Abstract: A bi-directional perfusion cannula is provided that includes an elongate tube for insertion into an artery. The elongate tube has a first aperture at a distal end of the tube which is forward during insertion and configured so that blood can flow into the artery in the direction of insertion, an elbow formed in the elongate tube, and a second aperture formed in or slightly rearward of the elbow and configured for supplying blood into the artery in a second direction which is generally opposite to the insertion direction.

Abstract: A medical system including an elongate member and an elongate element associated with the elongate member so that a shape of the elongate member can be altered upon applying energy to the element.

Abstract: A stoma dilator having a base dilator and a plurality of dilators coaxially disposed over the base dilator. The base dilator has a hub and an opening therethrough. Each of the plurality of dilators has a tapered distal end, a proximal end, and a tubular body, and are held in separated, telescoping position by a dilator positioner such that part of each distal end is exposed from beneath another dilator and is graspable for movement such that a smaller dilator does not become inaccessible inside of a larger dilator. The stoma dilator includes a hollow sheath positioned over an outermost dilator to hold open a tissue opening created by the plurality of dilators. The base dilator and the plurality of dilators may be removed while the sheath remains in a tissue opening. Another device may be inserted through the sheath, and the sheath may be peeled away therefrom.

Abstract: Neuromodulation assemblies (200) include an extravascular prosthesis (202) disposed around and contacting at least a portion of an exterior surface (204) of a vessel (V) and a radially expandable intravascular prosthesis (206) contacting an interior surface (208) of the vessel. The neuromodulation assemblies are configured to compress, pinch, or squeeze a target nerve within the adventitia of the vessel between the extravascular and intravascular prostheses in order to impinge and disrupt the target nerve, thereby blocking or stopping nerve signal transduction. Neuromodulation assemblies configured in accordance with the present technology may also utilize radio-frequency energy, a drug, and/or magnetic attraction to block nerve signal transduction for neuromodulation thereof.

Abstract: Devices and methods for treating obesity are provided. More particularly, intragastric devices and methods of fabricating, deploying, inflating, monitoring, and retrieving the same are provided.

Abstract: The three dimensional, low friction vasoocclusive coil has a portion that is three dimensionally box or cubed shaped. The three dimensional box or cubed shaped portion will form a basket for filling the anatomical cavity at the site in the vasculature to be treated. The vasoocclusive device is formed from at least one strand of a flexible material formed to have a first inoperable, substantially linear configuration for insertion into and through a catheter or cannula to a desired portion of the vasculature to be treated, and a second operable, three dimensional configuration for occluding the desired portion of the vasculature to be treated. The vasoocclusive coil may optionally include a portion that is substantially J-shaped or helically shaped, for filling and reinforcing the three dimensional portion.

Abstract: A patient in whom blood diversion due to cerebral venous steal is present, and abolishment of the cerebral venous steal is indicated, is treated by increasing the cerebral venous pressure in the patient. This increase in cerebral venous pressure restores the collapsed cerebral vasculature, thereby increasing cerebral blood flow. The increase in cerebral venous pressure may be achieved using an occluding catheter in the superior vena cava or the internal jugular veins, using external compression of the cervical veins, or any other suitable mechanism. The occlusion may be controlled precisely during treatment, possibly as a function of cerebral blood flow, and after treatment the patient may experience a persistent effect because the cerebral vasculature is no longer collapsed.

Abstract: Devices, methods and systems are provided for occluding an opening within the tissue of a body, such as a left atrial appendage. In one embodiment, a device includes a framework extending between a primary hub and a secondary hub. The secondary hub is moveable relative to the primary hub upon deploying the framework from a constricted position to a deployed position such that the secondary hub remains proximal a distal end of the framework. The framework, in the deployed position, includes engaging members proximal the distal end of the framework, and the framework includes multiple frame segments each extending with an arcuate configuration at a distal side of the framework such that the frame segments, at the distal side thereof, each extend radially and distally toward the distal end, then turn and extend radially and proximally inward toward the secondary hub.

