Abstract: A positioning anchor is provided for a stent-graft for implantation to treat a damaged body lumen. The positioning anchor is generally tubular surrounding a primary fluid conduit. Arms extend laterally from the generally tubular structure of the anchor surrounding lateral fluid conduits. The form of these arms is preferably custom configured to match a particular patient's luminal geometry. The anchor thus fits within the luminal geometry to remain in a desired fixed position for implantation of the anchor and any stent-graft coupled to the anchor. The anchor is most preferably formed with two walls having a void therebetween which can be filled with fixation media to further secure the anchor at the desired implantation site. A lumen shaper balloon and delivery catheter are also disclosed for proper delivery, expansion and inflation of the positioning anchor and stent-graft elements according to this invention.

Abstract: Medical devices and methods for making and using the same. An example medical device may include an elongate tubular member, an endosurgery stent disposed on the outer surface of the tubular member, a push tube slidably disposed along the outer surface of the tubular member, and a push member slidably disposed in a lumen formed in the tubular member. The push member may be coupled to the push tube.

Abstract: A device and method for treating a hollow anatomical structure using matter in a plasma state. Device includes a tubular delivery device comprising a tubular body, a hub, and a distal end, wherein the tubular body device having a longitudinal fluid delivery channel and an exit port near the distal end. Device also contains a container having pre-plasma matter being operatively coupled to the hub, at least one energy-emitting element operatively coupled near the distal end of the tubular delivery device. The energy-emitting element is operatively connected to energy source.

Abstract: Embodiments of the invention are directed towards a rapid exchange catheter configured for insertion into a subintimal space and crossing an occlusion in a subintimal space. The catheter includes a proximal end, a distal end, a first lumen configured to receive a first wire, the first lumen extending longitudinally through a least a lateral port of the catheter, and a second lumen having at least a portion distal of the lateral port and extending through at least the distal end of the catheter. The catheter also includes an exchange port arranged on a exterior portion of the catheter configured to the receive a second wire and second rapid exchange port in communication with the second lumen. Moreover, other embodiments of the invention are directed towards methods for using the rapid exchange catheter to cross an obstruction in a vessel, e.g., a total or partial occlusion, in a subintimal space.

Abstract: A delivery device and method for use, the delivery device including a stent device, a restraining sheath, and a pull member. The restraining sheath is mounted coaxially over the stent device for maintaining the stent device in a delivery configuration, and may include a line of weakness extending axially. The pull member is to be pulled so as to split the restraining sheath at the line of weakness and withdraw the restraining sheath from over the stent device. The pull member and the line of weakness may be located on opposing sides of the restraining sheath. The pull member may have an inner part extending inside of the restraining sheath, an outer part extending outside of the restraining sheath, and a wraparound portion there between for wrapping around an axial end of the restraining sheath to radially capture the restraining sheath between the inner and outer parts.

Abstract: An endoluminal prosthesis comprises a graft having a tubular body comprising proximal and distal ends, inner and outer surfaces, and partially and fully deployed states. A temporary channel is disposed external to the outer surface of the graft in the partially deployed state. The temporary channel begins at one of the proximal and distal ends of the graft, and extends along only a portion of a longitudinal length of the graft. The temporary channel is removed when the graft is in a fully deployed state.

Abstract: A system and method including a guide wire having a plurality of sensors attached near an end of the guide wire, and a processor configured to determine a position of a body component and a position of a catheter moving along the guide wire based on the signals received from the plurality of sensors. Feedback information can be generated based on these determined positions to help guide a medical procedure.

Abstract: Described herein are systems and methods from delivering prosthetic devices, such as prosthetic heart valves, through the body and into the heart for implantation therein. The prosthetic devices delivered with the delivery systems disclosed herein are, for example, radially expandable from a radially compressed state mounted on the delivery system to a radially expanded state for implantation using an inflatable balloon of the delivery system. Exemplary delivery routes through the body and into the heart include transfemoral routes, transapical routes, and transaortic routes, among others.

Abstract: Methods are disclosed including thermally processing a scaffold to increase the radial strength of the scaffold when the scaffold is deployed from a crimped state to a deployed state such as a nominal deployment diameter. The thermal processing may further maintain or increase the expansion capability of the scaffold when expanded beyond the nominal diameter.

