Substaintially rigid and stable endoluminal surgical suite for treating a gastrointestinal lesion

Exemplary embodiments of devices and method for affecting at least one anatomical tissue can be provided. A configuration can be provided that includes a structure which is expandable (i) having and/or (ii) forming at least one opening or a working space through which the anatomical tissue(s) is placed in the structure. For example, the structure, prior to being expanding, can have at least one partially rigid portion. In addition, or as an alternative, upon a partial or complete expansion thereof, the structure can be controllable to have a plurality of shapes. Further, the structure can be controllable to provide the working space with multiple shapes and/or multiple sizes.

Floating, multi-lumen-catheter retractor system for a minimally-invasive, operative gastrointestinal treatment

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

Occluding Catheter and Method for Prevention of Stroke

An occluding catheter for preventing stroke by occluding blood flow through right and left carotid arteries is provided. The occluding catheter includes a shaft that has a proximal end and a distal end, and a proximal occluding balloon carried by the shaft. The proximal occluding balloon is inflated to occlude blood flow through one of the right carotid artery and the left carotid artery. A distal occluding balloon is carried by the shaft and is inflated to occlude blood flow through one of the right carotid artery and the left carotid artery that is not occluded by the proximal occluding balloon. The shaft has a segment that is located between the proximal occluding balloon and the distal occluding balloon. Also provided is an alternative arrangement with a single occluding balloon, and an associated method of diverting emboli from cerebral circulation.

Occlusion perfusion catheter

Catheters for occluding, visualizing, irrigating, evacuating, and delivering agents to a treatment area are disclosed. The catheters comprise a catheter body comprising five lumens, first and second occlusion balloons coupled to the catheter body, an optional space-occupying balloon coupled to the catheter body and disposed between the first and second occlusion balloons, and an optional visualization means that enables visualization between the first and second occlusion balloons. Methods for using these catheters are also disclosed. A method comprises inflating the first and second occlusion balloons, inflating the space-occupying balloon, allowing fluid to exit via an evacuation lumen, optionally irrigating or aspirating to facilitate fluid exit via said lumen, and delivering an agent to a treatment area via the agent lumen.

ENDOVASCULAR CATHETER WITH MULTIPLE CAPABILITIES

An endovascular catheter combination configured to have multiple capabilities is disclosed. These capabilities include proximal and distal occlusion of a segment of a target blood vessel (such as the carotid artery) thus excluding the segment of the blood vessel from circulation for purposes such as surgical consideration. Another capability includes intravascular shunting of the blood through the excluded portion of the artery during a procedure such as an endarterectomy. Additionally, a microsensor provides a measurement of the rate/volume of blood flow through the distal end of the catheter. In one embodiment, a guidewire is provided with a filtration mesh as an anti-embolic mechanism both at the time of initial positioning of the catheter and after reversing the occlusion. 1. An endovascular catheter comprising:a flexible lumen with a leading end, a trailing end and a central portion disposed between the leading end and the trailing end;a first syringe and a second syringe, each disposed proximate the trailing end;at least one aperture in the central portion, the at least one aperture being fluidly connected to an opening at the leading end thereby providing a bypass;a common carotid balloon operatively connected to the first syringe;an internal carotid balloon operatively connected to the second syringe; andwherein the internal carotid balloon is disposed proximate the leading end and the common carotid balloon is disposed between the internal carotid balloon and the at least one aperture, the internal carotid balloon and the common carotid balloon being spaced apart by a distance.2. The endovascular catheter as recited in claim 1 , further comprising a blood flow sensor disposed at the leading end that monitors blood flow through the at least one aperture.3. The endovascular catheter as recited in claim 1 , further comprising an extendable netting at the leading end.4. The endovascular catheter as recited in claim 3 , wherein the netting is a concave netting.5 ...