Abstract: Catheter balloon assemblies (10) for delivering a therapeutic agent to a body vessel are provided, as well as related methods of manufacturing and methods of treatment. The catheter balloon assemblies may include a concentrically disposed dual balloon assembly at the distal portion of the catheter having an inner balloon (44), a porous outer balloon (42) concentrically arrayed around the inner balloon and a catheter shaft (30) adapted to deliver a therapeutic agent to the body vessel through the apertures in the outer balloon. Radial outward expansion of the inner balloon may urge the outer balloon into contact with the wall of a body vessel, where the therapeutic agent may be delivered from the catheter shaft through apertures in the outer balloon directly to the wall of the body vessel.

Abstract: Sinusitis, mucocysts, tumors, infections, hearing disorders, choanal atresia, fractures and other disorders of the paranasal sinuses, Eustachian tubes, Lachrymal ducts and other ear, nose, throat and mouth structures are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies and endoscopic studies.

Abstract: The present embodiments provide apparatus suitable for treating a medical condition at a target site. In one embodiment, the apparatus comprises a plurality of strands, each having proximal and distal regions, wherein the plurality of strands are twisted in a generally helical manner to form a tubular shape. The proximal and distal regions of each of the plurality of strands comprise a contracted configuration adapted for delivery to the target site. Further, the distal region of at least one of the plurality of strands comprises an expanded, radially deployed configuration adapted to facilitate treatment of the medical condition. The distal region of at least one of the plurality of strands may be deployed in a self-expanding or balloon-expandable manner.

Abstract: Disclosed herein are implantable fistula treatment devices and methods. In some embodiments, a distal anchor for an implantable fistula treatment device may comprise a suture and multiple foldable members including at least a distal-most foldable member and a proximal-most foldable member. The distal-most foldable member may comprise a suture attachment structure. The proximal-most foldable member may be configured to couple to a surface of a body lumen at a distal opening of a fistula.

Abstract: A device for intravascular intervention can comprise an intervention element, an elongate manipulation member, and a joining element. The elongate member can comprise a hooked portion extending about a proximal portion of the intervention element. The joining element can substantially permanently attach the hooked portion to the intervention element.

Abstract: A blood flow cessation device includes a catheter, an expandable member, and a rapid exchange port. The catheter includes a distal end portion and a proximal end portion. The expandable member is positioned at the distal end portion and is selectively expandable to stop blood flow through a vessel. The rapid exchange port is formed in the catheter at a location proximal of the expandable member. The rapid exchange port is configured receive a guidewire that passes through the distal end portion of the catheter to be positioned within the vessel.

Abstract: The present invention is directed toward an intragastric device used to treat obesity that includes a wire mesh structure capable of changing from a compressed pre-deployment shape to an expanded post-deployment shape with a greatly increased volume. The post-deployment shape contains a light weight at the top and a heavier weight at the bottom to ensure proper positioning within the stomach. In the post-deployment shape, the device contains larger spaces in the upper portion and smaller spaces in the lower portion to sequester food and delay gastric emptying. Alternatively, the device can be enveloped by a membrane containing larger holes at the top and smaller holes at the bottom to sequester food and delay gastric emptying. The device has a dynamic weight where the weight of the device in the pre-feeding stage is less than the weight of the device in feeding or post-feeding stage.

Abstract: An occluding device including expandable scaffold and a flow-limiting member is described. In some embodiments the scaffold is an expandable or self-expanding stent deliverable over a guide wire. The flow-limiting member can include a valve that can be closed following deployment. On deployment the stent and flow-limiting member can engage an inner surface of a body cavity lumen, blocking flow of material. In some embodiments the body cavity is a blood vessel, and the device can be used to block blood flow. In some embodiments the device includes bioactive agents.

Abstract: Disclosed is an expandable transluminal sheath, for introduction into the body while in a first, small cross-sectional area configuration, and subsequent expansion of at least a part of the distal end of the sheath to a second, enlarged cross-sectional configuration. The sheath is configured for use in the vascular system and has utility in the introduction and removal of implant delivery catheters. The access route is through the femoral arteries and the iliac arteries into the aorta. The distal end of the sheath is maintained in the first, low cross-sectional configuration during advancement to the arteries into the aorta. The distal end of the sheath is subsequently expanded using a radial dilatation device, which is removed prior to the introduction of implant delivery catheters.

