Abstract: A stent graft delivery system includes a handle, a guidewire catheter extending distally from the handle, at least one tube, and at least one wire extending through the at least one tube, wherein each wire of the stent graft delivery system is configured as a loop at the distal end of the tube. The stent graft delivery system can be employed to implant stent grafts in a patient to thereby treat, for example, an aortic aneurysm spanning a region of an aorta that includes at least one arterial branch.

Abstract: A method for detecting vascular obstruction and a system using the same are provided. The method includes steps of: detecting a blood vessel through a probe to generate a reference signal before the blood vessel is obstructed, wherein the probe is configured to transmit or receive ultrasonic waves; detecting the blood vessel through the probe to generate a detection signal; performing Fourier transformation on the reference signal to generate a reference power spectrum, and performing Fourier transformation on the detection signal to generate a detection power spectrum; transforming the reference power spectrum into a reference time-frequency spectrogram, and transforming the detection power spectrum into a detection time-frequency spectrogram; judging a similarity between the reference time-frequency spectrogram and the detection time-frequency spectrogram, and judging whether the blood vessel is obstructed or not according to the similarity.

Abstract: Some embodiments provide a soft tissue device, such as a transverse carpal ligament cutting device having one or more balloons that are deflated when the device is in an inactive position and are inflated when the device is in an active position. Other embodiments provide a soft tissue cutting method, such as a method of cutting a transverse carpal ligament that uses a soft tissue cutting device.

Abstract: A method of removing clot from a vessel, including delivering a clot retrieval device across the clot, wherein the clot retrieval device includes an inner body having a collapsed delivery configuration and an expanded deployed configuration; and an outer body extending along a longitudinal axis and at least partially overlying the inner body. The outer body includes a first scaffolding section, a second scaffolding section hingedly connected distal of the first scaffolding section; the first and second scaffolding sections of the outer body being expandable to a radial extent which is greater than the radial extent of the inner body in the deployed configuration to define a clot reception space between the inner and outer bodies. The method also includes expanding the clot retrieval device; and urging, by the expanding of the first and second scaffolding sections, at least a portion of the clot therebetween.

Abstract: A system includes an adjustable implant configured for implantation internally within a subject and includes a permanent magnet configured for rotation about an axis of rotation, the permanent magnet operatively coupled to a drive transmission configured to alter a dimension of the adjustable implant. The system includes an external adjustment device configured for placement on or adjacent to the skin of the subject having at least one magnet configured for rotation, the external adjustment device further comprising a motor configured to rotate the at least one magnet and an encoder. Rotation of the at least one magnet of the external adjustment device effectuates rotational movement of the permanent magnet of the adjustable implant and alters the dimension of the adjustable implant. Drive control circuitry is configured to receive an input signal from the encoder.

Abstract: The present disclosure comprises devices, systems, and methods having an inverted sheath configured to cover, and in some instances constrain, a medical device and to retract through eversion, thus enabling the deployment of medical device at the treatment site. A constraining sheath can evert hydraulically. A constraining sheath can be configured to neck down a medical device to achieve a lower delivery profile. Furthermore, a constraining sheath can comprise a balloon to expand or positionally or structurally adjust a medical device.

Abstract: Described are methods, systems, devices for facilitation of intraluminal medical procedures within the neurovasculature. A catheter advancement device includes a flexible elongate body having a proximal end, a distal end, and a single lumen extending therebetween. The flexible elongate body has a proximal segment, an intermediate segment, and a tip segment. The proximal segment includes a hypotube coated with a polymer. The intermediate segment includes an unreinforced polymer having a durometer of no more than 72D. The tip segment is formed of a polymer different from the intermediate segment and has a durometer of no more than about 35D and a length of at least 5 cm. The tip segment has a tapered portion that tapers distally from a first outer diameter to a second outer diameter over a length of between 1 and 3 cm.