Abstract: Valve delivery catheter assemblies including components that limit trauma to the expanded prosthetic valve and body channels as the distal tip of the catheter is withdrawn through the expanded valve and thereafter from the body. Catheter assemblies according to the present invention can include a handle assembly, an introducer sheath, and a distal tip assembly. The handle assembly can include a fixed main handle and two or more rotating handles that allow a user to control the distal tip assembly of the catheter. A safety button can be included on the handle assembly to allow for precise and consistent positioning of the prosthetic valve in the body. A valve retaining mechanism can be included to assist in retaining the prosthetic valve prior to deployment.

Abstract: A medical stent mold includes a tube having an interior passage sized and dimensioned to receive a stent assembly disposed at least partially about a central portion of a stent balloon. The medical stent mold may also include a housing forming a chamber through which the tube extends. The tube may include a thermally conductive material and may have a body portion that extends within the chamber and an end portion that is proximate the body portion and that extends away from the housing. Forced convection may be used to quickly heat and cool the tube. Methods of increasing retention of an expandable stent assembly on a stent balloon and of detecting a leak in a stent balloon are also included.

Abstract: A catheter is described for the transvascular implantation of prosthetic heart valves, e.g., including self-expanding anchorage supports, to reduce the risk to the patient during the implantation. Accordingly, a prosthetic heart valve with anchorage supports is temporarily housed in a folded form in a cartridge-type unit during the implantation. The cartridge-type unit can be fixed on the proximal end of a guide system, which includes a flexible region that can be guided through the aorta. Actuating elements run through the interior of the hollow guide system, permitting sections of the cartridge-type unit to be displaced radially about their longitudinal axis and/or laterally in a proximal direction, thus allowing individual sections of the anchorage support and the associated prosthetic heart valve to be sequentially released.

Abstract: An apparatus and method of deploying a stent graft having a proximal anchor stent ring includes restraining proximal apexes of the proximal anchor stent ring between a spindle body of a spindle and a control release sleeve of a tapered tip. The control release sleeve is advanced relative to the spindle to release a first proximal apex through an opening in the control release sleeve while the remaining proximal apexes remain restrained by the control release sleeve. The control release sleeve is further advanced relative to the spindle to release the remaining proximal apexes from the control release sleeve. In another example, a stent capture fitting has variable length stent capture fitting arms. As the stent capture fitting is retracted, the proximal apexes of the proximal anchor stent ring are sequentially exposed from and released by the variable length stent capture fitting arms.

Abstract: A prosthetic cardiac valve comprises an anchor having an atrial skirt, an annular region, and a ventricular skirt. The prosthetic valve also has a plurality of prosthetic valve leaflets each having a first end and a free end. The first end is coupled with the anchor and the free end is opposite the first end. The prosthetic cardiac valve has an open configuration in which the free ends of the prosthetic valve leaflets are disposed away from one another to allow antegrade blood flow therepast, and a closed configuration in which the free ends of the prosthetic valve leaflets engage one another and substantially prevent retrograde blood flow therepast. The anchor has a collapsed configuration for delivery to the heart and an expanded configuration for anchoring the prosthetic cardiac valve to a patient's heart.

Abstract: The present disclosure describes treatment of the vasculature of a patient with an expandable implant. The implant is constrained to a reduced delivery diameter for delivery within the vasculature by at least one sleeve. The implant can be constrained to other diameters, such as an intermediate diameter. The sleeves can be expanded, allowing for expansion of the diameter of the expandable implant, by disengaging a coupling member from the sleeve or sleeves from outside of the body of the patient. The expandable implant can comprise a steering line or lines which facilitate bending and steering of the expandable implant through the vasculature of a patient.

Abstract: In an embodiment, a stent is provided for use in blood vessels with blockage near or in a bifurcation. The stent includes a side aperture. The stent is inserted into one of the daughter branches of the bifurcation and positioned with the use of markers. The stent is then expanded so as to support the wall of the blood vessel while allowing the blood to continue to flow to both daughter branches.

Abstract: Methods are disclosed including thermally processing a scaffold to increase the radial strength of the scaffold when the scaffold is deployed from a crimped state to a deployed state such as a nominal deployment diameter. The thermal processing may further maintain or increase the expansion capability of the scaffold when expanded beyond the nominal diameter.