Abstract: A surgical device for application in a treatment performed on the human or animal body with the aim of providing access to a surgical site in the body by exerting a force, upon expansion of the device at the location of the surgical site, on the organs and/or tissues at the surgical site, e.g. for mobilizing and/or supporting organs and/or tissues, the surgical device including an expansion structure, at least one fluid reservoir, and a conduit for conveying fluid from the reservoir to the expansion structure.

Abstract: A dilator which can suppress rapid change in resistance and can perform smooth insertion into a hole includes a distal portion, an outer diameter of which increases towards a proximal end side in an axial direction; and a reduced cross-sectional area portion which is provided at least on a largest outer diameter portion of the distal portion, and is obtained by reducing a part of an outer periphery of a circular cross section, and a width of the reduced cross-sectional area portion in a chord direction is equal to or greater than a depth of the reduced cross-sectional area portion in a direction perpendicular to the chord direction.

Abstract: Medical systems and related methods are disclosed. In some embodiments, the medical systems include an inner tubular member defining an aperture and an outer tubular member at least partially surrounding the inner tubular member. The inner and outer tubular members can be arranged such that an implantable medical endoprosthesis can be disposed therebetween.

Abstract: A medical implant for occluding a blood vessel. The medical implant comprises a cup shaped elastic blood impermeable membrane sized and shaped for substantially occluding a lumen of a blood vessel, at least one scaffolding element mounted, sized and shaped for being attached at least one blood clot forming in front of the elastic blood impermeable membrane, and at least one anchoring element having a tip directed outward from the center of the cup shaped elastic blood impermeable membrane.

Abstract: Embolic implants, delivery systems and methods of manufacture and delivery are disclosed. The subject implants are deployed in two stages. If sized properly as observed in the first stage, they are deployed to the second stage and detached. If not sized properly in/at the first stage, the implants are designed to be withdrawn and replaced with a more appropriately sized implant or another treatment option selected. Some of the implant configurations may be withdrawn even after the second stage deployment as well.

Abstract: A directional sequential dilation system includes a dilation tube assembly having a plurality of cylindrical, nesting directional dilation tubes including an initial cylindrical dilation tube that provides a passage for neuro-monitoring. Subsequent cylindrical directional dilation tubes sequentially increase in size including the increase in diameter. Each tube is configured to nest onto a previous cylindrical directional dilation tube via an off-centered structure formed in each of the subsequent cylindrical directional dilation tubes. The off-centered cutouts allow the subsequent cylindrical dilation tubes to dilate the soft tissue while at the same time sequentially migrate the incision dilation in a particular direction and distance from the initial cylindrical dilation tube insertion point (i.e. the initial neuro-monitoring insertion point). The directional sequential dilation system is particularly useful in spinal surgery.

Abstract: The present disclosure relates to a sheath system for enabling access through an opening in the body of a patient is provided. The sheath system includes a dilation assembly having a radially expandable tubular sheath defining a lumen having a first cross-sectional area when in a non-expanded condition, and a handle assembly operatively coupled to a proximal end of tubular sheath, the handle assembly defining an aperture formed therein, and a first thread defined on the handle in the aperture thereof. The sheath system further includes an expansion assembly including a tubular member defining a lumen having a second cross-sectional area which is larger than the first cross-sectional area of the tubular sheath of the dilation assembly and having an outer surface defining a second thread, the second thread being arranged for engaging the first thread.

Abstract: A mechanism for removing a fluid-filled object from a patient. The apparatus includes a deflation tube with a puncture member at one end of the tube for piercing a hole in the object wall. The apparatus includes a retrieval mechanism slidable within the deflation tube lumen. The retrieval mechanism includes an expansion element that is expandable when positioned within the object from a first configuration with a dimension less than that of the deflation tube lumen to a second or deployed configuration with a dimension that is greater than an outer dimension of the puncture member. The expansion element contacts an inner surface of the inflatable object as the deflation tube and retrieval mechanism are withdrawn from the body cavity. The expansion element may be a T-bar, a foldable anchor, an inflatable member, or another expandable form.