Abstract: Apparatus and methods are described including inserting an implantable device (20) into a blood vessel of a subject while the implantable device is disposed inside a delivery device and is constrained in a constrained configuration by the delivery device. The implantable device is released from the delivery device into the blood vessel, thereby causing the implantable device to assume a non-constrained configuration by an upstream end of the implantable device radially expanding (120), a central portion (122) of the implantable device radially expanding such that along the central portion of the implantable device the inner surface (24) of the implantable device defines a diverging portion (25) of a conduit (26), and the implantable device forming a folded portion (128) between the upstream end of the implantable device and the central portion of the implantable device. Other applications are also described.

Abstract: A medical device lead connector includes electrically conducting contact rings spaced apart by an electrically insulating ring and in axial alignment. The electrically conducting contact ring and the insulating ring having an interface bond on an atomic level.

Abstract: Implantable devices for placement at a cavity or opening such as an aneurysm are disclosed. The implantable devices, in a deployed condition, have a generally inverted U-shaped profile with a curved or angled framework support structure sized and configured for placement in proximity to tissue surrounding the opening and anchoring legs extending proximally from the framework structure sized and configured to contact the wall of a neighboring lumen at opposed locations. Occlusive and semi-occlusive membranes may be associated with the framework support structure and deployed over the opening to provide exclusion of the opening and flow diversion. Proximal anchoring segments providing additional lumen wall surface area contact for the implantable device following deployment may be incorporated.

Abstract: The present technology is directed to adjustable interatrial shunting systems that selectively control blood flow between the left atrium and the right atrium of a patient. The adjustable interatrial devices include a shunting element having an outer surface configured to engage native tissue and an inner surface defining a lumen that enables blood to flow from the left atrium to the right atrium when the system is deployed across the septal wall. The systems can include an actuation assembly for selectively adjusting a geometry of the lumen and/or a geometry of a lumen orifice to control the flow of blood through the lumen.

Abstract: A delivery device according to principles described herein includes a catheter having three concentric shafts including an inner core, an outer sheath over the inner core and an outer support shaft at least partially extending over the inner core and the outer sheath. A timing belt having a plurality of belt teeth on a surface of the timing belt is coupled to an outer sheath over a medical device or stent on the inner core such that movement of the timing belt link causes movement of the outer sheath from its position over the medical device or stent. The delivery device is actuated by rotation of a thumbwheel a thumbwheel coupled to a barrel having a plurality of teeth such that rotation of the thumbwheel causes movement of the barrel such that the barrel teeth engage the belt teeth to cause movement of the timing belt causing movement of the outer sheath.

Abstract: Disclosed herein are embodiments of spring cannulae, including one or more holes in the sidewall of the cannula. Some disclosed cannulae include a wire, helically wound to form coils, and at least one hole in the cannula that interrupts one or more of the coils. Some embodiments further include a fused region of the coils through which the hole passes. Some embodiments include a ring attached to ends of the interrupted coils, where the hole is surrounded by the ring. Some embodiments include a sheath that is attached to a radial surface of the interrupted coils, where the hole passes radially though the sheath.

Abstract: Embodiments of the present disclosure provide an introducer device and method for introducing a delivery apparatus into a patient's vasculature. Disclosed methods can include positioning a sleeve of an introducer sheath in a blood vessel of a patient, the sleeve having a lattice layer with a lumen therethrough, inserting a distal end portion of the delivery apparatus and a prosthetic heart valve into the lumen, and advancing the distal end portion of the delivery apparatus through the lumen from the proximal end to the distal end. The method can then include expanding the lumen from a first diameter smaller to a second diameter at least equal to the diameter of the prosthetic heart valve to allow passage of the prosthetic heart valve through the lumen, and returning the lumen of the sleeve to a diameter smaller than the second diameter after advancing the prosthetic heart valve through the lumen.

Abstract: The present invention provides a dry powder that is suitable for use in forming a hydrogel and characterized by a stable composition at ambient conditions. The dry powder includes a prepolymer including a straight chain polyethylene glycol, and a thermally activated free radical initiator selected from the group consisting of sodium persulfate, potassium persulfate, and ammonium persulfate. The present invention also provides a method of forming the dry powder, and a method of preparing a hydrogel where a reaction mixture is formed including the dry powder and a buffered aqueous solution.

