Abstract: A medical system may comprise a catheter having a main lumen and a distal tip positioned in a working configuration at a working location. The medical system may also comprise a sensor system coupled to the catheter to generate measurement signals. The medical system may also comprise a control system. The control system may be configured to receive the measurement signals from the sensor system. The control system may be operable to identify from the received measurement signals the working configuration of the distal tip of the catheter. The control system may be configured to control at least one degree of freedom of the distal tip of the catheter to maintain the working configuration of the distal tip of the catheter based on a selected stiffness mode and the received measurement signals. The selected stiffness mode determines the at least one degree of freedom of the distal tip.

Abstract: A prosthesis delivery device and method are described herein. An elongate sheath extends about a longitudinal axis, and a hub is coupled to the sheath. A handle is distal to the hub, and a connector assembly is coupled to a proximal end of the handle. The connector assembly is removably coupled to the hub, and the connector assembly includes a longitudinal passageway defined therein in communication with the longitudinal hub lumen. In one aspect, the connector assembly includes a plurality of jaw elements, and an actuating ring operable to move the jaw elements between the attachment configuration where the jaw elements are coupled to the hub, and the detachment configuration where the jaw elements are radially displaced and decoupled from the hub to remove a component from the sheath lumen.

Abstract: An assembly for treating a native valve in a human heart includes a prosthetic heart valve having an expandable frame and a valvular structure. The assembly also includes a tubular sleeve and a valve catheter disposed within the sleeve. A plurality of metal extension arms are coupled to the valve catheter for holding the prosthetic heart valve. The extension arms are configured to radially expand with the prosthetic heart valve during expansion of the prosthetic heart valve at a treatment site. A plurality of metal rods extend distally from the valve catheter. The rods are axially movable relative to the extension arms. A plurality of release members are provided for releasing the prosthetic heart valve from the extension arms upon movement of the metal rods.

Abstract: A device for fracturing calcifications in heart valves includes a stabilizer and an impactor movable towards each other. The impactor includes one or more impactor arms, each of which extends distally from a proximal cap. The impactor further includes one or more lever arms each of which is distally coupled to a lever cap and proximally coupled to a corresponding one of the one or more impactor arms. The lever cap slides on a shaft which extends towards the proximal cap. Proximal movement of the lever cap towards the proximal cap causes the one or more lever arms to deform and to push against the one or more impactor arms and to cause the one or more impactor arms to deform.

Abstract: The present technology relates to aneurysm devices with additional anchoring mechanisms, and associated systems and methods. In some embodiments, the aneurysm devices are endovascularly deliverable to a site proximate an aneurysm near a parent artery with bifurcating branches. The aneurysm devices can include a closure structure (102) comprising a distal-facing aspect configured to at least partially occlude the aneurysm and a proximal-facing aspect configured to arch over lumina of the bifurcating branches. The devices further include a supplemental stabilizer (103) connected to the closure structure. The supplemental stabilizer is configured to reside in the parent artery. The closure structure includes a hinge point (175) where the closure structure folds to form a loop element configured for anchoring within at least one of the bifurcating branches.

Abstract: Embolic implants delivery systems and methods of manufacture and delivery are disclosed. The devices can be used for aneurysm and/or fistula treatment. The designs offer low profile compressibility for delivery to neurovasculature, while maintaining advantageous delivery and implant detachment control features.

Abstract: A surgical rib retractor has a housing having a first shoulder. The surgical rib retractor also has a body pivotably coupled to the housing and having a second shoulder. The retractor further has a first arm unit pivotably coupled to the first shoulder and configured to receive one rib. The surgical rib retractor also has a second arm unit pivotably coupled to the second shoulder and configured to receive another rib. The surgical rib retractor also has a first arm actuator constrained to be rotatable relative to the first shoulder and coupled to the first arm unit to pivot the first arm unit as the first arm actuator is rotated. The surgical rib retractor further has a second arm actuator constrained to be rotatable relative to the second shoulder and coupled to the second arm unit to pivot the second arm unit as the second arm actuator is rotated.

Abstract: Devices, systems, and methods for treating damaged or diseased valves are disclosed. A representative embodiment includes an elongated shaft having a longitudinal axis, a proximal portion, and a distal portion, and a dissection arm at the distal portion. The dissection arm can have a longitudinal axis and be moveable between a low-profile state and a deployed state. In the deployed state, a portion of the arm can flex outwardly away from the longitudinal axis of the shaft. The arm is configured to be deployed within a space within a vessel wall such that, as the arm moves from the low-profile state to the deployed state, the arm pushes against vessel wall tissue at a periphery of the space, thereby separating tissue at the periphery to form a dissection pocket having a predetermined shape.

