Abstract: An annular mapping catheter includes a catheter body. The catheter body has a distal end and a proximal end. The distal end of the catheter body is provided with a distal end assembly, and the proximal end of the catheter body is provided with a handle. The distal end assembly is made of a head end catheter that has a shape memory function. The distal end assembly in a free state presents a predetermined bent shape including an annular part and a vertical part. The vertical part connects the annular part to the catheter body. The distal end assembly is provided with an electrode. The annular mapping catheter can detect an electrocardiogram activity near a pulmonary vein ostium and can better locate a cryoballoon in the heart.

Abstract: An embolic implantation system configured to deliver an embolic implant intravascularly to a treatment site includes an elongated delivery tube to which the embolic implant is detachably attached by a flexible loop extending through a retaining ring or opening on the embolic implant and an elongated detachment member or pull wire extending through the delivery tube and flexible loop. The pull wire has a bump near its distal end that inhibits the pull wire from moving further distally when the bump presses distally against the flexible loop and/or retaining ring. The flexible loop and retaining ring thereby serve as a distal obstruction obstructing distal movement of the bump and thereby distal movement of the pull wire into the implant.

Abstract: The present disclosure provides for an interlocking cannula system that includes a handle and a set of cannulas. The set of cannulas includes a sequence of smaller to larger cannulas constructed such that the smaller cannulas may be nested within larger cannulas. Each cannula in the set of cannulas includes a respective locking mechanism configured such that each cannula may be interlocked with each of the other cannulas in the set. The handle is constructed such that each cannula in the set may interlock with the handle by the respective locking mechanism of the cannula. In some instances, the respective locking mechanisms are constructed to enable an ordered release of the cannulas.

Abstract: Embodiments of a catheter assembly are disclosed. The catheter assembly comprises a shaft; at least one connector assembly. The connector assembly can comprise a first connector portion and a second connector portion, wherein the first connector portion is fixedly coupled to a distal end of the shaft, and is coupled to the second connector portion with a limited degree of freedom of movement by at least one radially extending pin retained within at least one slot on the second connector portion. The at least one slot can have an oversized circumferential dimension that allows limited rotation of the second connector portion relative to the first connector portion about a longitudinal axis of the shaft.

Abstract: A device and method for predictably and controlling the collapsing of a collapsible and expandable stent for subsequent translation through a delivery sheath lumen to an anatomical target such as a heart valve or intravascular location for expansion and implantation. The loading device defines in inner lumen comprising a successively decreasing, from the proximal to the distal direction, inner diameter to a region of constant inner diameter wherein the stent is in a collapsed configuration. The device and method may provide for an at least partially collapsed configuration of the stent that may be further collapsed as a part of the implantation procedure and may comprise a stent that is pre-loaded for future use.

Abstract: A scoring device includes an elongate shaft, a balloon disposed on a far side of the shaft and inflatable radially of the shaft by a fluid flowing into the balloon, at least one storage tube disposed along an outer surface of the balloon and having a storage lumen defined therein, and an elongate scoring wire storable in the storage tube and made of a harder material than the balloon. The storage tube is fixed to the balloon or the shaft, and an opening portion is defined in the storage tube to provide fluid communication between outer and inner circumferential surfaces of the storage tube along the storage lumen when the balloon is inflated. The scoring wire is movable in the storage lumen along a longitudinal axis of the storage tube.

Abstract: Disclosed herein are various exemplary systems and methods for deploying an implant to a target location of a body vessel. The delivery member can include a tubular body including a lumen and compressed distal portion. The delivery member can include a loop wire with a loop opening positioned approximate the compressed distal portion. The delivery member can include a pull wire that has a proximal pull wire portion and a distal pull wire portion connected by a suture linkage. The suture linkage can include a proximal suture knot engaged to the proximal pull wire portion and a distal suture knot engaged to the distal pull wire portion. Pull wire beads positioned on the proximal pull wire and distal pull wire portion can retain the suture knots during proximal translation of the pull wire. The suture linkage can include slack that is effective to prevent premature deployment of the implant.

Abstract: An endoluminal needle or punch is describes wherein the distal end of the endoluminal needle is able to articulate laterally out of the longitudinal axis of the steerable endoluminal needle. The endoluminal needle further comprise a blunted distal end configuration that is minimally traumatic. Under control by the user, at the proximal end of the endoluminal needle, a sharp stylet can be advanced to punch tissue and then be retracted to maximize safety. The endoluminal needle is configured for use within an introducer.