Abstract: Medical device delivery systems, and related methods and components, are disclosed.

Abstract: A system for treating a bifurcation includes first and second delivery catheters, each having an expandable member. A stent having a side hole is disposed on the second delivery catheter. A portion of the first delivery catheter is disposed under a portion of the stent. The first delivery catheter is slidable relative to the second delivery catheter, and the first delivery catheter passes through the side hole. Expansion of the first expandable member expands a portion of the stent and expansion of the second expandable member expands the rest of the stent.

Abstract: A wellbore treatment fluid containing lost circulation materials and methods for using the treatment fluid, the fluid including a carrier fluid and shape changing polymer structures. The shape changing polymer structures may be folded or rolled into various cross-sectional surface area reducing configurations and are capable of reversibly extending and reversibly contracting with changes in temperature. The materials forming the shape changing polymer structures may include at least one selected from poly[ethylene-co-(vinyl acetate)], poly(?-pentadecalactone), poly(?-caprolactone), and copolymers thereof. A method for utilizing the treatment fluid for creation or maintenance of a well includes forming or providing the treatment fluid and introducing the treatment fluid into a borehole.

Abstract: A stent device delivery system and method of making. The stent device delivery system includes a stent device, an outer sheath overlaying the stent device in a radially compact, delivery configuration of the stent device, and an inner catheter extending axially and radially within a lumen of the stent device. The inner catheter provides a stent bed upon which the stent device is located so that a radially inner surface of the stent device engages a radially outer surface of the stent bed. The stent bed may define an inwardly tapering profile, narrowing in radius from a distal portion of the stent device to a proximal portion of the stent device.

Abstract: Embodiments of the present invention relate generally to the field of tissue repair and regeneration. More specifically embodiments of present disclosure relate to devices or constructs and methods to prepare various devices or constructs useful in directing cellular repair and controlling tissue regeneration to prevent or minimize postsurgical or post traumatic adhesions, excessive scars and/or fibrotic reactions of injured tissues.

Abstract: A delivery system and method for delivering a prosthetic heart valve to the aortic valve. The system includes a delivery catheter having a steering mechanism thereon for delivering a balloon-expandable prosthetic heart valve to the aortic valve through an introducer passing into the left ventricle through its apex. The introducer may have a more floppy distal section than a proximal section to reduce trauma to the heart wall while preserving good operating field stability. The delivery catheter includes a deflecting segment just proximal to a distal balloon to facilitate positioning of the prosthetic heart valve in the proper orientation. A trigger in a catheter handle may be coupled to a deflection wire that actuates the deflecting segment, while a slider in the handle controls retraction of a valve pusher. The prosthetic heart valve may be installed over the existing calcified leaflets, and a pre-dilation valvuloplasty procedure may also be utilized.

Abstract: A stent device delivery system and method of making. The stent device delivery system includes a stent device, an outer sheath overlaying the stent device in a radially compact, delivery configuration of the stent device, and a pull member. The outer sheath may include a first layer and a reinforcement layer that are laminated together, a portion of the pull member captured radially between the first layer and the reinforcement layer. At least a partial length of the captured portion of the pull member may be formed with a varying radial profile.

Abstract: Method for positioning an artificial heart valve at the anatomic position of a malfunctioning heart valve of a heart of a patient, by employing a catheter bearing the artificial heart valve and a valve fixation device, at the tip of the catheter, the method including the procedures of receiving a marking input associated with an image of the heart, and respective of the anatomic position, in a medical positioning system (MPS) coordinate system, moving the tip toward the anatomic position, constantly detecting the current position of the artificial heart valve, and producing an indication when the current position substantially matches the anatomic position, thereby enabling the catheter to fix the malfunctioning heart valve in place, by the valve fixation device.

Abstract: A handle assembly for a delivery device the sequential release of trigger wires from a prosthesis to release the prosthesis from the delivery device. The handle assembly has two handles, one of which is a rotating handle. The rotating handle has a first and second trigger wire release mechanisms which operate to sequentially release a first and second trigger wire, respectively, and a locking mechanism. The other handle has a locking mechanism that prevents that operation of the second trigger wire release mechanism until the first trigger wire has been released.

