Abstract: Apparatus and methods are provided for removing obstructive material within a body lumen. The apparatus includes a macerator device deployable from a sheath that includes an expandable cage carried by a shaft and within a constraint tube. The shaft is movable relative to the constraint tube for deploying and expanding the cage within a body lumen such that an open end of the cage is oriented towards obstructive material. The cage is advanced to capture the material or the material is directed into the cage using an expandable member expanded beyond the material and retracted to direct the material into the cage. The cage is withdrawn into the constraint tube to compress the cage radially inwardly. Materials extending through apertures in the cage are sheared off by a sharpened edge of the constraint tube. The smaller, sheared off particles are then aspirated from the body lumen through the sheath.

Abstract: Endovascular treatment of, for example, delayed cerebral vasospasm involves the placing of a microcatheter in the affected vessels followed by the teachings of the instant disclosure, which is clinically improved with comparison to slow infusion of a vasodilating compound. Systems, processes and self-expanding designed stents and stent-like members are featured and highlighted. The stents and stent-like members being retrieved, nothing is left in the vessel. Drug-eluting stents, resorbable stents and angiographically imagable coatings, including tantalum brushes over part or all of subject system components are also disclosed.

Abstract: A catheter for removing tissue from a body lumen and for providing information relating to the body lumen. The catheter includes a tissue cutting element that rotates relative to the catheter body and is mounted to the drive shaft for imparting rotation to the tissue cutting element. An energy emitting element of the catheter rotates relative to the catheter body and is rotatable independently of the tissue cutting element.

Abstract: The present teachings provide devices and methods for percutaneously removing internal tissue. Specifically, one aspect of the present teachings provides a tissue incising element with a sharp cutting edge and a longitudinal lumen and a tissue stabilizer slidably disposed within the longitudinal lumen of the tissue incising element. The tissue incising element has a deployed configuration during tissue cutting and a small collapsed configuration during the percutaneous delivery and removal. The tissue stabilizer includes a tissue supporting/gripping element configured to support tissue during incising and capture the removed tissue.

Abstract: A medical device assembly for incising a stenosis in a blood vessel which includes an incising device, a tubular sheath, and a catheter having an inflatable balloon mounted thereon. The incising device includes a self-expanding scaffold having a plurality of cutting elements projecting radially outward therefrom, and an elongate member extending proximally from the self-expanding scaffold to be manipulated by a user. The self-expanding scaffold is positionable in the lumen of the sheath in a contracted configuration and deployed out of the lumen of the sheath to permit the self-expanding scaffold to expand to an expanded configuration. The inflatable balloon of the catheter is configured to be advanced distally into an interior of the self-expanding scaffold through a proximal opening of the self-expanding scaffold, and inflation of the inflatable balloon urges the cutting elements radially outward to incise a stenosis.

Abstract: A tissue removal kit or assembly comprises a cannula and a tissue removal probe axially slidable within the cannula. The tissue removal probe comprises an elongated member a distal end configured to curve when distally deployed from the cannula. The tissue removal probe further comprises a drive shaft rotatably disposed within the member, and a rotatable tissue removal element (e.g., an abrasive burr) disposed on the drive shaft adjacent the member distal end. The curved member distal end may associate the tissue removal element, which has its own axis of rotation, with a radius of revolution about the longitudinal axis of the member. The member is laterally flexible and resilient, so that the radius of revolution can be adjusted. In this manner, the tissue removal element can remove tissue around an adjustable arc.

Abstract: A hydrodynamic catheter includes a catheter body with a catheter lumen and an infusion tube extending within the catheter body, the infusion tube configured for coupling with a fluid source near the catheter proximal portion. An inflow orifice and an outflow orifice are positioned at locations along a catheter body perimeter. A fluid jet emanator is in fluid communication with the infusion tube, where the fluid jet emanator includes one or more jet orifices configured to direct one or more fluid jets through the catheter lumen from near the inflow orifice toward the outflow orifice. A pivot cylinder located along the catheter body perimeter is positioned distal relative to one or more of the fluid jet emanator, the inflow orifice, or the outflow orifice.

Abstract: The present disclosure is directed, in one embodiment, to a wire centering sheath system in which wires outwardly extend from a sheath to brace against a vessel wall. The wire centering sheath system may be used to center endovascular devices.