Abstract: A drainage stent delivery system including an elongate shaft of a medial device, a drainage catheter or stent, and a locking mechanism for selectively coupling the drainage stent to the elongate shaft. The drainage stent is selectively coupled to a distal portion of the elongate shaft such that the proximal end of the stent is positioned proximal of the distal end of the elongate shaft. The locking mechanism includes an engaging feature of the elongate shaft which engages a portion of the stent such that the stent may be selectively coupled to the elongate shaft through rotational motion of the elongate shaft relative to the stent. In some instances, the engaging feature of the elongate shaft may be a tab which extends into an opening of the stent.

Abstract: A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.

Abstract: A catheter for the local delivery of therapeutic agents and methods of using the same for the treatment or prevention of disease are disclosed. A catheter may include a tubular net and a guidewire attached to the tubular net longitudinally along the abluminal side of the net. The catheter may further include a tubular member that opens onto the abluminal side of the tubular net.

Abstract: Dilators and sheaths for use in minimally invasive vascular therapy are disclosed. In some embodiments, the dilators include a slot that accesses a guidewire lumen within the dilator. These slots facilitate rapid exchange of one dilator for another. In another embodiment, a dilator is sufficiently stiff to facilitate entry, but also designed to facilitate placement of the dilator along a tortuous path.

Abstract: New devices, systems, and methods are disclosed for preventing, treating, and/or at least minimizing ischemia and/or reperfusion injury by restoring and/or modulating blood flow, particularly in the cerebral vasculature where blood vessels are narrow and tortuous. These devices, systems, and methods make it possible for a clinician to adequately and systematically restore blood flow to ischemic tissue while simultaneously modulating the blood flow to minimize reperfusion injury. New thrombectomy devices and systems, which, for example, expand with greater radial force, further enable improved binding with clots and restoration of blood flow.

Abstract: A balloon catheter is provided for dilating hardened stenoses. The balloon catheter has dilation elements integrally formed on the outer surface of the balloon. The dilation elements have cross-sectional shapes that improve the performance of the balloon catheter.

Abstract: Devices and methods for treating obesity are provided. More particularly, intragastric devices and methods of fabricating, deploying, inflating, monitoring, and retrieving the same are provided.

Abstract: An absorbable and expandable closure member used to occlude or exclude a body lumen or cavity, such as a blood vessel, fallopian tube, duct, aneurysmal sac, etc., comprising a closure member comprising one of more sheets of a biomaterial that are rolled, stacked, or folded to form a multilayer construct of a generally cylindrical configuration for deployment through a delivery system, either as a singularly or part of a multiplicity of closure members. The biomaterial is derived from a source material, such as small intestinal submucosa or another remodelable material (e.g., an extracellular matrix) having properties for stimulating ingrowth of adjacent tissue into the biomaterial deployed within the bodily lumen. The closure member is deployed to the bodily lumen from a delivery sheath, cartridge, and/or over a inner guiding member, such as a wire guide or catheter.

Abstract: The apparatus for deployment of a therapeutic device such as a micro-coil detachably mounts the therapeutic device to a distal portion of a pusher member. In one embodiment, the therapeutic device is detachably mounted to the distal portion of the pusher member by a tubular collar that can be heated by a heater such as an electrical resistance coil to expand the collar and release and deploy the therapeutic device. The apparatus for deployment of a therapeutic device such as a micro-coil may also provide for a pusher member and a connector fiber for securing the therapeutic device to the pusher member. The connector fiber passes through a heater within the distal portion of the pusher member, for heating and breaking the connector fiber to release the therapeutic device when a desired placement of the therapeutic device within the vasculature is achieved.