Abstract: A self-sealing tubular graft is provided for implantation within a patient's body that includes an elongate tubular body including first and second self-sealing cannulation regions and a loop region extending between the first and second cannulation regions. The loop region includes one or more reinforcement members attached to a first length of the loop region and extending at least partially around a circumference of the tubular body. For example, the reinforcement members may include one or more sinusoidal or zigzag members extending along the first length with alternating peaks and valleys extending at least partially around a circumference of the tubular body. Self-sealing patches are also provided that include one or more reinforcement members embedded within base material.

Abstract: A mitral valve prosthesis can be delivered within the native mitral annulus. The valve prosthesis has a valve component on which prosthetic valve leaflets are attached, and a lower support which anatomically and dynamically conforms to a native mitral valve annulus and which is flexibly attached to the valve component. The valve prosthesis can be delivered to the native mitral valve annulus in a collapsed configuration in which the valve component and anchoring element are serially rather than concentrically positioned to one another, thereby minimizing the diameter of the valve prosthesis during delivery. The devices and methods described are useful for treatment of various mitral valve disorders which result in, for example, mitral regurgitation.

Abstract: A percutaneous transluminal angioplasty (PTA) catheter may be configured to perform vein expansion and occlusion. A infusion port (132) located proximal to the occlusion feature (162) can be used to inject contract enhancement agent as well as other substances. The catheter can be used especially advantageously in vascular regions associated with hemodialysis access.

Abstract: An expandable introducer sheath for passage of implant delivery catheters, such as catheters for delivery of prosthetic heart valves. The expandable sheath balances the amounts, shapes and positions of various stiff and elastic structures in the sheath to selectively program the expandability and buckling stiffness of the sheath. The expandable sheath can include, for example, an expandable tubular layer that includes alternating stiff and elastic wall portions of a single radial thickness. The combination of stiff and elastic wall portions allow for torque and push strength to advance the expandable sheath while at the same time accommodating temporary expansion. The expandable sheath can also be reinforced with a tubular layer of braided fibers or a stent structure for additional strength. Other embodiments include selective use of slots or gaps at the distal end of a stiff wall portion to enhance expandability and distribute strain.

Abstract: Provided is a stent having a novel structure, the stem simultaneously having both the stability of shape against the action of external force, such as compression force, tensile force, or torsional force, and high flexibility in the direction of twisting of the stem. Connection groups are provided at three or more positions set at circumferentially equally-spaced intervals, the connection groups each including connection sections which are disposed circumferentially close to each other between axially adjacent tubular divided bodies. The connection groups on both sides axially of each of the tubular divided bodies are provided at positions circumferentially offset from each other while at least one turning portion is present between the connection groups.

Abstract: The present disclosure sets forth a guiding tube for placing medical implants within body tissue. The guiding tube includes an elongated, dimensionally stable tubular body encompassing an inner channel adapted to receive a medical implant wherein the tubular body has at least one electromagnetic element, the element configured to exert an electromagnetic force on at least one magnetic element of the medical implant inserted into the inner channel of the guiding tube. The medical implant includes a stimulation lead having at least one directional electrode with an elongated body insertable into an inner channel enclosed by a tubular body of the guiding tube.

Abstract: A medical device to be inserted into a body lumen to obstruct flow in the body lumen includes a shaft unit; a proximal slider and a distal slider that are slidable along the shaft unit; a first expanding member including a distal portion coupled to the proximal slider and a proximal portion coupled to the shaft unit; a second expanding member including a distal portion coupled to the distal slider and a proximal portion coupled to the proximal slider; and a cover that surrounds an outer periphery of the first expanding member and coupled to the proximal portion of the first expanding member, the cover being tubular and flexibly deformable independently of the first expanding member.

Abstract: A machine includes a spindle for storing wire, a wire passage structure having an interface coupline, a controllable drive system, a control system, and a pressure-resistant housing. The drive system is configured to feed the wire through the wire passage structure and through the interface coupling, under the control of the control system. The housing encloses the wire passage structure, the controllable drive system, and at least a portion of the control system.

Abstract: This invention relates to the design and function of a retrieval device for a prosthetic heart valve for re-positioning or removal of a previously implanted valve prosthesis from a beating heart without extracorporeal circulation using a transcatheter retrieval system.

Abstract: A medical device includes a polymer scaffold crimped to a catheter having an expansion balloon. A sheath pair is placed over the crimped scaffold after crimping to reduce recoil of the crimped polymer scaffold and maintain scaffold-balloon engagement relied on to hold the scaffold to the balloon when the scaffold is being delivered to a target in a body. The sheath pair is removed by a health professional before placing the scaffold within the body.