Abstract: An apparatus is provided that operable in different modes to perform various functions for treating a body lumen. The apparatus includes a shaft including a proximal end, a distal end, a lumen extending therebetween, and a balloon on the distal end having an interior communicating with the lumen. The apparatus includes a valve on the distal end that selectively opens or closes an outlet communicating with the lumen. With the valve open, fluid introduced into the lumen exits the outlet into a body lumen. With the valve closed, fluid introduced into the lumen expands the balloon. The apparatus also includes an actuator for axially compressing the balloon, and a helical member extends between ends of the balloon interior that expands the balloon from a contracted condition to an expanded helical shape when the actuator is activated.

Abstract: A dental implant cleaning or chemotherapeutic treatment device includes an elongated hollow stem, and bristles operably attached to the elongated hollow stem adjacent a first end of the elongated hollow stem and projecting from the elongated hollow stem nonparallel to the elongated hollow stem.

Abstract: A catheter has an inflatable assembly at its distal portion, including a containment chamber, an axial core and a plurality of longitudinally oriented partitions extending from the axial core to the wall of the chamber to divide the containment chamber into at least four inflatable sectors. Hydraulic valves are connected to respective sectors to enable selective inflation of the sectors by a fluid when the valves are connected to a source of the fluid, and at least one surface electrode is mounted on each of the sectors. When introduced into a heart chamber and diametrically opposed sectors are inflated the assembly is stably fixed against the walls of the heart chamber and readings can be obtained from the surface electrodes of the inflated sectors.

Abstract: A catheter which includes a cutting element having one or more raised elements is provided. The cutting element has a cup-shaped surface at the distal end that may be smooth and continuous except for the raised elements. The raised elements have a surface that tends to direct cut particles of material towards one or more of the axis of rotation of the cutting element, the catheter axis, or a particle collection chamber. In further aspects of the invention, a cutting element oscillates in a direction roughly parallel to the axis of rotation of the cutting element.

Abstract: There is disclosed embodiments of a vascular filter having, among other things, a plurality of discrete segments, each having two or more loops and an extension. The loops of each segment can be connected to form a dome or conical shaped end with an unblocked central opening. Prongs and beads may be provided to enhance visualization and anchoring in a vessel. Methods for inserting and moving or removing the filter from the vessel are also disclosed.

Abstract: The devices and methods generally relate to treatment of occluded body lumens. In particular, the present devices and methods relate to controlled removal of the occluding material from the blood vessels as well as other body lumens. The atherectomy devices have features to convey the materials away from the operative site without the need to remove the devices from the body lumen. Additional aspects include controlled rates of tissue removal as well as other safety features to prevent accidental cutting of the lumen wall.

Abstract: A rotary self-advancing endoscope system which produces propulsion by rotating, with a motor, a rotating cylindrical body provided on an outer periphery side of an insertion portion main body and causes the insertion portion main body to move forward into an examinee's body, wherein the system is configured to periodically repeating a combination of a state in which the rotating cylindrical body forward-rotates at a predetermined RPM and a state in which the rotating cylindrical body is stopped from rotating and releases accumulated elastic energy and, when a drive current to the motor has reached a predetermined threshold value, reverse-rotate the motor.

Abstract: A tissue-removing catheter includes a cutter. The catheter also includes a longitudinal force-transmitting member extending along a catheter body and being longitudinally movable relative to the catheter body. A distal end portion of the longitudinal force-transmitting member is operatively connected to a distal longitudinal portion of a cutter housing such that distal movement of the longitudinal force-transmitting member relative to the catheter body and the cutter imparts pivoting of the distal longitudinal portion to its open position to expose the cutter.

Abstract: An ultrasonic surgical blade comprising a body having a proximal end and a distal end. The distal end of the body is movable relative to a longitudinal axis by vibrations produced by a transducer. The body comprises a longitudinally extending bore formed within the ultrasonic surgical blade. The ultrasonic surgical blade is configured to emit a spray from the bore at the distal end thereof to substantially prevent fluid from contacting the distal end of the ultrasonic surgical blade.