Abstract: A delivery device for implanting a medical device that includes an expandable fixation member adapted to fix the position of the medical device within a lumen of a human body. The delivery device has an inner shaft rotatably disposed in a tubular outer shaft. A retention member is secured to and rotatable with the inner shaft and has a free end and a retainer portion adapted to protrude outwardly through an exit aperture in the outer shaft to extend circumferentially about the exterior of the outer shaft. The fixation member of the medical device may be retained on the tubular shaft in a low profile configuration by the outwardly protruding retainer portion and may be released to expand upon retraction of the retainer portion in response to rotation of the inner shaft.

Abstract: Embodiments of the disclosure may include a method for providing access within a patient that may include inserting a medical device through an opening of the patient. The medical device may include an overtube having a lumen and a slot and an elongate member disposed within the lumen of the overtube, wherein the elongate member may include an expandable member configured to expand and collapse. The method may further include positioning the medical device proximate a site in the patient, positioning the overtube relative to the elongate member such that a portion of the expandable member faces the slot, and the slot faces the site, and expanding the portion of the expandable member out of the slot and toward the site.

Abstract: According to this load detection method, load (Fi) in insertion of a linear body having flexibility in an inlet of a hollow tube inserted in a bending vessel in a body is detected, an image of the hollow tube or the linear body is taken, a degree of bending of the hollow tube or the linear body is detected based on the image, and load (Fo) at a tip end of the linear body is calculated based on the detected insertion load (Fi) and the degree of bending. Therefore, the load (Fo) at the tip end of the thin linear body can readily be detected.

Abstract: A device, method, and system of deploying an embolic protection device at a location distal to a treatment site in a vessel of a patient. A delivery catheter is encircled by a sealing member which is expandable from a delivery configuration to a deployed configuration. The device creates a seal to prevent the flow of blood during the treatment of vascular disease. A distal protection element is delivered by the delivery catheter and deployed to filter or remove embolic debris.

Abstract: The invention described is directed to an intracorporeal occluding device having elements with non-traumatic ends and devices, systems and methods for occluding the lumens of anatomical passageways and/or for delivering drugs or other substances to the bodies of human or animal subjects.

Abstract: A medical instrument including an inflatable balloon and a plurality of filamentary tool elements with a proximal movable section that is attached to a wall of the balloon and with a distal end projecting freely from the balloon, wherein the proximal end forms a substantially cylindrical shape when the inflatable balloon is inflated and deflated and the distal end bends inwards from the substantially cylindrical shape when the balloon is deflated.

Abstract: A method of treating a patient with a calcified aortic valve includes introducing a guide wire into a blood vessel. The guide wire is advanced through the aorta to the aortic valve and then through the aortic valve. A balloon dilatation catheter is introduced into the blood vessel over the guide wire. The balloon dilatation catheter includes an elongate body, a distal portion, a guide wire lumen, an inflation lumen, and a dilatation balloon. The balloon dilatation catheter further includes at least one deflection wire lumen, and at least one deflection wire residing in the at least one deflection wire lumen and having a distal end attached to the distal portion. The balloon dilatation catheter is advanced over the guide wire through the aorta, through the aortic valve, and the dilatation balloon is inflated.

Abstract: This disclosure provides a method of treating obesity and related disorders through the administration of a composition comprising a neurotoxin and a mucosal permeabilizing agent. Methods for making and using the described compositions are also provided.

Abstract: A medical device may include an elongate shaft having a longitudinal axis and a distal end. The medical device may include a distal tip having at least one electromagnetic coil disposed adjacent the distal end and a plurality of bulbous elements disposed about the longitudinal axis. The plurality of bulbous elements may be operatively associated with the at least one electromagnetic coil such that the plurality of bulbous elements may translate relative to the longitudinal axis in response to activation of the at least one electromagnetic coil. A method of crossing an obstruction may include approaching the obstruction with a medical device, supplying alternating current to at least one electromagnetic coil, and advancing the medical device into engagement with the obstruction.