Abstract: A temperature monitoring system for a substrate heating furnace includes a temperature monitor, and the temperature monitor is located on a prong of a mechanical arm which is configured to fetch and place a substrate. The temperature monitor is configured to monitor the temperature of the substrate which has been heated by the substrate heating furnace and is located on the prong.

Abstract: An implantation tool to implant a paranasal sinus fluid access implant device to fluidly connect the lacrimal apparatus in the orbit with a paranasal sinus has a securement mechanism reconfigurable from a securement configuration to secure the implant device to a mounting portion of a carrier member to a released configuration to release the implant device from the carrier member, and with a release mechanism disposed at least partially in an interior working space housed within the implantation tool. An implantation method with an approach through the palpebral fissure advances the implant device through a surgical route mostly under tension.

Abstract: A cage can be positioned around a medical balloon, such as an angioplasty balloon, to assist in a medical procedure. The cage can include a plurality of strips, each extending between a set of rings including first and second rings. As the balloon expands, the first and second rings move closer together and allow the strips to expand outward. The cage may have wedge dissectors on the strips.

Abstract: A balloon catheter includes a shaft and a balloon having one or more fold lines. The balloon is disposed outside the shaft, and the balloon includes one or more first regions and one or more second regions. The first region retains medicine on an outer surface of the balloon. The second region retains less medicine than the first region or retains no medicine.

Abstract: A delivery system for an implantable stented device having a handle with a plurality of actuation members, each actuation member connected to one or more stent attachment elements, a sheath having a proximal end attached to the handle, and a plurality of tubes extending within the sheath. The stent attachment elements extend from distal ends of the tubes. A first actuation member is configured to move a first stent attachment element proximally toward the handle and a second actuation member is configured to move a second stent attachment element proximally toward the handle, sequentially releasing specific portions of the stented device by causing distal ends of the stent attachment elements to contact an exterior of the distal ends of the tubes, thereby disengaging the first and second stent attachment elements from the stented device.

Abstract: A stent delivery system can include a core member, an introducer sheath, and a microcatheter. The core member can have a distal segment. The stent engagement member can have a generally tubular body positioned about the core member distal segment and can be rotatably coupled to the core member. The engagement member can include an inner layer that has a first durometer and an outer layer that has a second durometer less than the first durometer. The stent can extend along the core member distal segment such that an inner surface of the stent is engaged by the engagement member outer layer for facilitating rotation of the stent relative to the core member.

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

Abstract: Vascular expandable devices and associated methods are disclosed herein. An expandable vascular device can include a generally tubular sidewall formed of a plurality of braided strands. The device can have a compressed state for delivery in which the device has a compressed state diameter of 0.027 inches or less. The device can have an expanded state in which the device has an expanded state diameter. A full expansion distance of the device corresponds to a longitudinal unconstrained distance at which the distal end of the expandable device attains the expanded state diameter. The full expansion distance can be 20 mm or less.

Abstract: Vascular expandable devices and associated methods are disclosed herein. An expandable vascular device can be implantable across an aneurysm in a blood vessel of a patient. The device can include a generally tubular structure formed of a plurality of braided metallic elements. The device can have a compressed state with a compressed state diameter of 0.027 inches or less and an expanded state with an expanded state diameter of 1.75 mm or more. Each of the plurality of metallic strands can have an oxide layer having a thickness of about 400 angstroms or less. The tubular structure can be configured to self-expand from the compressed state to the expanded state.

Abstract: The present invention concerns a self-expanding implant device comprising a proximal portion at a first longitudinal end, a distal portion at a second longitudinal opposite the first longitudinal end, and a connecting portion between the proximal portion and the distal portion, wherein the proximal portion and the distal portion each comprise a radially self-expanding structure, wherein the connecting portion comprises longitudinally oriented bendable struts, preferably at least 4 struts, more preferably 6 struts or more, which connect the self-expanding structure of the proximal portion with the self-expanding structure of the distal portion, wherein in a fully expanded state, the implant device comprises a maximum implant diameter along a direction perpendicular to the longitudinal direction and wherein the struts of the connecting portion comprise a strut length along the longitudinal direction, characterized in that the strut length is such that when the self-expanding structure of the proximal portion is