Abstract: A surgical tool arrangement for performing endoscopic surgical procedures which includes a powered handpiece and a cutting accessory which detachably connects to the handpiece. The cutting accessory has a distal end which defines a cutting head incorporating a suction arrangement directly adjacent the cutting features thereof.

Abstract: A tissue resection device may include an hourglass shaped burr to resect tissue according to the shape and curvature of the hourglass shaped burr. The tissue resection device may also include a depth stop window and a movable protective guard to control the amount of cutting.

Abstract: A device and method for treating a patient with total or near total occlusion is provided. The device can be positioned in a blood vessel at a treatment site. An occlusion at the treatment site is enlarged by a catheter. The catheter can be advanced over a guidewire into the occlusion. One or more of [a] compression or torsion applied to the guidewire or [b] compression or torsion applied to the catheter body expands or creates a path through the occlusion. The expansions or creation of the access path can be by cutting or abrading the occlusion or by a shoe-horn effect.

Abstract: The present disclosure relates to resection devices and methods. The resection device includes an outer tubular member; and an inner tubular member disposed within the outer tubular member, the inner tubular member including a burr having a body with flutes extending along a length of the body, the flutes including parabolic wave patterns located along surface edges of the flutes. In an embodiment, the parabolic wave patterns extend along entire lengths of the flutes. Other resection devices and methods are also disclosed.

Abstract: The present invention is directed to material removal instrument for forming cavities in interior body regions, particularly cavities in intervertebral discs and vertebrae. The instrument includes a cannula and a rotation mechanism disposed at least partially within the cannula. A cutting element extends from the rotation mechanism and impacts and dislocates tissue as the rotation mechanism is rotated within the body. Dislocated tissue with withdrawn from the body via the cannula.

Abstract: Devices and methods for cutting and collecting a specimen from a mass of tissue. The device may include an integrated cut and collect assembly. The integrated cut and collect assembly includes a cutting portion and a collection portion that includes a flexible membrane. The collection portion of the assembly is attached to the cutting portion thereof. The cutting portion is configured to cut the specimen from the mass of tissue and the collection portion is configured to collect the cut specimen and to encapsulate and isolate the cut specimen within the membrane to enable its safe retraction from the mass of tissue.

Abstract: Contraceptive methods, systems, and devices generally improve the ease, speed, and reliability with which a contraceptive device can be deployed transcervically into an ostium of a fallopian tube. The contraceptive device may remain in a small profile configuration while a sheath is withdrawn proximally, and is thereafter expanded to a large profile configuration engaging the surrounding tissues, by manipulating one or more actuators of a proximal handle with a single hand. This leaves the other hand free to manipulate a hysteroscope, minimizing the number of health care professional required to deploy the contraceptive device.

Abstract: Clot engagement element comprising bundle of unwoven fibers can be assembled to form an acute stroke treatment device. The device has the capability of forming a three dimensional filtration matrix comprising effective pores with a distribution of sizes. The bundle of fiber design allows the device to be effectively delivered into circuitous cerebral arteries to remove clot that causes stroke. The fiber bundle based filtration matrix offers the advantages of conforming to the changing inner perimeter of a blood vessel during a clot removal process and thus the capability to effectively retain and remove a clot in the vessel. The filtration matrix offers the additional advantage to trap any break-off of the clot during the removal process. A plurality of fiber bundles can be combined to form an effective clot engagement element. Supplemental engagement structure as well as mechanical treatment structure can be integrated into the stroke treatment device.

Abstract: Described is a system which includes: a cable including: a first fiber optic interconnect to provide an input light; and a second fiber optic interconnect to provide an output light; and a first housing coupled to the cable, the first housing including: a first deflection circuit to deflect the input light received from the first fiber optic interconnect in response to a vibration or movement of the first housing; and a second housing coupled to the cable, the second housing including: a light source to generate the input light for transmission to the first deflection circuit via the first fiber optic interconnect; and a photo detector to receive the output light from the first deflection circuit via the second fiber optic interconnect.

Abstract: Atherectomy catheters and methods of using them are described herein. In particular, described herein are optical coherence tomography (OCT) catheters that may include a distal tip that can be deflected away from the long axis of the device using a multi-channel bushing. The bushing may include at a hinge point that is offset (e.g., located on a side of the elongate body near the distal end of the elongate body) and a rotatable cutter near an imaging assembly that can be driven against the wall with a high mechanical advantage.