Abstract: Heart valve delivery systems and methods of delivering and implanting heart valves using delivery catheters are disclosed. The delivery systems can include a handle assembly which can include a first control mechanism, a second control mechanism, and a decoupling mechanism. The delivery systems can also include a delivery catheter extending from the handle assembly. The delivery catheter can include an outer shaft, which can be controlled by the first control mechanism; a prosthesis containing capsule comprising a proximal capsule portion connected to the outer shaft, and a distal capsule portion releasably coupled to the proximal capsule portion. After deploying a valve prosthesis, the capsule can be closed by activating the decoupling mechanism in the handle to rapidly close the distal and proximal capsule portions together. The delivery system can also include a centering element to guide the distal and proximal capsule portions together.

Abstract: Delivery systems for polymeric tubular implants, kits that include such delivery systems, and methods of treating patients by implanting tubular implants using the delivery systems. The delivery systems include an inner shaft, an expandable member slidably disposed about the inner shaft and configured to receive the tubular implant, and a tubular outer shaft disposed about the inner shaft.

Abstract: Prosthesis delivery devices and methods are provided that enable precise control of prosthesis position during deployment. The catheter for delivering a prosthesis to a treatment site in a body lumen typically carries one or more self-expanding tubular prostheses within a sheath. A radially expandable control member is positionable within the prostheses and has an expanded shape which engages an inner surface of the prostheses to urge the prostheses outwardly against the sheath. The radially expandable control member therefore controls axial position of the prostheses during deployment. Thus one or more prostheses may be deployed at a treatment site precisely. When multiple prostheses are deployed, excessive spacing or overlap between adjacent prostheses is minimized. The prostheses of the present invention are often deployed in stenotic lesions in peripheral arteries as well as coronary arteries and other body lumens.

Abstract: A stent device delivery system and method of making. The stent device delivery system includes a stent device and an outer sheath overlaying the stent device in a radially compact, delivery configuration of the stent device. The outer sheath may include a first layer of polymeric material and a reinforcement layer of polymeric material that are laminated together.

Abstract: Systems and methods are disclosed for delivering a stent to a lumen internal to a body of a patient and for sheathing a stent just prior to an insertion procedure. One embodiment comprises a delivery device having a partially sheathed configuration, a fully sheathed delivery configuration, and a deployed configuration. A panchor (combination pusher and anchor) is configured to engage and limit proximal and distal movement of the implantable device. An outer sheath surrounds a distal portion of an inner member and retains the implantable device near the distal end. The outer sheath is slidably moveable relative to the inner member to deploy the implantable device. Proximal movement of a trigger results in movement of the outer sheath to deploy the implantable device. A sheathing mechanism is configured to crimp and fully sheathe the implantable device prior to a deployment procedure.

Abstract: The invention provides a device (50) and system for treating a heart valve having an anchor (54, 56) and one or more sutures attached to the anchor. The anchor has an expanded deployed configuration and a low caliber undeployed configuration. A delivery in a heart includes catheter and a needle slidable in the lumen of the catheter. The distal end of the catheter is inserted through the myocardium of the heart until the catheter tip is juxtaposed to the underside of the valve leaflet to be treated. The leaflet is then pierced with tip of the needle. The needle is pushed until the anchor in its undeployed configuration passes through the needle tip and is released from the catheter. The anchor is then brought to its deployed configuration on one or both surfaces of the valve leaflet.

Abstract: A coronary predilatation and stent deployment catheter assembly includes a single sheathless unitary catheter body having a proximal end and a distal end, a predilatation balloon located at the distal end of the body, and a stent inflation balloon located along the body a distance of between about 5 millimeters and about 15 millimeters proximally of the predilatation balloon. An expandable stent is disposed over the stent balloon. A predilatation balloon inflation connection is located proximally of the stent inflation balloon and in fluid communication with the predilatation balloon through a predilatation inflation lumen. A stent balloon inflation connection is located proximally of the stent inflation balloon and in fluid communication with the stent inflation balloon through a stent balloon inflation lumen. At least one radiopaque marker is disposed on the predilatation balloon and at least one radiopaque marker is disposed on the stent inflation balloon.

