Abstract: According to the invention there is provided an intravascular catheter comprising an elongated flexible jacket having opposed proximal and distal ends and a central passageway extending between and interconnecting the ends. A rotating working head is located at the distal end of the jacket. A flexible drive cable extends through the passageway of the jacket, having a driving end operatively connected to the working head for rotating it, and a driven end operatively connected to a high-speed motor. The working head is rotatably mounted in a bearing sleeve which is further attached to the catheter jacket. The working head is actuated, by a actuator which adjust the a pair of tip portions from an at least initial retracted position with a first effective working diameter to an extended position with a second effective working diameter greater than the first effective diameter. Centrifugal forces generated by rotation of the cable cause the tip portions to assume the greater effective working diameter.

Abstract: Atherectomy catheters are described having a cylindrical cutting head rotatably mounted at the distal end of a catheter body. The head has an axially elongated aperture and an open interior. A severing means is disposed adjacent the elongated aperture such that atheromatous material invaginated by the head is severed and diverted into the interior of the head. A preferred embodiment has the elongated aperture helically-disposed about the central axis of the cylindrical head and a cutting means formed integrally along the periphery of the aperture. Another preferred embodiment has the cylindrical head provided with a tapered distal end that extends distally from a housing for the head and incorporates an extension of the elongated aperture.

Abstract: The instrument comprises:a tubular outer support forming a shell about a determined axis and including an annular bottom portion that is circularly symmetrical about the axis to define a substantially spherical annular surface of the support for application against the cornea; anda tool carrier received inside the outer support and movable relative thereto between a high position and a low position, the tool carrier including a smooth tool-holding socket whose inside wall is resiliently deformable in the radial direction, the socket being axially movable relative to the support, a resilient member disposed between the socket and the support urging the tool carrier towards its high position, and a threaded drive socket screwed into the support above the smooth socket to constitute an adjustable top abutment for the smooth socket and opposing the return effect of the resilient member.

Abstract: An atherectomy catheter includes a catheter body having a cylindrical housing at its distal end. The cylindrical housing includes an elongate cutting aperture on one side thereof and a mechanism for severing atheroma which enters within the opening. In a first embodiment, the cutting mechanism comprises a circular cutting blade which is advanced over an elongate guide member which defines a path for the blade. Use of the guide means helps assure that the cutting blade will not be lost from the housing during use. In a second embodiment, a rotatable helical cutting blade is mounted within the housing. In that particular embodiment, the helical cutting blade can serve as the guide member for the circular cutting blade.

Abstract: An expandable and compressible atherectomy cutter for cutting plaque from a stenosis in an artery includes a cutter assembly which, relative to its axis of rotation, has a plurality of radially separated and axially aligned blades. The distal ends of these blades are joined together at a grommet and the proximal ends are free for individual engagement with grooves which are axially oriented on the hub of a rotatable torque tube. Each groove on the hub has a plurality of notches, and each notch in a groove has a corresponding notch in each of the other grooves which lies in the same radial plane and at the same radial distance from the rotational axis of the torque tube. Although notches in different radial planes can have different radial distances, the proximal ends of the blades simultaneously engage with only the notches in the same radial plane.

Abstract: To reduce damage to surrounding tissue while fragmenting some tissue such as for example not damaging the capsular wall while removing the lens during cataract removal surgery or not damaging artery or vein walls during bypass surgery while freeing the artery or vein to be transplanted, an incision is made for the insertion of surface-discriminating fragmenting handpiece. The surface-discriminating fragmenting handpiece fragments and permits aspiration of the tissue without damaging the surrounding wall by moving surfaces which permit the diseased tissue to fall within their cutting zone but which move at a rate of speed and have openings between them of such a size that the more integrated and smoother tissue does not fall within their cutting zone.

Abstract: A device for removing obstructions from vessels or small openings in the body, comprising a rotatable ablator tip which is guided to the obstruction in a reduced diameter configuration, expanded and rotated to remove the obstruction, and contracted to remove the device from the body. The variably expandable abrasive tip coil in one embodiment of the invention is actuated by a piston means disposed within the coil. A pair of collars is attached to the ends of the coil, and the piston effects relative longitudinal axial movement of the collars and, hence, the respective ends of the coil tip. When the ends of the coil tip are so moved with respect to one another, expansion and contraction of the diameter of the coil tip results. In another embodiment of the invention, the expansion tip coil is actuated by an expandable and contractible bellows means disposed within the coil, instead of the piston means.