Abstract: A device for extracting an elongated implanted structure from an obstruction within a vessel of a patient includes an inner sheath assembly and an outer sheath assembly. The inner sheath assembly includes an inner sheath and a tip, each having a passageway therethrough for receiving the implanted structure. The tip is configured for cutting and/or disrupting the implanted structure from the obstruction. The outer sheath assembly includes an outer sheath and a tip, each having a passageway therethrough for receiving the inner sheath assembly. The outer surface of this tip includes a plurality of raised elements circumferentially disposed therealong. The raised elements are configured for stabilizing the tissue of the vessel as the device is advanced through the vessel.

Abstract: An intravascular device (100) includes an elongated shaft (3) extending in an axial direction and an expandable braided arrangement (110) of a plurality of filaments. The braided arrangement has a proximal end, a distal end (1), and an intermediate region therebetween. The intravascular device can include an endpiece (112-1) located proximate an intersection of the elongated shaft and the braided arrangement. The endpiece can be configured to orient the filaments in a substantially single file continuum. At a junction with the endpiece, the filaments can initially extend in a substantially parallel, non-crossing manner, and as the filaments extend toward the intermediate region, the initially extending non-crossing filaments can cross each other.

Abstract: A catheter for removing tissue from a body lumen includes a rotatable cutter. The cutter includes an annular cutting tip at the distal end portion of the cutter for removing tissue from the body lumen. An axial cavity is defined by an interior surface of the cutter and extends proximally from the annular cutting tip toward the proximal end portion of the cutter. An eccentric opening extends from the central cavity through the cutter to allow tissue removed from the body lumen by the annular cutting tip to pass proximally through the eccentric opening toward an interior passage of the catheter body. The offset opening is offset from the longitudinal axis of the cutter.

Abstract: Devices and methods for preparing a surgical site, and in particular vertebral members, which may include a retractable tool and an actuator. The tool may include distal and proximal members. A distal side of the distal member may be fixed in a longitudinal direction and pivotable at a point of rotation. A proximal side of the proximal member may be pivotably connected to the actuator. In a retracted position, the distal member may be pivotably connected to the proximal member longitudinally in between the point of rotation and the proximal side of the proximal member. Moving the actuator in a distal direction may push the proximal member and the distal member such that the proximal member pivots with respect to the actuator and distal member, the distal member pivots with respect to the proximal member and point of rotation, and the proximal member and distal member move laterally outward.

Abstract: A surgical instrument includes a hub, a rotating member, an impeller, and an impeller enclosure. The hub has a proximal portion and a distal portion and defines a lumen therebetween. The distal portion of the hub includes a sleeve portion configured to rotatably support the rotating member. The rotating member extends through the hub and has a proximal end and a distal end. The proximal end of the rotating member is configured to couple to an external driving mechanism. The impeller is coupled to the distal end of the rotating member and is configured to accelerate fluid flowing into or out of the lumen. The impeller enclosure is coupled to the distal portion of the hub and defines an impeller volume around the impeller. One or more openings are defined around the sleeve portion of the hub such that the lumen is in fluid communication with the impeller volume.

Abstract: A tissue-removing catheter includes an elongate catheter body. The catheter body has a jogged portion that applies an urge force against a body lumen wall and urges a portion of the catheter body toward a portion of the body lumen wall. A tissue-removing element removes tissue from the body lumen during the cutting operation. The tissue-removing element is located generally adjacent the portion of the catheter body that is urged toward the body lumen wall by the jogged portion. An urging mechanism selectively applies a compressive load to the catheter body to adjust the bending stiffness of the jogged portion and the urge force applied by the jogged portion.

Abstract: A vessel-occluding medical device for the use in diagnosis and/or treatment of cardiovascular disease in the human body includes an outer tube, an inner tube slidably housed within the outer tube, and a tubular sleeve comprising a generally U-shaped, direction reversing region, which moves along the length of the tubular sleeve, to assume radially contracted and radially expanded state as the inner and outer tubes move between the first and second positions. When the tubular sleeve is in the radially expanded state, the inner portion of the tubular sleeve has a funnel-shaped surface and a longitudinally-extending opening to permit material to pass therethrough for receipt of material into the inner tube.