Abstract: An implantable device for control over the size of emphysematous bullae in a lung, including: an elongated central region having a fixed axial length; a first end including a first anchor; and a second end including a second anchor.

Abstract: A large bore catheter has a guiding rail extending therethrough and an advance segment of the rail extends at least about 10 cm beyond the distal end of the catheter. The advance segment is advanced from the vena cava through the tricuspid and pulmonary valves of the heart into the central pulmonary artery while the distal end of the large bore catheter remains in the vena cava. The large bore catheter is thereafter distally advanced over the rail until the large bore catheter distal end is at least as far as the central pulmonary artery. The rail is thereafter proximally removed from the large bore catheter, and at least a portion of a clot is drawn from a pulmonary artery into the large bore catheter.

Abstract: A staple cartridge comprising a power management circuit is disclosed.

Abstract: Catheter assembly with a coaptation aid for repair of leaflets of a heart valve includes an elongate catheter shaft adapted to be positioned transvascularly proximate a heart valve and a lever coupled to the catheter shaft. The lever has a hinge to transition the lever between an elongate delivery configuration generally aligned longitudinally with the catheter shaft and a deployed configuration extending transversely from the catheter shaft. The lever also includes an atraumatic tip at a distal end thereof and adapted to contact a distal side of a native leaflet of the heart valve when the catheter shaft is positioned proximate the heart valve and the lever is in the deployed configuration, and an actuation assembly coupled to the lever to remotely transition the lever between the delivery configuration and the deployed configuration. Method for fixation of native leaflets of a heart valve using the catheter assembly also disclosed.

Abstract: A packaging for an implant to hold the implant in a first condition. The packaging including a first packaging tube and a container, wherein the implant is movable from the container into the first tube and maintained within the first tube in a second condition, the implant having a first transverse dimension in the first condition and a second transverse dimension in the second condition, the second transverse dimension being less than the first transverse dimension.

Abstract: The present application discloses devices and methods for performing a vascular closure procedure that comprises inserting a sheath into a tissue tract defined in a body part, temporarily sealing a vascular access site, flushing the tissue tract with a flushing fluid via the sheath, dispensing a procoagulant material into the tissue tract adjacent the vascular access site via the sheath, and then unsealing the vascular access site to cause coagulation of blood adjacent the vascular access site.

Abstract: Delivery and detachment system for an implantable intravascular treatment device, the system including an outer delivery tube and a proximal inner tube telescopically slidable within the lumen of the outer delivery tube. The proximal inner tube has a weld window radially inward cutout defined therein along an axial section between the proximal and distal ends. A securement wire disposed axially within the lumen of the proximal inner tube is secured to an inner wall of the lumen of the proximal inner tube via at least one supplemental connection point coinciding with the weld window. Also, the method for making the delivery and detachment system wherein one or more positioning wires threaded through the lumen of the proximal inner tube are manipulated to force the securement wire and the proximal inner tube in direct physical contact with one another along an axial section coinciding with the weld window.

Abstract: An extension cannula for use with a conventional ECMO return cannula is provided. The extension cannula includes a flexible conduit transitionable between a collapsed insertion state and an expanded deployed state when in communication with blood flow from an ECMO machine via the ECMO return cannula. The extension cannula may be positioned through a conventional ECMO return cannula such that the proximal end of the flexible conduit is disposed within and proximal to the end of the ECMO return cannula, while the distal end of the flexible conduit is disposed in a patient's thoracic aorta to deliver oxygenated blood directly to the patient's thoracic aorta via one or more pores at the distal region of the flexible conduit to improve cerebral oxygenation, maintain systemic arterial pulsatility, and reduce the potential for end-organ injury.

Abstract: The invention relates to an introducer sheath for catheters to be inserted into a vascular system comprising a connecting valve (2) and an insertion tube (3) having a proximal portion (4) and a distal portion (5), said distal portion (5) being of reduced diameter in comparison with the proximal portion (4), and to enable its diameter to be reversibly changed the insertion tube (3) is provided with longitudinally extending expansion elements with incisions (11, 11?, 12) designed as predetermined breaking points.