Abstract: The cutting strength of a rotary surgical cutting instrument is increased by an on-axis bearing contact between the distal end of its rotatable inner member and the interior surface of its outer member. The outer member is provided with a distal cutting aperture angularly oriented to the rotation axis and circumscribed by an oval outer cutting edge. The inner member has two symmetrical rows of straight-sided triangular cutting teeth positioned to cooperate with the outer cutting edge to shear tissue, including bone, disposed in the cutting aperture. A clearance gap between the inner and outer members narrows in width in the region between the teeth and the aperture to prevent severed tissue from lodging between the inner and outer members. The height of the cutting teeth is at least 50% of their width, and 15% to 22% of the outer diameter of the inner member. The straight sides of the teeth converge to crests disposed in a first common longitudinal plane.

Abstract: A motor-driven surgical instrument having particular use in arthroscopic procedures has its drive motor operation controllable entirely from a switch cluster mounted on the instrument handpiece. The switch cluster is curved to substantially follow the circumferential profile of the handpiece and thereby avoid large platforms or projections that would add to the weight and bulk of the handpiece and destroy its balance. The switches in the cluster are arranged to minimize the movement of a surgeon's finger in quickly moving from a speed or direction control switch to an on/off switch. A unique arcuate printed circuit board having a small radius of curvature is employed as part of the switch cluster and is able to withstand the high temperatures to which the handpiece is exposed during sterilization between procedures. Disposable, single-use cutting blades are individually coded to provide a sensible parameter representing the optimum operating speed range of the cutting blade.

Abstract: An apparatus and method for drilling an orifice in a human cranium at an angle of substantially 90.degree. to a plane defined by a tangent to the surface of the cranium at the orifice. The apparatus comprises a ring structure adapted to guide and support a drill, the ring structure comprising a retaining member configured for engagement with a flexible member such as a spring and a sleeve member configured for insertion within the retaining member and operatively associated therewith to form a support assembly. The support assembly is capable of a restricted degree of vertical, slideable movement within a tubular member. The apparatus further comprises a tubular member, adjacent and external to the ring structure, adapted to guide and support the support assembly; a flexible member adjacent the support assembly for restricting vertical movement thereby within the tube; and support structure, the support structure being adapted to rest unsecured upon the cranium.

Abstract: A dilation catheter for reopening blood vessels includes an electrical motor drive and is insertable through vessels leading to a constriction point and has a working head for widening the vessel constriction. Catheters rotating slowly with up to 500 rpms are known, which because of the geometry of their head crowd soft material blocking vessels towards the sides. The present dilation catheter with motor drive is distinguished by an electric, battery-powered motor with motor gear box, by a spindle supported in a front bearing package with seal and a rear bearing package with seal, a junction point for the dilation catheter is located one end of the spindle, force is transmitted from the motor to the spindle, and a metal housing holding the spindle, motor and battery is shaped for gripping, holding and handling by a half-closed hand of a surgeon between the row of fingers and the thumb. The housing is kept gas-tight up to 130.degree. C.

Abstract: In a medical catheter, a cutting device is provided, which has a rotary cutting tool positioned at a front end of a tube and which is axially displaceable relative thereto between a working position and a rest position. Each position is defined by a stop. The cutting tool is mounted on a rigid shaft received in a bearing member which interacts with the stops.

Abstract: A rotationally expandable atherectomy cutter assembly for cutting plaque from a stenosis in an artery includes a plurality of radially separated and axially aligned blade elements. The distal ends of each blade element are fixably connected to a hub and the proximal ends of each blade element slidably engage helical slots formed in a distally flared extension tube of the assembly. The extension tube is connectable to a rotatable catheter. The helical slots are oriented in a first direction such that contact of the cutter assembly with the plaque of the stenosis, in conjunction with a second direction rotation of the catheter causes the proximal ends of the blade assembly to slide distally along the helical slots thereby expanding the cutting radius of the cutter assembly.