Abstract: Atherectomy catheter devices having a C-shaped balloon opposite a cutting window out of which a rotating cutter may extend and a proximal annular balloon. The C-shaped first balloon may be used to drive the cutter against a vessel and to deploy the cutter by assisting in deflecting a nosecone (distal tip) to expose the distal-facing cutting edge of the cutter. The proximal annular balloon may be used to occlude blood flow. The device may pulled, pushed or rotated in a vessel with the balloons inflated or deflated.

Abstract: Unitary endoscopic vessel harvesting devices are disclosed. In some embodiments, such devices comprise an elongated body having a proximal end and a distal end, a tip disposed at the distal end of the elongated body; and a cutting unit having a first cutting portion and a second cutting portion, the first cutting portion and the second cutting portion being moveable in a longitudinal direction relative to the elongated body to capture a blood vessel between the first cutting portion and the second cutting portion, and being rotatable relative to one another circumferentially about the tip to cut the captured blood vessel.

Abstract: A vascular device is provided having a catheter body and a rotatable cutter assembly located at the distal end of the catheter body. The cutter assembly has at least one helical cutting surface within a housing that is coupled by a torque shaft to a drive mechanism. A conveyor mechanism helically wound about the torque shaft conveys occlusive material conveyed into the housing by the helical cutting blade further proximally along the catheter body for discharge without supplement of a vacuum pump. The catheter body is manipulated to insert the distal end of the catheter body within a body lumen and advance the distal end of the catheter body toward the occlusive material.

Abstract: A tissue dissector is provided. The tissue dissector includes a cannula and an introducer coaxially coupled to the cannula and movable therein from a retracted position to an extended position. An introducer is coaxially coupleable to the cannula and movable therein from a retracted position to an extended position. The introducer including a generally annular lumen disposed in fluid communication with an inflation port operably disposed on the introducer and in fluid communication with an inflatable balloon that couples to the introducer. The inflatable balloon is movable from a deflated condition for positioning the introducer adjacent target tissue, to an inflated condition for separating the target tissue from nearby tissue and for providing a barrier therebetween such that the nearby tissue is not affected during the electrosurgical procedure.

Abstract: An endoscopic surgical instrument for removing tissue or bone, the instrument comprising (1) a generally tubular component (2) a cutting device which is housed in the distal end member and part of which protrudes beyond the window in the distal member, and (3) a means for operating the cutting device. The tubular component comprises a distal end member containing a cutting device, a proximal member, and between the distal member and the proximal member a hollow, generally tubular intermediate member which deforms elastically when the angle between the distal member family proximal member is changed. The intermediate member can for example be composed of a nickel titanium alloy, and/or can be slotted, and/or can be in the form of an accordion, and/or be in the form of a coil.

Abstract: An aortic valve cutter of the present disclosure has a flexible housing with a central lumen for receiving a guide wire. A high-speed rotating wire is disposed within the housing near an edge of the housing. A trough cut into a side of the housing exposes a portion of the rotating wire such that the rotating wire can be used as a cutter. Two pusher wires are disposed on an opposite side of the housing from the rotating wire. Troughs cut into the side of the housing form openings from which the pusher wires can extend. The pusher wires are staggered with respect to one another in the longitudinal direction. When the pusher wires are advanced, they extend outwardly from the troughs and can be used to stabilize the cutter at the aortic valve and push the cutting wire against the valve on the opposite side.

Abstract: Apparatus is provided for treating hypertension of a subject. The apparatus includes an implantable element which has a non-circular shape and which is configured to reduce the hypertension by facilitating an assumption of a non-circular shape by a blood vessel in a vicinity of a baroreceptor of the subject, during diastole of the subject. Other embodiments are also described.

Abstract: A tissue-removing catheter for removing tissue from a body lumen includes a tissue-removing element. The tissue-removing element may be coupled to a first longitudinal portion of the catheter body. An angular-displacement sensor may be coupled to the catheter body for detecting an angular displacement of at least the first longitudinal portion of the catheter body relative to the rotational axis when the first longitudinal body portion is rotated about the rotational axis. The tissue-removing element may be rotatable about a rotational axis to adjust an angular tissue-removing position of the tissue-removing element relative to the body lumen when the catheter body is inserted in the body lumen. An angular-displacement sensor may be generally adjacent the tissue-removing element for detecting an angular displacement of the tissue-removing element relative to the body lumen when the tissue-removing element is rotated about the rotational axis.