Abstract: A medical device can include an elongate manipulation member, and a thrombectomy device connected to the elongate manipulation member. The thrombectomy device can have a first configuration and a second configuration, the thrombectomy device being expandable from the first configuration to the second configuration. The thrombectomy device can include an arcuate marker-mounting projection attached to a portion of the thrombectomy device configured to contact a thrombus. A marker can be coupled to, and extending around, the arcuate marker-mounting projection with the marker and the arcuate marker-mounting projection contacting each other at three discrete locations. A method for engaging a thrombus can include advancing a thrombectomy device to a location radially adjacent to a thrombus in a blood vessel.

Abstract: An implantable medical device, such as an aortic aneurism repair stent graft, includes a framework of struts that includes a plurality of vertices. A fabric is in contact with the framework, and attached to the fabric at each of the vertices with a respective compound stitching connection. The compound stitching connection includes a plurality of short span fixation stitches and a fan spread of long span tear resistance stitches.

Abstract: An assembly for delivering a prosthetic heart valve to a native heart valve is disclosed. The assembly includes a self-expanding prosthetic heart valve formed with an expandable metallic stent and a flexible valvular structure. The assembly also includes a delivery apparatus having a delivery sleeve. The delivery sleeve includes a selectively steerable section and a distal portion for retaining the prosthetic heart valve in a compressed state. A handle is coupled to a proximal end of the delivery sleeve and a pull wire extends from the handle to the steerable section of the delivery sleeve. The handle preferably includes a rotatable portion for actuating the pull wire and thereby selectively controlling a curvature of the steerable section during advancement through the patient's vasculature. In preferred embodiments, the steerable section includes a flexible metallic tubular portion formed with a plurality of circumferentially extending openings.

Abstract: Methods and apparatus for treating disorders of the ear, nose, throat or paranasal sinuses, including methods and apparatus for dilating ostia, passageways and other anatomical structures, endoscopic methods and apparatus for endoscopic visualization of structures within the ear, nose, throat or paranasal sinuses, navigation devices for use in conjunction with image guidance or navigation system and hand held devices having pistol type grips and other handpieces.

Abstract: Vascular filtering devices and methods for their use are disclosed. In some embodiments, the vascular filtering devices include an elongate member having an unsupported membrane bag portion attached thereto. The membrane may be porous in some examples. Multiple elongate extensions may also extend from the membrane, and may extend along the elongate member, such as to a proximal region of the elongate member. The unsupported membrane bag portion may be configured to inflate or otherwise radially expand away from the elongate member as a result of blood flowing through the vessel within which the vascular filtering device is positioned.

Abstract: A temporary low profile intraluminal catheter for infusing agents into, or extracting fluids from, a bodily lumen featuring securement structure, wherein the securement structure allows the catheter to be placed with minimal intrusion into the bodily lumen is disclosed. With such design affording a more efficient, verifiable placement of the catheter with less complication due to infection and biofilm related issues, among other types of complications.

Abstract: A composite expandable medical balloon comprising a base balloon, the base balloon comprising a coextrusion, the coextrusion comprising an inner layer formed from an elastomeric polymer and an outer layer formed from a thermoplastic polymer a fiber braid disposed along the base balloon, the fiber braid comprising at least one polymeric fiber disposed over the base balloon, wherein the base balloon is designed to exhibit minimal delamination between the inner layer the outer layer of the base balloon, and methods of making the same.

Abstract: A calcification treatment device includes an outer body (12) including an inner cavity and at least one outer calcification treatment member (16) facing towards the inner cavity. An inner body (18) is movable into the inner cavity and includes at least one inner calcification treatment member (20) facing towards an inner surface of the outer body. One of the outer and inner calcification treatment members includes an expandable treatment member and one of the outer and inner calcification treatment members includes one or more fracturing elements capable of fracturing a calcification of a valve tissue.

Abstract: An occlusive device, occlusive device delivery system, method of using, and method of delivering an occlusive device, and method of making an occlusive device to treat various intravascular conditions is described.