Abstract: A surgical apparatus particularly useable for arthroscopic surgery includes a tool insertable in a hollow, powered handpiece. The tool includes a hollow housing in which a driven member is rotatably sleeved, which driven member is provided at its forward end with a material working portion of suitable surgical type. The tool housing and driven member adjacent their rear ends both include funnel-shaped portions adapted to receive corresponding pin-like elements on the handpiece for respectively angularly fixing the tool housing and rotatably driving the driven member.

Abstract: An atherectomy device for reducing stenosis material from a vascular vessel is provided. The atherectomy device includes an elongated flexible tubular member having at least one lumen extending therethrough and having proximal and distal extremities. A flexible drive means disposed within the tubular members is free to move both rotationally and axially therein. A cutting assembly is carried by the distal extremity of the flexible tubular member with a cutter being carried by the distal extremity of the flexible drive means for removing a portion of the stenosis from the vessel wall. An inflatable dilation balloon is carried by the tubular member proximally of the cutter for further reducing the stenosis after initial reduction by the cutter. A perfusion channel maintains blood flow past the dilation balloon. Methods of the present invention include cutting and dilating a stenosis, cutting then immediately dilating a stenosis, and dilating then immediately cutting a stenosis.

Abstract: A catheter atherotome and method for its use for performing partial atherectomy in an artery and thereby enlarging the lumen effectively available for blood flow through the artery. An expansible cutter head at the distal end of a catheter includes several elongate flexible members mounted in a parallel array and spaced angularly apart from one another about the associated ends of two concentric members of the catheter in such a way that longitudinal and rotary relative movement of the members of the catheter selectively either bows the flexible members arcuately outwardly into a cutting position or draws them into alignment parallel with the catheter. A sharpened edge of a blade carried on at least one flexible member extends circumferentially and is directed toward the catheter's proximal end when the flexible members are bowed.

Abstract: A surgical instrument having a handpiece; a vibration source within the handpiece for generating mechanical vibrations in response to current supplied thereto; an elongated tool operatively associated with the vibration source and attached to the handpiece at a point where essentially no vibrational motion occurs; the tool extending away from the handpiece to a work site, whereby vibration of the working tip of the tool causes disintegration of hydrated biological material; a motor oberatively associated with the vibration source for rotating the tool and its working tip about its circumference through at least one revolution; a support structure located within the handpiece for mounting said vibration source and capable of independent longitudinal movement relative to the handpiece; a fingergrip for longitudinally reciprocating the support structure and tool towards and away from the work site independently of moving the handpiece; an open portion for irrigating the work site with fluid to assist in withdraw

Abstract: A tool driver comprising a shaft, a shank, a flange, a clamp and a retainer. The shaft has a longitudinal axis and opposed ends. The shank is joined to one end of the shaft. The flange is joined to the other end of the shaft and has an outwardly facing flange surface extending from the shaft transversely of the axis. The clamp has a clamping surface facing the flange surface. The clamp is movable axially relative to the flange to vary the separation of the surfaces. The retainer is operatively connected to the clamp and is movable relative to the clamp between a first position and a second position. The retainer, in the first position, precludes relative movement of the clamp and the flange.

Abstract: Method and apparatus for skullcap and other bone cutting during autopsy. A power driven rotary cutter in the form of a circular blade saw is mounted on a carrier which moves around the skull of the cadaver and permits the cutter to move radially, toward and away from the axis of the skull. A follower which engages the skull controls the depth of cut so that only the skull bone is cut without damage to the brain tissue in the skull. The cutter is driven by a cable from a remote motor to minimize the weight of the cutter assembly on the carrier. The casing in which the cutter is mounted can be a handpiece of a cable driven tool. The cutter can also be used manually by removing the handpiece from the carrier. Power to the cutter is controlled so that the cutter cuts only bone and stops when soft tissue is engaged by the cutter, which avoids serious damage to soft tissue, and also avoids serious injury to the user if the blade slips.

Abstract: A lense for keratometry and a keratotome for making an incision for receiving such a lense. The lense comprises an optical zone and an anchoring zone with a sloping shape such that this zone can be inserted under a strip disengaged from the cornea of the receiving eyeball via a tapering incision diverging from the cornea. The keratotome according to the invention is adapted to perform such an incision. The result is that the lense is anchored in the cornea in a more efficient, less traumatic and more aesthetic manner.