Abstract: Embodiments described herein address the need for improved catheter devices for delivery, repositioning and/or percutaneous retrieval of the percutaneously implanted heart valves. One embodiment employs a plurality of spring-loaded arms releasably engaged with a stent frame for controlling expansion for valve deployment. Another embodiment employs a plurality of filaments passing through a distal end of a pusher sleeve and apertures in a self-expandable stent frame to control its state of deployment. With additional features, lateral positioning of the stent frame may also be controlled. Yet another embodiment includes plurality of outwardly biased arms held to complimentary stent frame features by overlying sheath segments. Still another embodiment integrates a visualization system in the subject delivery system. Variations on hardware and methods associated with the use of these embodiments are contemplated in addition to those shown and described.

Abstract: A stent delivery system may be used to position a stent in a body lumen. An endoscope may be positionable in the stent delivery system facilitating direct visual observation during placement of the stent. The stent delivery system may include a first conduit, wherein the endoscope is positionable. A second conduit, wherein the first conduit is positionable, may function to releasably position the stent in the body lumen during use. The stent delivery system may include a lock that functions to inhibit movement of the first conduit relative to the second conduit during use. Retraction of the distal end of the second conduit, relative to the first conduit and the stent, may deploy the stent in a body lumen. Indicia, visibly positioned on the proximal end of the stent delivery system, may function to facilitate determination of an extent of deployment of the stent during use.

Abstract: A cardiac assist system using a helical arrangement of contractile bands and a helically-twisting cardiac assist device are disclosed. One embodiment discloses a cardiac assist system comprising at least one contractile elastic band helically arrangement around a periphery of a patient's heart, where upon an actuation the band contracts helically, thereby squeezing the heart and assisting the pumping function of the heart. Another embodiment discloses a helically twisting cardiac-apex assist device comprising an open, inverted, substantially conical chamber with two rotatable ring portions of different diameters located at the base and apex of the chamber, with a plurality of substantially helical connecting elements positioned substantially flush with the chamber wall and connecting the two rotatable ring portions, whereby a relative twisting motion of the two rings causes a change in volume of the chamber thereby assisting the cardiac pumping function.

Abstract: A release device for releasing a medical implant from an insertion device, having an indirect or direct clamping body for clamping the implant in the insertion device, the clamping device having a proximal end, and having a distal end, wherein the clamping body has at least one web, at least one extension and at least two clamping surface regions, wherein the extension is oriented substantially in the radial direction of the clamping body, and wherein the at least two clamping surface regions are substantially pointing toward one another and are aligned substantially parallel to one another, wherein the at least one web or the at least one extension has at least one of the two clamping surface regions, and wherein the at least two clamping surface regions and/or the at least one extension connect/connects to at least one region of the implant in the clamped state.

Abstract: A catheter system configured to deploy a valve prosthesis can include a catheter tip at a distal end of the catheter system. The catheter tip can include a device holder releasably connected to and retaining the prosthesis. The catheter tip can also include a first housing portion that accommodates the first portion of the prosthesis, and a second housing portion that accommodates the second portion of the prosthesis. The first housing portion and the second housing portion are configured to move relative to one another such that the catheter system sequentially releases the prosthesis to an expanded state by uncovering the second portion of the prosthesis allowing the second portion of the prosthesis to expand.

Abstract: An implant may include a frame and a cover to facilitate endoluminal vessel occlusion, selective release of embolic material toward a target region, and/or endoluminal stenting. The frame of the implant provides radial expansion properties to secure the cover within a body vessel. The cover and/or the frame can occlude flow of a fluid through the body vessel.

Abstract: A prosthesis introducer system may include an introducer. A trigger wire release mechanism and a restraining member may be positioned near the distal end of the introducer. The system may include first and second trigger wires, each including a proximal portion releasably coupleable to a portion of a prosthesis and a distal portion coupled to the trigger wire release mechanism. The second trigger wire may be engaged by the restraining member. Each of the first and second trigger wires may include a taut portion. The second trigger wire may include a slack portion extending distally from the taut portion and positioned distal of the restraining member. Upon actuation of the trigger wire release mechanism, the first trigger wire may be releasable from the prosthesis and the second trigger wire may be releasable subsequent to the release of the first trigger wire.