Abstract: A medical device suitable for location in a body lumen is movable between a first loaded configuration and a second loaded configuration. The device has an unloaded configuration which is intermediate the first loaded configuration and the second loaded configuration. The device can be a stent for deployment in a blood vessel.

Abstract: A medical catheter for hypothermic treatment with a catheter tube has at least one through-channel and at least two temperature control channels, at least one heat exchange element, in particular an expandable balloon, which is arranged in a distal catheter portion of the catheter tube and is fluidically connected to the temperature control channels in such a way that a temperature control circuit is formed. The catheter tube has a smaller external diameter in the distal catheter portion than in a proximal catheter portion.

Abstract: System and methods of delivering adhesive material are described for occluding target locations within a patient. The systems include a catheter configured to deliver adhesive to a target location and one or more of a light source to harden the adhesive, a retention structure to contain the adhesive prior to curing, a balloon to occupy a target location, and an open cell foam plug to occupy a target location.

Abstract: A tool (410) for use with an implant (20) includes a housing (426) and a controller (440). The housing includes a tubular wall (428) that circumscribes a longitudinal axis; is dimensioned to house at least part of the implant; and defines a track (430) that follows a generally-helical path around the longitudinal axis. The controller includes a rod (442) that extends from a proximal part of the tool to the housing; and an actuator (444). The actuator is fixedly coupled to the rod, includes an engaging element (446) that engages the track, and is rotatable with respect to the housing. The controller and the housing mechanically cooperate such that rotation of the actuator with respect to the housing slides the housing longitudinally with respect to the actuator. Other embodiments are also described.

Abstract: The present invention relates to a device for endoscopy or endosonography-guided transluminal interventions whereby two luminal structures in the body may be drawn toward each other and a fluid conduit formed in between. The device may have a hollow central member to which is coupled a distal retention member and in one embodiment a proximal retention member. The retention members may each be positioned inside one of the luminal structures and expanded from a first condition to an expanded second condition having an increased radius. The length of the central member may be shortened and its diameter expanded to approximate the two retention members and thereby the luminal structures.

Abstract: The present disclosure relates to a braid for treating an aneurysm. The braid can include a distal end opposite a proximal end. Translating the braid can cause the delivery portion to expand and form a distal sack as well as invert into itself.

Abstract: A retrieval medical device for entrapping and retaining an object located in a body for its extraction therefrom is described. The device includes a basket-filter constituted by a plurality of filaments extending from the proximal end towards the distal end. The filaments are bound together in the vicinity of the proximal end to form a plurality of main branches. Each main branch includes at least two filaments. The filaments are entangled together in the vicinity of the distal end. Each main branch has a ramification point at which it ramifies into at least two single filaments extending from the ramification point towards the basket distal end of the basket-filter. One of the single filaments extends in the form of a right spiral, whereas another single filament extends in the form of a left spiral. The filaments extending from the ramification points interlace with each other, thereby forming a mesh between the branching point and the basket proximal end having density greater than 5.

Abstract: A stent (scaffold) or other luminal prosthesis comprising circumferential structural elements which provide high strength after deployment and allows for scaffold to uncage, and/or allow for scaffold or luminal expansion thereafter. The circumferential scaffold is typically formed from non-degradable material and will be modified to expand and/or uncage after deployment.

Abstract: A method of treatment of nasal conditions comprising: delivering an expandable structure in a crimped configuration to a nasal lumen; expanding the expandable structure within the nasal lumen to a stable expanded configuration; removing the structure from the nasal lumen, after a time period, where removing comprises causing the structure to self-crimp. The expandable structure optionally comprises: a first shape memory (SM) portion which is in a strain-induced state; and a second portion which resists expansion of said structure due to said first portion, over a plurality of different expansion states of said first portion. Optionally, the properties of the second portion vary over its cross section. For example an outer surface and/or peripheral layer may have desirable environmental resistance properties and/or a frame may have desirable mechanical properties, for example a high creep resistance.