Abstract: A surgical instrument that includes a rigid outer member within which is disposed a hollow inner member having rigid proximal and distal ends and a region disposed between the rigid proximal and distal ends that is relieved to render such region relatively flexible. The flexible region is integral with a portion of the proximal end disposed adjacent to the flexible region. The inner member transmits force (such as torsion) applied to its proximal end to move a cutting implement disposed at its distal end and cause it to cut tissue admitted through an opening in the distal region of the outer member. In another aspect, a region of the inner member is weakened (e.g., by relieving an integral region of the member) with respect to the remainder of the inner member to cause this region to break if the force (e.g., torque) applied to the inner member exceeds a predetermined threshold.

Abstract: Trocar needle for laparoscopy with a truncated cone bit (1) having at its truncated cone end a cutting blade (2) with a rounded edge arranged obliquely to the axis of the needle and to the plane perpendicular to the axis of the needle which continues with a cutting thread (3) developing in a single turn around the truncated cone tip.

Abstract: A surgical tool for forming a circular opening through the skin which is of smaller diameter at the outer skin surface than at the inner surface of the skin employs a trephine having a circular cutting edge. The trephine is inserted into a pocket surgically formed beneath the skin with its cutting surface facing the skin. A rod member is then inserted through the skin and threaded into the trephine. The rod member is attached to a spring biassed plunger within a tool housing which is released from a ready position by withdrawal of a locking pin. Upon release of the plunger, the spring drives the plunger to drive the cutting edge of the trephine outwardly through the skin.

Abstract: An atherectomy system for coring, ingesting and removing an obstruction material from within a patient's vessel having a flexible guide wire defining a void for holding obstruction material during the atherectomy process and for accurately guiding a flexible catheter in the vessel. Coupling means at the proximal end of the flexible catheter for coupling it to drive means.

Abstract: An apparatus of a new type of resectoscope for prostatectomy essentially comprising an electrical driving system which is connected to a replaceable high resistivity electrotome, or a screw thread cutting-knife, and a tube-electrode to achieve the spinning-type of resection for prostate or bladder tumor. A DC-motor and a transmission-gear set are mounted within a hand grip. Other devices, such as the resectoscope sheath, telescope universal electro-surgical unit, optical light source, and universal light guide cable may be connected to this apparatus. The resectoscope provides a high speed operation, safety, effectiveness, and convenience.

Abstract: A hard tissue biopsy instrument includes an outer hollow needle attachable to a housing to project from one end thereof and having a sharpened outer tip; an inner hollow needle attachable to the housing within the outer hollow needle and having a milling outer tip, the inner hollow needle being rotatably and axially movable with respect to the outer hollow needle; and a rotary drive for rotating the inner hollow needle within the outer hollow needle.

Abstract: A surgical device including a handpiece adapted to receive a surgical tool, a motor driven drive shaft for rotating the tool about an axis, a static seal element sealed to the motor assembly, and a dynamic seal element sealed to the drive shaft, the seal elements having mating sealing portions defining a face seal in a surface transverse to the axis of rotation of the drive shaft.

Abstract: The cutting head for a surgical reamer has a leading end for insertion into a bone canal and a trailing end for attachment to a drive shaft. The cutting head has a cutting surface formed about an axis of rotation of the cutting head. The cutting surface is formed by the rotation of the cutting edges on a plurality of flutes spaced around the axis of rotation. Each cutting edge has a first portion spaced a predetermined radial distance from the axis of rotation at the tip portion and terminates at a terminating point which is at a greater radial distance from the axis of rotation than the starting point. The cutting edge on each flute has a second portion having a starting point at the trailing end of the cutting head which is at a second predetermined radial distance from the axis of rotation. The second portion extends axially towards the tip portion and terminates at a point at a greater radial distance from the axis of rotation than the starting point thereof.

Abstract: A rotating bur is disposed in a small-diameter tissue removing suction tube to grind tissue drawn into an entrance end of the tube. The bur includes a grinding head recessed from the entrance end, and is closely spaced between the internal sidewalls of the suction tube to grind tissue entrained into the tube. The entrance end of the suction tube includes an annular sharp edge to facilitate removal of tissue strands from a tissue mass. The ground tissue is then conducted through the suction tube by the suction, and discharged into a remotely located container.