Abstract: A dilation introducer for orthopedic surgery is provided for minimally invasive access for insertion of an intervertebral implant. The dilation introducer may be used to provide an access position through Kambin's triangle from a posterolateral approach. A first dilator tube with a first longitudinal axis is provided. A second dilator tube may be introduced over the first, advanced along a second longitudinal axis parallel to but offset from the first. A third dilator tube may be introduced over the second, advanced along a third longitudinal axis parallel to but offset from both the first and the second. An access cannula may be introduced over the third dilator tube. With the first, second, and third dilator tubes removed, surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

Abstract: The present invention provides methods for facilitating weight loss in a patient. The methods of the present invention comprise the steps of administering a neurotoxin to a stomach tissue of an obese patient and performing one of several types of bariatric surgeries in the patient, thereby reducing or eliminating unwanted side effects, such as nausea and vomiting.

Abstract: A blood clot filter is collapsible toward a longitudinal axis into a collapsed configuration for insertion into a blood vessel, and is radially expandable outwardly from the longitudinal axis to an expanded configuration for contact with the inner wall of the blood vessel at two longitudinal spaced locations. A first plurality of spaced, elongate arms, in the expanded configuration, curve outwardly away from the longitudinal axis toward the leading end of the filter to form a first filter basket and to center a hub at the trailing end of the filter within the vessel. A second plurality of spaced elongate legs angle outwardly away from the longitudinal axis toward the leading edge of the filter in the expanded configuration to form a second filter basket opening toward the leading end. The ends of these legs include hooks to bend and straighten in response to withdrawal force.

Abstract: Embodiments of an expandable sheath can be used in conjunction with a catheter assembly to introduce a prosthetic device, such as a tissue heart valve, into a patient. Such embodiments can minimize trauma to the vessel by allowing for temporary expansion of a portion of the introducer sheath to accommodate the delivery apparatus, followed by a return to the original diameter once the prosthetic device passes through. Some embodiments can comprise a sheath with inner and outer tubular layers, and an intermediate tubular layer comprising a shape memory alloy. Other embodiments comprise one or more layers having one or more longitudinal notches or cuts to facilitate expansion of the sheath. Embodiments of the present expandable sheath can avoid the need for multiple insertions for the dilation of the vessel, thus offering advantages over prior art introducer sheaths.

Abstract: A mechanical tensioning device includes a housing including a passageway and an opening that is in communication with the passageway. A plunger is movably disposed in the passageway. A first end of the plunger includes an inner member. A connector is coupled to the housing and includes a channel that is in communication with the passageway and a port in communication with the channel. A catheter is coupled to the connector and includes a lumen that is in communication with the channel and an expandable member. The inner member extends through the lumen and into the expandable member such that a distal end of the inner member is fixed to a distal end of the expandable member. The inner member is moveable between a first configuration in which the inner member is curved within the expandable member and a second configuration in which the inner member is less curved within the expandable member.

Abstract: A tool serves to facilitate one or more of dilation of a flexor tendon sheath and corresponding pulleys, attachment of a severed flexor tendon thereto, passage of the severed flexor tendon through the flexor tendon sheath and the corresponding pulleys, and reattachment of the severed flexor tendon. The tool includes a tip portion, a shaft portion, and a handle portion. During use of the tool, the tip portion and at least a part of the shaft portion can be passed through the flexor tendon sheath, and the handle portion is can be used to control such passage. The tip portion and the shaft portion can be used to dilate the flexor tendon sheath. The severed flexor tendon can be attached to the tip portion, and the tool can be withdrawn from flexor tendon sheath to pass the severed flexor tendon to a repair site.

Abstract: Configurations are described for conducting minimally invasive medical diagnoses and interventions utilizing elongate instruments and assemblies comprising one or more imaging devices, and one or more remote retraction and distraction devices. Retraction and distraction devices, such as balloons, mechanical retraction members, and/or trocar screw geometries may be utilized to access, investigate, and intervene at the joint capsule, or inside of the joint capsule. Imaging devices, such as optical image capture devices, ultrasound transducers, and optical coherence tomography fibers, may be utilized to assist with navigation of the pertinent tools during diagnostic and interventional steps.