Abstract: A tubular stent includes a stent body having a distal end and a proximal end, a covering surrounding at least a portion of the stent body and an adjustable annular ring secured to the stent body. The adjustable annular ring is configured to permit radial expansion of the adjustable annular ring while resisting radial compression of the adjustable annular ring.

Abstract: In some embodiments, a medical device may include one or more of the following features: (a) a metal fabric formed of braided metal strands, (b) the medical device having a collapsed configuration for delivery through a channel in a patient's body and having a generally dumbbell-shaped expanded configuration with two expanded diameter portions, separated by a reduced diameter portion formed between opposed ends of the device and unsecured metal strand ends at the opposed ends, and (d) a thrombogenic agent located on the metal fabric.

Abstract: A catheter assembly includes a catheter having a proximal end and a distal end; an expandable device releasably attached to the catheter near the distal end; a generally tubular constraining sleeve extending around and compressing the device to an outer peripheral dimension suitable for endoluminal delivery; a tip fixedly secured to the distal end of the catheter; and a bridge member disposed between the tip and the expandable device so as to fill a gap therebetween as the catheter assembly is bent during endoluminal delivery of the expandable device to a treatment site.

Abstract: An intraluminal prosthesis includes an outer three-dimensional (3D) anti-migration structure that is attached to the outer wall of a fully covered or partially covered stent to prevent migration and still allow stent removal at a later period of time. A method of manufacturing the intraluminal prosthesis includes attaching the anti-migration structure by usage of a polymer such as polyurethane.

Abstract: The present disclosure relates to delivery systems for delivering and deploying interventional devices to a targeted area within a body, such as delivering a replacement heart valve to a targeted heart valve. A delivery device includes a steerable catheter and a replacement valve delivery system positioned within the steerable catheter and configured to be translatable within the steerable catheter. The steerable catheter includes one or more control wires running from a distal end of the catheter to a handle at the proximal end of the catheter. Each control wire is coupled to a control of the handle such that manipulation of the control provides deflection and control of the steerable catheter.

Abstract: A surgical rib retractor has a housing having a first shoulder. The surgical rib retractor also has a body pivotably coupled to the housing and having a second shoulder. The retractor further has a first arm unit pivotably coupled to the first shoulder and configured to receive one rib. The surgical rib retractor also has a second arm unit pivotably coupled to the second shoulder and configured to receive another rib. The surgical rib retractor also has a first arm actuator constrained to be rotatable relative to the first shoulder and coupled to the first arm unit to pivot the first arm unit as the first arm actuator is rotated. The surgical rib retractor further has a second arm actuator constrained to be rotatable relative to the second shoulder and coupled to the second arm unit to pivot the second arm unit as the second arm actuator is rotated.

Abstract: A method of deploying a stent includes receiving a delivery system loaded with a stent and securing the stent in a compressed arrangement by a stent holding assembly including first and second holders having a first protective cover disposed at one end for enclosing a first fastening assembly and a second protective cover disposed at one end of the second holder for enclosing a second fastening assembly, respectively, the stent coupled to the first and second holders members by the first and second fastening assemblies, respectively. The method further includes delivering the stent in an axially expanded and a radially compressed arrangement to an implantation site, retracting the first and second protective covers to expose the first and second fastening assemblies, and actuating the first and second fastening assemblies such that the stent radially expands to engage an inner wall of a lumen.

Abstract: The present application relates to an expandable spinal implant (1) comprising two elongated implant members (20, 30). The implant members (20, 30) are rotatably coupled to a central base portion (10) and comprise a first end with an axis of rotation and circumferentially arranged gear teeth (23, 33). The gear teeth (23) of the first elongated implant member (20) is interlocked into said gear teeth (33) of the second elongated implant member (30).

Abstract: Methods and systems of fabricating a polymeric stent are disclosed herein.

Abstract: A delivery sheath includes an outer tubular layer and an initially folded inner tubular layer. When an implant passes therethrough, the outer tubular layer expands and the inner tubular layer unfolds into an expanded lumen diameter. The sheath may also include selectively placed longitudinal support rods that mediate friction between the inner and outer tubular layers to facilitate easy expansion, thereby reducing the push force needed to advance the implant through the sheath's lumen.

Abstract: A delivery sheath includes an outer tubular layer and an initially folded inner tubular layer. When an implant passes therethrough, the outer tubular layer expands and the inner tubular layer unfolds into an expanded lumen diameter. The sheath may also include selectively placed longitudinal support rods that mediate friction between the inner and outer tubular layers to facilitate easy expansion, thereby reducing the push force needed to advance the implant through the sheath's lumen.