Abstract: A surgical device employs a catheter for removing obstructive material from the body cavity or lumenal passage. The catheter has a blade subassembly on its distal tip for coring, homogenizing, diluting, and aspirating the obstructive material. The obstructive material is homogenized and diluted after it is cored but prior to its aspiration into the catheter. Homogenization and dilution of cored obstructive material is shown to enhance the reliability of the surgical protocol by helping to prevent clogging of the catheter during aspiration.

Abstract: An over-the-wire atherectomy cutter includes a hollow cylindrical sleeve which is coaxially attached at its proximal end to a hollow rotatable catheter. The periphery of the distal end of the sleeve is sharpened.A hollow, substantially cylindrical body is coaxially positioned within the sleeve in an interference fit. A frustum-shaped portion is formed on the distal end of the body and tapers inwardly toward a hollow cylindrical distal tip. The frustum-shaped portion has two openings which extend the axial length of the frustum-shaped portion, to create a pair of straight blades that connect the body to the tip. The straight blades are contiguous to the sharpened distal end of the sleeve to establish a pair of diametrically opposed arcuate cutting edges that are positioned on the distal end of sleeve.

Abstract: The arthroscopic surgery instrument includes an elongated outer sheath member having substantially fully open distal and proximal ends, and an inner hollow cylindrical cutting blade member rotatable within the sheath member. The cutting blade member has a distal end that is substantially fully open. The cutting blade member and the sheath member are each provided with a pair of spaced longitudinally extending, diametrically opposed tabs at their corresponding distal ends. The spaces between the tabs on the sheath member defines oppositely disposed cutting windows. Cutting edges are formed on each of the tabs on the cutting blade member and the sheath member and extend to the free ends of each member. The cutting edges on the cutting blade member are cooperable with the corresponding cutting edges on the sheath member. A rotary drive motor rotates the cutting blade member relative to the sheath member.

Abstract: A catheter and method of use for engaging material within the body of a living being to accomplish a medical and/or surgical procedure, e.g., form and enlarging an opening in a restriction in a vessel, duct, or lumen formed by the material, or to destroy a stone or other hard body formed of the material. The catheter comprises an elongated body portion and a rotatable working head located at the distal end of the catheter. The catheter is positioned with the working head adjacent the material to be enlarged. The working head comprises at least two, non-sharp, impacting surfaces, each of differing aggressiveness of restriction opening action. The less aggressive of the impacting surfaces is brought into engagement with the material when the working head is rotated in one rotational direction. The more aggressive of the impacting surfaces is then rotated in the opposite rotational direction and brought into engagement with the material to complete the procedure.

Abstract: A biopsy device consisting of a housing, a coring section on the housing having a cylindrical wall with a leading cutting edge to be bored into a tissue from which a biopsy sample is to be taken and an internal hollow space bounded by an inside surface of the cylindrical wall for accepting a sample of a tissue which the cutting edge has penetrated; a severing blade with a severing edge mounted to the cylindrical wall at least partially inside of the hollow space for pivoting movement between (a) a first position wherein the severing edge is adjacent to the inside wall surface and (b) a second position wherein the severing edge is radially inwardly with respect to the cylindrical wall from the position of the severing edge in the first position, so that as the severing blade moves from the first position to the second position, the severing edge cuts across a tissue core in the internal hollow space to allow the core to be separated from the remainder of the tissue; and structure for selectively moving the sev

Abstract: A catheter and method of use for engaging material within the body of a living being to accomplish a medical and/or surgical procedure, e.g., from and enlarging an opening in a restriction in a vessel, duct, or lumen formed by the material, or to destroy a stone or other hard body formed of the material. The catheter comprises an elongated body portion and a rotatable working head located at the distal end of the catheter. The catheter is positioned with the working head adjacent the material to be enlarged. The working head comprises at least two, non-sharp, impacting surfaces, each of differing aggressiveness of restriction opening action. The less aggressive of the impacting surfaces is brought into engagement with the material when the working head is rotated in one rotational direction. The more aggressive of the impacting surfaces is then rotated in the opposite rotational direction and brought into engagement with the material to complete the procedure.

