and includes an outer surface having three or more projections separated by recesses. The second spacer is coupled to the core member and disposed between the first plate and the second plate. A stent extends along the core member distal segment such that an inner surface of the stent is engaged by one or more projections of the first plate or the second plate.

Abstract: Components and corresponding systems are described for providing removal of a clot or fragment thereof to address an acute ischemic stroke condition. In particular, a filter design is presented that provides metal elements below a bundle of polymer fibers to provide more mechanical strength while cushioning the vessel wall from direct contact with the metal elements. Designs of stent retrievers are presented with polymer covers or mounted on the exterior of a microcatheter. Corresponding systems are described that can use various combinations of the components, generally in combination with an aspiration catheter. Corresponding procedures are described that can effectively use the various devices and systems.

Abstract: The present embodiments provide systems and methods for treating a medical condition. In one embodiment, the system comprises a stent having proximal and distal regions, and further having a delivery state and an expanded state. A therapeutic agent is disposed on a segment of the stent. The stent is disposed around an exterior surface of a core assembly in the delivery state. A coupling assembly releasably secures the proximal region of the stent to the exterior surface of the core assembly. The coupling assembly secures the stent to the core assembly for a predetermined period while the stent is in the expanded state and during release of the therapeutic agent at a target site. The coupling assembly further enables the stent to be disengaged from the core assembly and deployed in a bodily passageway.

Abstract: A method and device to correctly orient an intracranial occlusion device, such as a stent having differential porosity, with respect to desired areas of greater or lesser blood flow (e.g., branch vessels and aneurysms, respectively), said device being particularly adapted for use in treating aneurysms in intracranial or other tortuous vasculature. An intravascular device comprising a delivery catheter having a hub and angular lumen capable of constraining a pusher wire within a packaging catheter to deploy said stent in an orientation wherein the area of least porosity abuts the aneurysm, and area of maximal porosity permits blood flow to a branch or other vessel. A method of using same.

Abstract: In some aspects, the present disclosure provides a delivery device for delivering a detachable medical implant that comprises an elongated delivery member and a first engagement portion. The first engagement portion comprises a first proximal-facing surface, a first distal-facing surface, and a first lumen that is configured to accommodate an activation wire, wherein at least 50% of a surface area of the first proximal-facing surface is angled away from a proximal end of the first engagement portion. In other aspects, the present disclosure provides a medical delivery system comprising: such a delivery device; an implantable device comprising a medical device portion and a second engagement portion, the second engagement portion comprising a second lumen configured to accommodate an activation wire, a second proximal-facing surface and a second distal-facing surface; and an activation wire. Other aspects pertain to methods of medical device delivery using such a medical delivery system.

Abstract: A catheter based balloon enabled prosthetic heart valve delivery device is provided. The balloon enabled delivery device is configured to deploy a prosthetic heart valve through inflation. The balloon enabled delivery device is further configured to reduce or prevent migration of the prosthetic heart valve during deployment. Migration is prevented through a combination of balanced inflation of the balloon, inflation fluid flow balancing structures, retention rings, retention covers, and balloon surface treatments.

Abstract: A stent graft delivery system and method of assembling the same is disclosed. The stent graft delivery system includes a stent graft cover configured to maintain a stent graft in a constricted configuration, and is configured to slide relative to the stent graft to enable the stent graft to expand radially outwardly. The stent graft cover extends along a first central axis. A tapered tip defining an opening therethrough is configured to track along a guidewire. The opening extends along a second central axis that is offset from the first central axis. This provides a delivery system with an opening in a leading edge that is not center relative to the outer stent graft cover.

Abstract: An infusion device (10) includes one or more of automatic insertion and retraction of an introducer needle (40) and catheter (28), introducer needle safety and extension set. The device (10) can further comprise a top-push button (16) activation feature, a side-push button (402) activation feature or a rotary-button (412) activation feature, and one or more of a manual interlock of an outer barrel and base, and a manual interlock for an extension set top and base. Packaging (500) for an integrated and/or removable inserter with activation button protection is also disclosed.

Abstract: An implant that may maintain position with a Eustachian tube of a patient, the implant includes an engagement body, an anchoring assembly, and a pressure balance assembly. The engagement body includes an exterior surface dimensioned to bear radially outward against the Eustachian tube. The anchoring assembly may lock the implant in the Eustachian tube. The pressure balance assembly includes a vented pathway that may transition between an occluded state and a vented state. The vented pathway may provide fluid communication between the proximal end and the distal end of the implant in the ventilated state while inhibiting fluid communication between the proximal end and the distal end of the implant in the occluded state.