Abstract: A cannula and method include a shaft portion having a proximal end, a distal end, a longitudinal axis and a lumen extending from the proximal end to the oppositely disposed distal end along the longitudinal axis. A hub is attached to the proximal end of the shaft portion and includes a transverse portion, which extends transversely relative to the longitudinal axis of the shaft portion. An opaque marker is disposed on the transverse portion at a position corresponding to an expanded size of an expandable element such that the opaque marker indicates the expanded size in an imaging system image.

Abstract: A delivery device for percutaneously delivering a stented prosthetic heart includes a sheath, a handle, and adjustment device including a fine adjustment mechanism, and an outer stability shaft. The sheath defines a lumen and is configured to compressively constrain the stented prosthetic heart valve. The handle is coupled to the proximal portion of the sheath and includes an actuator mechanism coupled to a proximal portion of the sheath that is configured to selectively move the sheath relative to the housing to release the stented prosthetic heat valve. The adjustment device is coupled to the handle and includes an adjustment lumen through which the sheath and the handle slidably extend. The outer stability shaft is coupled to the adjustment device. The fine adjustment mechanism is configured to selectively move the handle and the sheath relative to the adjustment device and the outer stability shaft.

Abstract: A surgical manipulating instrument provides a shaft with pivoting arms operably coupled thereto to transition between an inserting configuration with the arms at least substantially parallel to the shaft and a deployed configuration with the arms fanned out to provide a paddle within a person during surgical procedures. The shaft may provide access for a suction and/or irrigation device.

Abstract: An expandable introducer sheath for passage of implant delivery catheters, such as catheters for delivery of prosthetic heart valves. The expandable sheath balances the amounts, shapes and positions of various stiff and elastic structures in the sheath to selectively program the expandability and buckling stiffness of the sheath. The expandable sheath can include, for example, an expandable tubular layer that includes alternating stiff and elastic wall portions of a single radial thickness. The combination of stiff and elastic wall portions allow for torque and push strength to advance the expandable sheath while at the same time accommodating temporary expansion. The expandable sheath can also be reinforced with a tubular layer of braided fibers or a stent structure for additional strength. Other embodiments include selective use of slots or gaps at the distal end of a stiff wall portion to enhance expandability and distribute strain.

Abstract: The present disclosure provides a stent graft defining a lumen having a first end and a second end, the stent graft comprising (a) a first portion at the first end of the stent graft having a first diameter and a first length, wherein a first stent structure of the first portion is balloon-expandable, (b) a second portion of the stent graft having a second diameter and a second length, wherein a second stent structure of the second portion is self-expanding, (c) a breakable restraint configured to be coupled to the second portion in a pre-deployment state and decoupled from the second portion in a deployed state, and (d) a third portion at the second end of the stent graft has a third diameter and a third length, wherein a third stent structure of the third portion is balloon-expandable.

Abstract: Techniques for modifying the surface of implantable devices, such as bioprosthetic valves, to improve the biocompatibility of the implantable devices are provided. In particular, a customizable, non-fouling surface coating may be formed on the surface of implantable devices that improves the biocompatibility of the implantable devices and has the potential to further reduce the occurrence of complications for patients of all ages. Additionally, various molecules of interest to specifically promote endothelialization of the implantable device may be added to the surface coating, which may facilitate the formation of an endothelial layer on the surface of the implantable device that would naturally maintain a non-thrombogenic, non-immunogenic environment in the long-term.

Abstract: An embodiment of the invention relates to a method of configuring blood vessels at an anastomosis, the method comprising: ensheathing a segment of a transected first blood vessel in a lumen of a sleeve so that an open end of the segment protrudes from a sleeve end; suturing edges of an incision made in a second blood vessel to the open end of the first blood vessel to create an anastomosis; and sliding the sleeve along the first blood vessel to position the sleeve at the anastomosis.

Abstract: A stent comprised of a scaffolding structure having components configured to allow at least a portion of the stent to decrease in diameter in response to an axial force applied to the stent. Further, the components and elements of the stent may be configured to balance transverse forces applied to the stent, thus reducing the incidence of infolding.

Abstract: A pedicle screw comprises a head. A shaft is joined to the head. The shaft comprises a first threaded portion, a middle portion and a second threaded portion. The middle portion comprises a modified threaded portion being configured to mitigate damage to a patient's nerve root. A first marker is joinable to the shaft proximate the modified threaded portion. The first marker comprises a material being radiographically distinguishable from the shaft in which a placement of the modified threaded portion is observable.