Abstract: This disclosure concerns release mechanisms for medical implants, particularly embolic coils and the like, which utilize bulbous elements and receiving elements to constrain the bulbous elements. In some cases, the receiving elements are sized and shaped to help constrain the bulbous element axially and/or radially, and may work in concert with constraining elements and/or release wires that are optionally moveable independently of the receiving elements.

Abstract: A subaxillary traction device having an elongated body portion with a first end and a second end, at least one receptacle member disposed on the first end defining a cavity to receive a fingertip, a handle opening disposed adjacent or near the first end and a handle opening disposed adjacent or near the second end, the handle openings being of sufficient size to receive at least one finger there through, whereby the body portion is positionable under the posterior axilla of a fetus experiencing shoulder dystocia such that traction may be applied allowing delivery of the posterior aim affecting the safe delivery of the baby.

Abstract: Systems and methods for treating an aneurysm in accordance with embodiments of the present technology include intravascularly delivering an occlusive member to an aneurysm cavity and deforming a shape of the occlusive member via introduction of an embolic element to a space between the occlusive member and an inner surface of the aneurysm wall.

Abstract: An attachment for a catheter assembly may include a platform, which may include an upper surface and a bottom surface. The bottom surface may be configured to contact skin of a patient. At least a portion of the upper surface may be configured to support the catheter assembly. The upper surface may support the catheter assembly at an angle with respect to skin of the patient that is approximately equal to an insertion angle of a catheter of the catheter assembly. The attachment may include snap feature coupled to the upper surface of the platform. The attachment may include a blunt cannula extending distally from the snap feature. The blunt cannula and the portion of the upper surface may provide a generally straight pathway for an instrument inserted distally through the attachment into the catheter assembly.

Abstract: A stent assembly for insertion into an airway of a patient includes a stent defining an interior pathway along a length of the stent. The stent assembly includes a removal instrument for removal of the stent from the airway of the patient. The removal instrument is configured to cause a helical motion of the stent to remove the stent from the airway of the patient.

Abstract: An apparatus, assembly and method for controlling release of a drug from a drug-eluting balloon during delivery of a drug-eluting balloon to a situs within a body. More particularly, the present invention relates to a diametrically expandable sleeve having a first non-diametrically unexpanded state in which drug retained on or in a drug-eluting balloon is protected from release by a sleeve and a second diametrically expanded state in which drug retained on or in the drug-eluting balloon is exposed for focal release in the body by diametric expansion of the sleeve, exposing openings in the sleeve during diametric expansion and closing the openings in the sleeve when the sleeve is in its diametrically unexpanded state.

Abstract: Various exemplary angled surgical trocars and methods of using angled surgical trocars are provided. In general, a trocar configured to be advanced into a body of a patient can have an angled distal portion. The trocar can have a cut-out at its distal end in the angled distal portion of the trocar. The trocar can be advanced into the patient's body alone or with an obturator located therein. The obturator located in the trocar can have a flexible portion configured to bend within the trocar's angled distal portion. The trocar and obturator can be used in a variety of medical procedures, for example thoracic procedures in which the trocar is used to provide access to a thoracic cavity of a patient.

Abstract: A catheter including one or more echogenic members facilitate guiding the catheter to a selected locations within a patient using ultrasound imaging. The echogenic members may include expandable members, such as balloons, be positioned near a distal end of the catheter. The echogenic members include an echogenic material, such as a coating or a fluid, that is configured to enhance the diffuse sound scattering of the echogenic member. An expanded echogenic member is detectable using ultrasound imaging.

Abstract: Systems and methods are described herein for resurfacing bones, and in particular, for detecting and resurfacing one or more femoroacetabular impingements (FAIs). A FAI resurfacing controller may be used to perform this detecting and resurfacing of FAIs. The FAI resurfacing controller may include a bone model generator to receive bone imaging and to generate a model of at least one osteophyte and of a surface of a native bone surrounding the at least one osteophyte. The FAI resurfacing controller may include an osteophyte identifier to set a virtual 3D boundary surface between native bone surface and the at least one osteophyte. The FAI resurfacing controller may include a resurfacing navigator to generate and output a navigation file. The navigation file may include the model with the 3D boundary surface between native bone surface and the at least one osteophyte.