DEVICES FOR THE TREATMENT OF VASCULAR ANEURYSM

Devices for the treatment of vascular aneurysms are described. The treatment is achieved through the delivery of an effective amount of elastin stabilization agent to an isolated volume at the aneurysm. The elastin stabilization agent maybe embedded in a delivery composition. The device optionally has an aspiration means to improve the effectiveness of the treatment. 1. A method for treating an isolated portion of a blood vessel , the method comprising:delivering a therapeutic composition to the isolated volume of the blood vessel following aspiration of the fluid using a device that is positioned within the vessel with an extendable portion forming the isolated volume with the wall of the vessel wherein the therapeutic composition is delivered into the isolated volume through a fluid exchange portion in fluid communication with a lumen of the shaft that extends from the patient wherein the flow in the vessel is maintained through a by pass channel of the delivery device while treatment is performed, wherein the therapeutic composition comprises an elastin stabilizing composition.2. The method of wherein the shaft further comprises a rapid exchange guidewire lumen with a guidewire port near the distal end of the shaft.3. The method of wherein the extendable element comprises an actuation element that controls the transition of the extendable element between the lower profile configuration and the extended configuration.4. The method of wherein the fluid exchange portion is on the shaft of the device comprising one or more exchange openings in fluid communication with the isolated volume.5. The method of wherein the one or more exchange openings comprises a tubular conduit displaced from the shaft having an opening that is in fluid communication with the isolated volume.6. The method of wherein the fluid exchange portion comprises a side channel that is a portion of the second lumen having an opening on the side of the sealing element of the device.7. The method of ...

BALLOON DEVICES AND METHODS FOR USE

Balloon catheters and methods are provided for selectively occluding blood flow into a right atrium of a patient's heart communicating with an inferior vena cava (IVC) and superior vena cava (SVC). In one embodiment, a catheter includes first and second balloons adjacent one another on a distal end of the catheter shaft. During use, the distal end is introduced into the right atrium and positioned such that the first balloon is located within the right atrium. The first balloon is expanded within the right atrium and the catheter shaft directed such that the expanded first balloon engages at least a portion of the IVC to prevent substantial inflow into the right atrium from the IVC. The second balloon is then expanded to limit inflow into the right atrium from the SVC, and a medical procedure is performed within the patient's body. 1. A balloon catheter for selectively occluding blood flow into a right atrium of a heart communicating with an inferior vena cava (IVC) and superior vena cava (SVC) , comprising:an elongate shaft comprising a proximal end, a distal end sized for introduction into a patient's body, and first and second inflation lumens extending between the first and second ends;a first balloon carried on the distal end formed from compliant or semi-compliant material, the first balloon having a first length;a second balloon carried on the distal end adjacent the first balloon formed from semi-compliant or non-compliant material, the second balloon having a second length longer than the first length; anda hub on the proximal end comprising first and second ports communicating with the first and second inflation lumens, respectively, the first inflation lumen communicating with an interior of the first balloon and the second inflation lumen communicating with an interior of the second balloon, such that the first and second balloons are independently expandable by introducing inflation media into the first and second ports.2. The balloon catheter of claim ...

METHODS AND SYSTEMS FOR ESTABLISHING RETROGRADE CAROTID ARTERIAL BLOOD FLOW

Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. The flow control assembly includes one or more components that interact with the blood flow through the shunt. 1. A system for use in accessing and treating a target artery , said system comprising:an arterial access device adapted to be introduced into a common carotid artery and receive blood flow from the target artery;a shunt fluidly connected to the arterial access device, wherein the shunt provides a pathway for blood to flow from the arterial access device to a return site; anda flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state, wherein the flow control assembly includes one or more components that interact with the blood flow through the shunt, wherein the flow control assembly comprises two or more parallel flow paths and a valve to open or close one or more of the flow paths to adjust the state of flow by selectively directing blood flow through one or more of the flow paths.2. A system as in claim 1 , further comprising a port fluidly communicating with the shunt claim 1 , wherein the port may be used to connect an aspiration device to the shunt.3. A system as in claim 2 , further comprising a second valve which controls fluid communication between the shunt and the port.4. A system as in claim 3 , wherein the second valve automatically opens with attachment of an aspiration or injection device ...

Systems, methods and devices for performing gynecological procedures

Systems, methods, apparatus and devices for performing improved gynecologic and urologic procedures are disclosed. The system and devices provide simplified use and reduced risk of adverse events. Patient benefit is achieved through improved outcomes, reduced pain, especially peri-procedural pain, and reduced recovery times. The various embodiments enable procedures to be performed outside the hospital setting, such as in a doctor's office or clinic.

Method And Apparatus For Treating A Carotid Artery

One disclosed embodiment comprises a method for treating lesions in the carotid artery of a mammalian body. The method comprises transcervical access and blocking of blood flow through the common carotid artery (with or without blocking of blood flow through the external carotid artery), shunting blood from the internal carotid artery and treating the lesion in the carotid artery.