Abstract: Methods for making a magnesium biodegradable stent for medical implant applications, using magnesium foil or pure magnesium or magnesium alloys that are biodegradable and performing a lithographic technique to configure the features and dimensions of the magnesium foil, and rolling the magnesium foil to form a cylinder.

Abstract: A method includes obtaining or providing a sheet of material; forming from the material a member comprising a plurality of switchback portions that zigzag about a loop; and shaping the member such that the plurality of switchback portions are elastically deformable and zigzag and curve about the loop.

Abstract: A constraining structure for use with a balloon catheter includes multiple longitudinal struts and multiple expandable radial rings. The constraining structure can expand radially but may not expand substantially in the longitudinal direction. The constraining structure can have multiple compartments configured to expand independently of one another. Inflating the balloon catheter within the constraining structure can allow for dilation of the blood vessel in a pre determined topography.

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: Systems for the delivery of endoluminal devices are disclosed. An illustrative system may include a delivery sheath having an inner sheath and an outer sheath. The delivery sheath may be configured to restrain a stent in a compressed delivery configuration. The outer sheath may cover the entire length of the stent and the inner sheath may cover a portion of the length of the stent.

Abstract: A locking mechanism for a medical implant may include a buckle member, a post member axially translatable with respect to the buckle member, the post member including a receiving portion proximate a proximal end of the post member, a distal end, a laterally-arched central body portion extending between the receiving portion and the distal end, and a cantilevered leg extending proximally from the distal end, and an actuator element including a proximal shaft portion and a distal engagement portion, the distal engagement portion being configured to releasably engage the receiving portion of the post member. The proximal shaft portion may be pivotable with respect to the distal engagement portion.

Abstract: In an embolization device (1) with a main body (3) and with at least one thrombogenic fiber (2), which main body can be converted from an elongate primary shape to a secondary shape, the at least one thrombogenic fiber (2) is arranged in a configuration wound around the main body. In a method for producing an embolization coil of this kind, a primary coil (30) forming a main body (3) of the embolization coil (1) has at least one thrombogenic fiber (2) wound around it, and the primary coil (30) is converted in shape to a secondary coil.

Abstract: Stent delivery system having a contracted delivery configuration and an expanded deployed configuration is provided. The stent delivery system includes a stent having a plurality of expandable elements and a plurality of interstices disposed between adjacent expandable elements, and a delivery catheter having an inflatable balloon including creases extending non-uniformly within the interstices of the stent in the contracted delivery configuration. Each crease defines a maximum radial height within a corresponding interstice, and the maximum radial heights of the creases vary. A method for stenting at a target site within a patient's vessel including providing a stent delivery system is also provided.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a catheter shaft. The catheter shaft may include an inner member having a distal region and a deployment sheath disposed about the inner member. A stent may be disposed between along the distal region of the inner member. A handle may be coupled to the catheter shaft. An actuation mechanism may be coupled to the handle for proximally retracting the deployment sheath. The actuation mechanism may be designed to shift relative to the handle from a pre-deployment position, along an early deployment region, and along a full deployment region. The medical device may also include a force reduction member for applying a force to the actuation mechanism while the actuation mechanism is disposed along the early deployment region.

Abstract: A treatment method is provided that includes an introduction step of introducing a transparent stent into a vitreous body of an eyeball, an expansion step of causing the stent to expansively deform inside the vitreous body to bring a retina into contact with a retinal pigment epithelium, and a placement step of placing the stent in the vitreous body with the stent keeping the retina in contact with the retinal pigment epithelium.

Abstract: Disclosed is an assembly for opening a vessel lumen comprising a radially expandable stent configured to open a vessel lumen, the radially expandable stent comprises a curved wall having a proximal portion, a distal portion and a lumen connecting the proximal portion and the distal portion. The assembly further comprises a knitted jacket comprising a plurality of interconnected loops, the knitted jacket further comprising a tubular wall that substantially surrounds an exterior surface of the radially expandable stent, and at least one retainer belt that slidingly passes through at least one knitted loop of the plurality of interconnected loops in the knitted jacket.

Abstract: A stent delivery assembly and methods of use are provided. The assembly can comprise a catheter, a cover member, a core member, a stent, and a stent retention mechanism. The stent can extend within the cover member lumen and have a section extending at least partially between an inner layer of the cover member and the core member. The stent retention mechanism can be coupled to the core member and comprise an outer surface that is configured to exert a radially outward force against the stent for axially restraining the stent relative to the core member when the stent is in contact with the inner layer of the cover member.