Abstract: An atherectomy system includes a guide wire which can be inserted into an artery of a patient to a region of occlusion, a torque tube having a cutter device affixed to its distal end which is insertable into the artery over the guide wire, and a protective support sheath surrounding the guide wire and the torque tube. A retraction device controllably retracts the support sheath so as to allow the cutter on the distal end of the torque tube to extend progressively greater distances beyond the distal end of the support sheath. The system also includes means for rotating the torque tube, thereby simultaneously rotating the cutter, and vacuum means connected to the torque tube for extracting dislodged cuttings from the patient's bloodstream. The guide wire is preferably provided with an abutment on its distal end which both mechanically limits the distance the cutter can advance into the patient's body and assists in retrieving the cutter from the patient's body following the atherectomy operation.

Abstract: An apparatus for in-situ cutting through one-way valves in a vein to convert the vein for use as an artery and a method therefor. The apparatus employs a cutting catheter and a pulling catheter. The pulling catheter is advanced through the vein in the normal direction of blood flow and is then connected to a cutting catheter and pulled back reversely through the one-way valves. The cutting catheter carries cutting blades which sever the valve cusps. The connection between the two catheters is effected by a filament which can be swiftly and readily connected to the pulling catheter. The cutting catheter employs a viewing scope which can be utilized to observe the valve cusps and align the cutting blades with the cusps to achieve effective cutting.

Abstract: A lesion localization and marking wire and needle assembly for marking non-palpable lesions within the body. A marking device having a helically wound coil of wire attached to an end of the shaft which is insertable into the body through a needle or cannula for rotatingly anchoring the marking device into a lesion or tumor is provided. The needle or cannula is inserted into the body with the marking device positioned therein so that when the cannula is positioned proximate to a lesion the shaft of the marker is rotated to advance the marker into the lesion to mark it for subsequent surgical procedures. A second helical wire may be provided on the shaft which cooperates with a wire guide device attached to the needle to enable the physician to determine the depth of the marking device as it anchors into the lesion. In particular, the device is provided for marking for biopsy lesions of the breast.

Abstract: A rotatable atherectomy cutter for removing obstructive tissue from a body vessel includes a hollow cylindrical base having an outer wall, a hollow cylindrical guide tip coaxially distanced from the base for slidably receiving a guide wire and a pair of dismetrically opposed blades each having a distal end and a proximal end. The distal end of each blade is connected to the guide tip and the proximal end connected to the base for alternately cutting the tissue with a first cutting edge and a second cutting edge longer than the first cutting edge. The proximal end of each blade is connected to an ovoid portion formed in the base for allowing the second cutting edge of the blade to extend beyond the outer diameter of the cylindrical base to cut a diameter of tissue larger than the diameter of the base. The base includes a straight wall portion connecting the pair of blades to establish the first cutting edge on each of the blades.

Abstract: A catheter assembly especially designed for the performance of atherectomy procedures which include an elongated flexible plastic tube which can be routed through the vascular system to the location of the atheroma to be removed and a working catheter insertable through the guide catheter in the form of an elongated flexible plastic tube having a series of fibers integrally formed with or otherwise attached to the distal end portion of the working catheter and normally laying flat against the wall of the catheter. The proximal end of the working catheter is adapted for connection to a high speed motor whereby the working catheter can be rotated relative to the surrounding guide catheter.

Abstract: A surgical instrument having a tube and a rotating cutter head. The cutter head has a sole blade bearing two cutting edges extending from a cylindrical base and meeting in a point. An helical debris channel follows from the blade point through the cylindrical base so that large pieces of tissue may be cut and carried away by suction within the tube.

Abstract: Curved bore drilling apparatus and methods having a remotely actuated, pivotal rocker arm and cantilevered, curved guide means which guide and advance a cutting means through a predetermined curved path to drill one or more curved bores within a solid material.

Abstract: The device comprises a rotationally driven surgical instrument incorporating a hand-held element having a mount rotatably installed therein for reception of interchangeable cutting and milling inserts, a driving motor for driving the mount receiving the tool inserts, a control unit for controlling the driving motor with means of setting the rotational speed and of preselecting the rotational speed range and direction of rotation as well as a digital indicator for displaying the rotational speed set up in each case. For the purpose of accessible storage of setting data, the control unit incorporates a non-volatile read-write memory for digital storage of rotational speeds, a code carrier as well as a coding/decoding arrangement.