Abstract: Catheter assemblies include a stabilization mechanism disposed at a distal end of the catheter assembly for stabilizing the catheter assembly within a subintimal space. The stabilization mechanism includes a self-expanding support structure that is slidably positionable within an inflatable balloon. The catheter assemblies include an outer shaft which has the balloon at a distal end thereof and an inner shaft which has the support structure mounted on a distal end thereof. The inner shaft is slidably disposed within a lumen of the outer shaft and has a first configuration in which the support structure is held in a compressed state within the outer shaft and a second configuration in which the support structure is permitted to return to an expanded state within the inflatable balloon. In the expanded state, the stabilization mechanism has a flattened laterally-extending profile.

Abstract: An atherectomy device with an exchangeable drive shaft is disclosed, having a drive shaft gear at a distal end of the exchangeable drive shaft for meshing engagement with a prime mover gear on the output shaft of the prime mover. The exchangeable drive shaft is inserted into an opening at the distal end of the handle housing and moved axially in a proximal direction. Surface features on at least the prime mover housing and the engageable drive shaft help to align the drive shaft gear with the prime mover gear for meshing engagement.

Abstract: An ultrasonic probe includes a probe body which includes an outer peripheral portion provided along a longitudinal axis, and a void defining surface defining a void, which is open to an outside along the longitudinal axis in at least one part of the outer peripheral portion, along the longitudinal axis. The void defining surface defines the void in the probe body from a first anti-node position of the ultrasonic vibrations to a second anti-node position of the ultrasonic vibrations different from the first anti-node position.

Abstract: A fiber scanning optical probe including: an optical fiber; an actuator that drives the optical fiber in two directions; and an asymmetric structure that is disposed at one end of the optical fiber.

Abstract: In one illustrative embodiment, a thrombectomy device is disclosed. The thrombectomy device includes a treatment portion, comprising a reversibly-expandable framework configured to be deployed from within a microcatheter into a selected vasculature for removing thrombus or embolus. The thrombectomy device further includes a substantially tubular connection member disposed on a proximal end portion of the treatment portion configured to receive a terminal portion of a delivery member for positioning the treatment portion within the vasculature. The framework includes structural features for engaging the thrombus or embolus including one or more of: framework peaks and valleys along a long axis of the treatment portion or a plurality of strut members.

Abstract: The invention relates to a valvulotome (1) guided by guidewire/catheter comprising a guidewire (2), a first inner tube (3) accommodating the guidewire (2), an expandable basket (5) with cutting elements (7), with said basket (5) being the distal end of a second tube (4) through which the first inner tube (3) extends, a catheter tube (8) through which the second inner tube (4) extends, said catheter tube being suited to accommodate and guide the expandable basket (5) in non-expanded state, a sleeve (6) that forms the distal end of the first tube (3) and functions as limiting element for the distal end of the basket (5) and through which the guidewire (2) has been passed.

Abstract: A vascular procedure includes sliding a constriction crossing mechanism over a wire guide having a tip positioned at a proximal side of a constriction, and rotating a sheath of the mechanism about an axis relative another sheath of the mechanism. The method further includes helically engaging the sheaths, and guiding an intraluminal treatment device into or past the vascular constriction. The mechanism includes a first sheath and a second sheath, and a tip coupled with the first sheath. The mechanism further includes a helical coupling between the first and second sheaths, which is configured to convert a torque on one of the sheaths to an axial force on the other of the sheaths for crossing a vascular constriction with the tip. An anchoring mechanism coupled with one of the sheaths includes a deployed state resisting displacement of the second sheath within a vascular structure of a patient.

Abstract: A system for removing matter from a partially or totally occluded stent includes a cutter that is urged radially outward toward the inner surface of the stent. Preferably, the cutter has a hardness that is less than or equal to the hardness of the material used to make the stent. Aspiration may be provided to remove portions of the occluding material from the vessel.