Abstract: A more accurate radiotherapy is implemented by using a vessel marker for radiotherapy having a deformation fixed shape for engaging with the inner wall of a vessel by deformation after being inserted into the vessel, and a position notification shape for notifying an outside of a radiation irradiation position. Also provided are a radiotherapy support method for supporting radiotherapy to be performed by using the vessel marker, a radiation irradiation control apparatus that irradiates, with radiation, a patient in which the vessel marker is indwelled, and a vessel marker indwelling support apparatus to be used when indwelling the vessel marker.

Abstract: An illustrative endoluminal implant having an elongated tubular member. The elongate tubular member having a proximal stent, a distal stent and an interconnecting sleeve. The proximal stent tapers from a first outer diameter adjacent the proximal end region to a second smaller outer diameter adjacent the distal end region. The distal stent has an outer diameter less than the first outer diameter of the proximal stent. The interconnecting sleeve is collapsible in response to an applied radial force such that the sleeve is positionable across a natural valve or sphincter.

Abstract: The present invention is an embolization coil having an optimum morphological stability. The embolization coil includes a wire material made of an Au—Pt alloy. The wire material constituting the embolization coil has such a composition that a Pt concentration is 24 mass % or more and less than 34 mass %, with the balance being Au. The wire material has such a material structure that a Pt-rich phase of an Au—Pt alloy having a Pt concentration of 1.2 to 3.8 times a Pt concentration of an ? phase is distributed in an ? phase matrix. The wire material has a bulk susceptibility of ?13 ppm or more and ?5 ppm or less. In a material structure of a transverse cross-section of the wire material, an average value of two or more average crystal particle diameters measured by a linear intercept method is 0.20 ?m or more and 0.35 ?m or less.

Abstract: A medical system includes an insertion device including a delivery shaft with an internal lumen, a coupling tube coupled to the delivery shaft and configured to receive a medical device, and a liner tube inserted through the internal lumen of the delivery shaft.

Abstract: Disclosed herein are systems and methods for dilating tissue for placement of a pedicle screw without the use of guide wires. The tissue dilation system includes, generally, a stylet and trocar which are used for the initial placement of the tissue dilation system. A second dilator is passed over the first. A second dilator is passed over the first dilator, and further includes a serrated edge for engaging with a target surface. The second dilator may be secured to the target surface by the serrated edge alone, or may additional be secured using one or more temporary fixation pins, which operably couple to the second dilator.

Abstract: A bariatric device and method of causing at least partial satiety in a recipient includes positioning a body in a recipient, the body having a wall defining a lumen, the wall configured to generally conform to the shape and size of the proximal cardiac portion of the stomach. Force is exerted with the wall on the proximal cardiac portion of the stomach in the absence of food thereby activating receptors located in the proximal cardiac portion of the stomach, thereby influencing a neurohormonal feedback mechanism of the recipient to cause at least partial satiety by augmenting fullness caused by food and simulating fullness in the absence of food.

Abstract: A tissue guard includes a body defining an open proximal end, an open distal end, and a lumen extending through the body between the open proximal end and the open distal end. A lip extends radially outwardly from the open proximal end of the body, the lip including a finger extending from an exterior peripheral surface thereof. The finger includes a flange at a distal end thereof adapted to operably engage an underside of a proximal ring of an access device to secure the tissue guard therein.

Abstract: A gastrointestinal device for treating obesity includes a three-dimensional porous structure configurable between a compressed pre-deployment configuration to facilitate delivery and an expanded post-deployment configuration. The porous structure includes a first opening at its proximal end and a larger second opening at its distal end. The porous structure also includes a sleeve coupled to its distal end. Optionally, the device further includes a suture at the proximal end of the wire mesh structure to facilitate retrieval and an anti-migration component positioned at the junction of the porous structure with the sleeve. The porous structure is deployed in a patient's stomach such that the anti-migration component sits proximal to the patient's pylorus and prevents migration of the entirety of the device into and through the pylorus. The sleeve extends through the pylorus, into the duodenum and ends in the duodenum or jejunum.