Abstract: An arthroscopic surgical instrument consists of an outer stationary member having a distal aperture, the wall of the outer member defining a first cutting edge at the aperture; an internal movable member disposed within the outer member, adapted to be power driven and having a second cutting edge arranged to move toward and closely past the first cutting edge in rapid, repetitive fashion to sever tissue. The instrument further includes a table extension provided at the aperture, projecting outwardly from the general contour of the body of the outer stationary member. The table extension is constructed and arranged to engage tissue against which the operator urges the instrument, in a manner to improve the repetitive cutting action.

Abstract: An expandable atherectomy cutting device comprises a flexible blade having one end connected to a torque tube and the other end connected to a tip. The tip and torque tube are rotatably positioned about a guide wire, and the torque tube is coupled to a drive element for rotating the flexible blade about the guide wire. A mechanism is associated with the tip and torque tube for pulling the tip toward the torque tube to cause the flexible blade to bow outwardly away from the guide wire to expand its radius of cutting action. The mechanism for causing the flexible blade to bow outwardly includes a base rotatably mounted in slidable relation in the torque tube, and a series of desmodromic filaments connecting the base to the tip for pulling the tip toward the torque tube. The flexible blade includes a bend so that it bows outwardly rather than inwardly.

Abstract: A locking device for releasably securing a first member to a second member which second member has an opening therein for receiving a portion of the first member, a groove in the portion of the first member within the opening, a cylindrical pin in the second member extending across the opening in the first member and in the groove in the second member in one angular position thereof, a portion of which pin is removed so that in another angular position the pin does not extend into the groove in the first member. In one modification, the pin is bowed slightly to provide spring like interference to movement thereof. In another modification, the central portion of the pin is eccentric whereby the central portion of the pin extends into the groove in the first member in one rotated position of the pin, and is completely out of the groove in another rotated position. In a further modification, the second member includes a cylindrical selecting part and a rotatably mounted securing part.

Abstract: An atherectomy cutting device for removing obstructive tissue from the lumen of a body vessel comprises a guide wire positionable in the lumen of the vessel, and a rotatable cutter supported on an eccentric wire. The eccentric wire has a distal portion extension establishing a substantially right angle with the eccentric wire and having a ring to permit sliding movement of the eccentric wire and cutter along the guide wire. The extension and eccentric wire also permit manipulative movement of the rotatable cutter in an arc around the guide wire. There is included a dual lumen sheath having a first lumen for supporting the guide wire and a second lumen for supporting the eccentric wire carrying the rotatable cutter.Also included is a method for removing obstructive tissue which involves manipulating the eccentric wire about the guide wire to move the cutter in an arc about the guide wire and thus increase the portion of obstructive tissue contacted by the cutter.

Abstract: A curved bore hole drilling apparatus and method utilizing two power driven drill shafts equipped with flexible shaft sections on the distal ends thereof with each flexible shaft section having a cutting tip. A semicircular channel shaped drill guide loosely engages each flexible shaft end section and is caused to rotate through an approximate 90.degree. angle as the cutting tips are advanced. The drill guides are pivotally mounted for rotation in substantially the same plane end, when rotated through an approximate 90.degree. angle so as to meet, the cutting tips of the associated rotating flexible drill bits form a curved semicircular bore hole which may extend through 180.degree.. The flexible shaft sections and guides are then backed out of the bore and the bore may be used for attachment of a tie such as a wire or a suture which is passed through the bore.

Abstract: A drive catheter having a distal tip for opening a partially or totally obstructed blood vessel. Both manual and motor applied motions are disclosed. In addition to a continuous rotation, two reciprocating motions are disclosed. One reciprocating motion is a back and forth translation of the tip in a ramming motion. A second reciprocating motion is a back and forth rotation about an axis. Different shaped tips are disclosed for the two reciprocating motions.

Abstract: Atherectomy device for removing material from an atheroma in the vascular system. A cutter is mounted in a cylindrical housing having a cutout on one side thereof at the distal end of a catheter. The catheter has a single luminal opening, and a flexible drive cable for operating the cutter passes through this opening. An inflatable balloon is positioned outside the housing opposite the cutout, and a medium for inflating the balloon is introduced through luminal opening of the catheter.