Abstract: Medical devices and methods are disclosed. An example method for accessing a body lumen may include providing a catheter system. The catheter system may include a catheter shaft having a lumen defined therein and an outer wall surface having a channel formed therein. A first guidewire may be disposed in the channel and a second guidewire may be disposed in the lumen. The method may also include advancing the catheter system through a body lumen to a location where the body lumen splits into a first section and a second section, advancing the first guidewire into the first section, and advancing the second guidewire into the second section, and advancing the catheter shaft along the second guidewire and into the second section. Advancing the catheter shaft along the second guidewire and into the second section may remove at least a portion of the first guidewire from the channel.

Abstract: A delivery device for implanting a prosthetic heart valve. The device includes an inner shaft assembly, an outer sheath and a connector assembly. The inner shaft assembly defines a guide wire lumen. The outer sheath is slidably received over the inner shaft assembly, and forms an exit port proximate a distal end thereof. The connector assembly establishes a guide wire passageway between the guide wire lumen and the exit port. The connector assembly is configured to permit sliding movement of the outer sheath relative to the inner shaft assembly when deploying the prosthetic heart valve. The connector assembly can include first and second tubes that are slidable relative to one another in facilitating movement of the outer sheath relative to the inner shaft assembly.

Abstract: A medical device includes a mesh member capable of radially expanding and contracting, and a cylindrical member located at one end of the mesh member. The mesh member is woven from a first wire and a second wire. The cylindrical member includes a wrapping portion and a lining portion that are fixed to each other at fixation portions positioned within spaces defined by the first wire and the second wire. Neither the wrapping portion nor the lining portion is fixed to either of the first wire or the second wire. Upon expansion or radial contraction of the mesh member, movement of the first wire or the second wire is not interfered with by the cylindrical member. This reduces the concentration of stress at the end of the mesh member and thus the likelihood that either the first wire or the second wire will break.

Abstract: A bifurcated catheter and methods of use are disclosed herein. The bifurcated catheter can include a fixed flat wire that is configurable as a stabilization wire. The bifurcated catheter can be configured to improve the initial access and directability by application of a pull force to the stabilization wire, in addition to a push force from the proximal end of the bifurcated catheter. The stabilization wire is anchored once the bifurcated catheter is positioned. The anchored, bifurcated catheter provides stability and pushability to assist the procedural catheter in traversing the tortuous peripheral vasculature.

Abstract: A delivery apparatus for a prosthetic heart valve includes a shaft, an inner balloon, and an outer balloon. The shaft has a lumen extending from a proximal end portion to a distal end portion and a plurality of openings formed in the distal end portion. The shaft is configured such that a fluid can flow through the lumen and the openings. The inner balloon has end portions and a center portion disposed between the end portions. The inner balloon is mounted on the distal end portion of the shaft and is in fluid communication with the openings of the shaft. When the inner balloon is inflated with the fluid, the end portions expand farther radially outwardly than the center portion. The outer balloon is mounted to the shaft and disposed over the inner balloon. The outer balloon is configured to fully expand after the inner balloon at least partially expands.

Abstract: The invention relates to a method for grafting an organic film onto an electically conductive or semiconductive surface by electro-reduction of a solution, wherein the solution comprises one diazonium salt and one monomer bearing at least one chain polymerizable functional group. During the electrolyzing process, at least one protocole consisting of an electrical polarization of the surface by applying a variable potential over at least a range of values which are more cathodic that the reduction or peak potential of all diazonium salts in said solution is applied. The invention also relates to an electrically conducting or semiconducting surface obtained by implementing this method. The invention further relates to electrolytic compositions.

Abstract: An occlusive medical device system may include an elongate shaft having a distal strain relief portion and a lumen extending longitudinally through the elongate shaft, the elongate shaft including a plurality of retaining arms extending distally from the distal strain relief portion; an occlusive medical device including a proximal mounting portion fixed to an expandable occlusive element; and a release wire disposed within the lumen of the elongate shaft. The plurality of retaining arms may extend into the proximal mounting portion. The release wire may be configured to engage the plurality of retaining arms in a distal engagement position, thereby urging the plurality of retaining arms radially outward into releasable engagement with the proximal mounting portion. When the release wire is in a proximal released position, the plurality of retaining arms is deflectable radially inward to disengage from the proximal mounting portion.