Abstract: The invention relates to an infusion catheter device. This catheter device 10 has an elongate, substantially tubular shape defining a longitudinal axis, a distal end (D) and a proximal end (P), configured to be introduced into a conduit (50) having an inner wall (54) and an outer wall (56) and comprising at least one partial or total obstruction (60) or occlusion to be treated, said device comprising, at its distal end (D), one or more infusion orifices (16, 18, 20, 22) for an infusion liquid (LI), and, upstream from the one or more infusion orifices, at the proximal side (P) of the infusion catheter (10), at least one obturating element (70) for temporary obturating, configured to treat said obstruction (60) or occlusion and to perform the infusion of the infusion liquid (LI) downstream from the obturating element (70) and in the obturating position. This device is suitable in particular for cardiac surgery and interventional cardiology.

Abstract: A small diameter vascular prosthesis includes an outer textile graft, an intermediate self-supporting coil or stent and an inner microporous layer. The outer textile graft allows for tissue ingrowth. The inner microporous layer provides blood impermeability without preclotting the prosthesis. The coil or stent provides kink resistance and resistance again collapsing of the outer textile graft and the inner microporous layer.

Abstract: A surgical access device includes a cannula having a variable length. The cannula may include a shaft assembly including an outer shaft, an intermediate shaft disposed within and longitudinal slidable relative to the outer shaft, and an inner shaft disposed within and longitudinal slidable relative to the intermediate shaft. The shaft assembly is movable between an unextended position, a fully extended position, and a semi-extended position between the unextended and fully extended positions. The cannula may include a shaft having annular folds formed therein. The annular folds are axially movable relative to each other such that the shaft is longitudinally movable between an unextended position and a plurality of extended positions.

Abstract: This invention is an intrasacular aneurysm occlusion device with a longitudinal mesh ribbon having a series of loops or segments with distal-to-proximal variation in their sizes, shapes, or orientations. For example, loops or segments can be progressively smaller in size and/or progressively more curved as one views the series in a distal-to-proximal direction. The device may also enable a user to selectively and remotely bend, steer, or elongate the loops or segments in real time as the ribbon is being deployed into an aneurysm sac.

Abstract: Provided herein are methods and systems for the removal of anatomical occlusions, and an occlusion removal device comprising a first body adapted to be mounted to a delivery wire and releasably engaged to the delivery wire, wherein while engaged the first body remains fixed on the delivery wire and upon release moves axially along the delivery wire, and a second body adapted to be mounted to the delivery wire. A first proximal body may be oriented proximally to a second distal body. The proximal body and the distal body may be adapted to expand upon exiting a delivery catheter. The proximal body may be releasably engaged by a mechanically breakable connection or an electrolytically or heat disconnectable connection, the electrolytically disconnectable connection being broken upon an application of electric current to the electrolytically disconnectable connection.

Abstract: A manufacturing process forms a bored hollow lumen. The manufacturing process includes providing a solid rod of a bioresorbable material and boring a hole axially through the solid rod. The manufacturing process also includes modifying surface defects formed on a luminal surface by the boring, the luminal surface defining the hole, thereby forming the bored hollow lumen. A bored hollow lumen includes a lumen wall including a bioresorbable material. The lumen wall has an abluminal surface and a luminal surface. The luminal surface defines a bore through the bored hollow lumen. The bioresorbable material has a uniform crosslinking density.

Abstract: A stomach lining patch includes a collapsible frame, a membrane covering the collapsible frame, collapsible frame and the membrane providing a collapsed configuration suitable for endoluminal delivery to a stomach of a patient and an expanded configuration suitable for lining an internal surface of a gastric wall of the stomach, and a set of anchoring arms extending from the collapsible frame and being configured to pass through a puncture in the gastric wall and lay flat against an outer surface of the gastric wall when the collapsible frame and the membrane are in an expanded configuration lining the internal surface of the gastric wall.

Abstract: A complete removal and reinsertion of instruments is avoided when the instruments are initially not correctly positioned during a minimally invasive operation on a bone, in particular a vertebra of the spine. This aim is achieved by an instrument set for spinal operations, including a guide rod, which has a cavity extending along the axis of the guide rod, and a guide tube, which can be received in the cavity of the guide rod, wherein the guide rod has a distal lip, which is arranged eccentrically to the cavity and/or to a center axis of the guide rod.

Abstract: Described are various embodiments of a cooling pack. In one such embodiment a cooling pack is provided for cooling a crotch region of a human while seated on a seating surface, the cooling pack comprising a tapered container for holding a cooling material therein, and defined by tapering upper and lower surfaces drawing into a tapered edge to be positioned between the crotch region and the seating surface in use, thereby providing cooling for the region.