Abstract: A delivery system including a distal capture device that has a sleeve with a passageway defined axially therethrough and one or more elastically deformable sections. Each of the one or more elastically deformable sections has a free terminating end and an opposite end mounted to the distal end of the sleeve. The elastically deformable sections transition between: (i) a fully expanded state in which the elastically deformable section is distally biased in a direction away from the sleeve; and (ii) a retracted state in which the free terminating end of each of the elastically deformable sections is proximally deflected backwards over itself in a direction toward the proximal end of the sleeve.

Abstract: A system includes a medical device for implanting in a valve of a subject, the implantable medical device having a self-expanding frame; and a holder configured to retain the frame of the implantable medical device in a constricted configuration and to control expansion of the frame. The holder has a controllably constrictable and expandable loop, wherein the loop is disposed about at least a portion of the self-expanding frame such that constriction or expansion of the first loop controls constriction or expansion of the frame.

Abstract: A shape memory alloy structure comprises at least one tubular member formed of shape memory material, each tubular member including a plurality of panels having side edges, wherein each tubular member is moveable between a radially contracted position and a radially extended position, and wherein the coupled side edges of adjacent panels of each tubular member form hinges for moving the structure between the contracted position and the extended position. Multiple layer tubular structures, methods for forming and fixtures for collapsing same are also disclosed.

Abstract: An expandable prosthetic device and method of delivery that allows the initial placement of multiple guidewires into selected target sites. The prosthesis includes a main body device. This main body device has a separate side branch guidewire lumen that passes through the main body device and through a side opening in the main body device. As the main body device is advanced, the side opening is self guided (by the side branch guidewire) and self-aligns to the side branch vessel ostium. The main body device is then deployed, leaving the side branch guidewire in place. A side branch device is then advanced along the side branch guidewire through the main body device, through the side wall opening and into the native side branch vessel. The side branch device can then be deployed to engage the main body device and the native side branch vessel.

Abstract: A delivery device can include a number of different features including, one or more of, but not limited to, the following. Shuttle and trigger retraction of an outer sheath. Arcuate movement of a trigger. An interlock device to prevent actuation of the trigger. An interlock device that can adjust the position of the outer sheath and the inner shaft. A retraction override switch and lock.

Abstract: An endovascular stent-graft (10) includes a generally tubular hourglass-shaped body (22), which is configured to assume a radially-compressed delivery configuration and a radially-expanded deployment configuration. The hourglass-shaped body (22) includes a flexible stent member (26), which includes a plurality of structural stent elements (28); and a tubular fluid flow guide (24), which includes a fabric (29), and is attached to the structural stent elements (28). The hourglass-shaped body (22) is shaped so as to define a narrow waist portion (32) longitudinally surrounded by and adjacent to wider first and second longitudinal portions (30, 34). The fabric (29) along the waist portion (32) is shaped so as to define at least first and second lateral apertures (36, 38). Other embodiments are also described.

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 retrieval catheter operable by a single clinician that will neither displace a deployed stent nor cause undue trauma to the vascular lumen or lesion. The retrieval catheter may be sized to accommodate both a guidewire and a balloon wire. The retrieval catheter is easy to navigate through tortuous passageways and will cross a previously deployed stent or stent-graft easily with minimal risk of snagging on the deployed stent or stent graft. The sheath and dilator are adapted to allow a guidewire or balloon wire to pass through the walls of both and to allow the sheath and dilator to move axially with respect to each other.

Abstract: Stents can become twisted during deployment within tortuous vessels such that proper expansion against the vessel wall is inhibited. Stents can be twisted prior to deployment in a direction opposite the direction of twisting during deployment to facilitate full expansion of the stent against the vessel wall along the stent's entire length.

Abstract: A delivery device can include several different features including, at least: a shuttle and trigger retraction of an outer sheath; an interlock device to prevent actuation of the trigger; a retraction override switch and lock; and an inner shaft adjuster to ensure correct alignment of the inner shaft and the outer sheath prior to device deployment. The inner shaft adjuster may include, at least: a proximal portion of the handle housing having slots therethrough: pins operatively fixed to the inner shaft and extending through and slidable within the slots: and a cap having an inner helical groove that mates with the pins. Rotation of the cap may push the pins and the inner shaft in a proximal-distal direction. The cap may have a distal lip configured to accept a proximal extension of the interlock and retain it in a locked position until the inner shaft has been adjusted or moved.