Abstract: A tissue guard for use with a surgical access device includes an upper portion having: a proximal ring with proximal and distal ends, the distal end having a first mechanical interface disposed therearound; a plurality of fingers extending about the proximal ring that the access device; an inner peripheral surface having an upper channel; and a plurality of second mechanical interfaces disposed about a distal end of the inner peripheral surface. The lower portion includes: a body having a proximal end including a corresponding first mechanical interface disposed therearound configured to engage the first mechanical interface of the upper portion; a lower channel defined within the body including a plurality of corresponding second mechanical interfaces configured to engage the plurality of second mechanical interfaces of the upper portion; and long and short petals disposed of the lower portion to facilitate insertion of the tissue guard within an incision.

Abstract: A catheter may include an elongated tube enclosing at least one catheter lumen, and a centering device coupled to a distal end of the elongated tube, wherein the centering device includes a plurality of legs. Each leg of the plurality of legs may include a first end fixed to an outer surface of the elongated tube. Each leg of the plurality of legs may include an outward bias such that a central portion of each leg of the plurality of legs is spaced radially outward from the elongated tube when the centering device is in an expanded state.

Abstract: Devices for treating a bone and methods of inserting such devices into a bone are disclosed. A device for treating a bone may include a flexible tube, a stiffening mechanism and an actuator. The flexible tube has a distal end and a proximal end. The stiffening mechanism within the flexible tube is configured to cause the flexible tube to become rigid. The actuator is configured to cause the stiffening mechanism to cause the flexible tube to become rigid in response to the actuator being actuated.

Abstract: A method for performing an efficient and thorough percutaneous discectomy includes making into the patient a percutaneous incision, which is a small stab wound, no more than approximately 10 mm in length. A stimulated combination neuro-monitoring dilating probe is passed through an approximately 10 mm or less skin incision and into a patient's disc space to establish a safe path and trajectory through Kambin's Triangle. Once a neuro-monitoring dilating probe is in the disc space, a second dilator is placed over the neuro-monitoring dilating probe and impacted into the disc space. Neuro-monitoring dilating probe may then be removed. An access portal optionally combined with a force dissipation device may then be placed over the second dilator and into the disc space. The second dilator is removed and then discectomy instruments may be placed through the access portal to perform the discectomy.

Abstract: Consistent with disclosed embodiments, systems, devices, methods, and computer readable media for filling a hollow body structure may be provided. In some implementations, an endovascular instrument for filling a hollow body structure may be provided and may include an elongated member configured to exhibit differing coiling properties along a length thereof. The elongated member may include a first region configured to bend within the hollow body structure to form a stabilizing frame. The elongated member may also include a second region located proximal to the first region and configured to bend, after formation of the frame, substantially within the frame, thereby forming a curved mass substantially within the frame. The first region and the second region may be interconnected. The embodiments may further include at least one structural property that differs between the first region and the second region.

Abstract: The present invention discloses a catheter system, comprising: a catheter head having a lumen, a proximal end and a distal end, and an opening positioned at a bottom of the distal end; and a rotatable inner tube having a lumen positioned in the lumen and at a proximal end of the catheter head, the inner tube including a front end having an arcuate opening; wherein the rotatable inner tube can be rotated so that the arcuate opening thereon can be made to engage or disengage with the opening at the bottom of the distal end of the catheter head. The invention also provides a catheter system and method for re-entry of a vascular false lumen into a true lumen in a quick, accurate and low-risk way.

Abstract: Devices and methods for inserting a pre-loaded intracanalicular plug for the treatment of dry eyes. In one embodiment, an intracanalicular plug inserter device includes: (a) an elongate body having a longitudinal axis, the body having: an inserter end, wherein the inserter end has an opening therein; and a distal end, wherein the distal end is longitudinally opposing the inserter end; and (b) a plug ejector, wherein the plug injector comprises: a slider; and a rod coupled to a first end of the slider, wherein the plug ejector is configured to be moveable between a first position adjacent an opening in the inserter end and a second position that is further from the opening. The plug is mounted within the body and abuts first end of the rod adjacent the opening in the inserter end.