Endoluminal system for gastrointestinal treatment

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

INTRAVASCULAR SHUNT FOR TRAUMATIZED ARTERIES

The present invention relates to a catheter assembly including a catheter body, a first and a second set of a plurality of fenestrations, a first and a second inflatable device, a first and a second pleat, at least one obstructing stop near each end portion of the catheter body, and a first and a second flexible tube connected to the first and the second inflatable device. The catheter assembly further includes a pumping device in communication with the first and the second inflatable device via the first and the second flexible tube. The catheter assembly is used to restore blood flow to a traumatized blood vessel. 1. A catheter assembly for restoring blood flow to a traumatized blood vessel , comprising:a catheter body, in a tubular shape, comprising: a first and a second tip, each configured to permit insertion into a blood vessel without damaging an inner wall of a blood vessel lumen;a first and a second set of a plurality of fenestrations, disposed proximate to each tip extending a length of the catheter body away from each tip towards a center portion of the tubular catheter body;a first and a second inflatable device, placed circumferentially and longitudinally about the catheter body, configured such that when uninflated each is capable of sliding over a section of the catheter body, and when inflated an inner annulus of each presses against an outer perimeter of the catheter body;a first and a second pleat, spaced apart by a midsection, located in the center portion of the catheter body between the first and the second inflatable device;at least one obstructing stop, located on the outer perimeter of the catheter body in a section longitudinally adjacent to each of the first and the second set of the plurality of fenestrations towards the center portion, to obstruct the first or the second inflatable device from sliding over the first or second set of a plurality of fenestrations proximate to the first or the second tip of the catheter body, anda first and ...

EROSION MITIGATING OCCLUDER

The present disclosure is directed to embodiments and methods of reducing or eliminating erosion resulting from the use of an occluder. In particular, the present disclosure is directed to reducing or eliminating erosion resulting from the use of an occluder while maintaining the fundamental function and effectiveness of the occluder with an improved occluder braid pattern. The embodiments and methods disclosed herein reduce or eliminate erosion, for example, by reducing the friction and force of an occluder on cardiac tissue and/or by increasing occluder disc compliance to cardiac structures and movement. 1. A medical device for treating a target site , the medical device comprising:a tubular member comprising a proximal disc portion at a proximal end, a distal disc portion at a distal end, and a waist member extending between the proximal disc portion and the distal disc portion, wherein the tubular member comprises at least one braided layer and has an expanded configuration when deployed at the target site and a reduced configuration for delivery to the target site; anda coating covering at least a portion of the tubular member.2. The medical device of claim 1 , wherein the coating comprises a fabric coating covering at least one of the proximal disc portion and the distal disc portion.3. The medical device of claim 1 , wherein the coating comprises a polymer coating encapsulating at least a portion of the at least one braided layer.4. The medical device of claim 1 , wherein the coating comprises a parlyene coating covering at least a portion of the at least one braided layer.5. The medical device of claim 1 , wherein the coating comprises a polymeric fabric coating located on an outside surface of the at least one braided layer claim 1 , wherein the polymeric fabric coating is deposited on the outside surface of the at least one braided layer through an electrospinning process6. The medical device of claim 1 , wherein the coating comprises a ceramic coating on ...

E-spun medical balloon having varied thickness and methods for forming same

The disclosed subject matter describes systems and methods of electrospinning a fiber for a variety of applications. An exemplary embodiment includes a medical device application for delivering a therapeutic agent, such as a sclerosing agent, to the walls of a blood vessel to perform sclerotherapy. A method of fabricating a medical balloon comprises charging a polymer material with an electric voltage, dispensing the charged polymeric material through a nozzle, collecting the charged polymeric material on a grounded mandrel, wherein the mandrel includes a tubular body having a plurality of openings extending through the tubular body, and forming an electrospun medical balloon defined by a body having a varied thickness.

CENTERED BALLOON FOR THE LEFT ATRIAL APPENDAGE

A medical device for reducing the volume of a left atrial appendage (LAA) may include an elongate shaft having a distal portion, and a volume-reducing means expandable from a collapsed to an expanded state, the volume-reducing means being releasably attached to the distal portion. The volume-reducing means may include an actuatable frame and an impermeable covering disposed over the frame. The volume-reducing means may be sized to fit within the LAA in the expanded state while maintaining an open fluid flow path from a distal region through the ostium of the LAA. A medical device may include a second volume-reducing means to be placed within and substantially occlude a distalmost region of the LAA. A method may include inserting a volume-reducing means into the LAA, expanding the volume-reducing means, and positioning the volume-reducing means such that an open fluid flow path is maintained through an entire cycle of the heart. 1. (canceled)2. A volume reducing device for a left atrial appendage comprising:a distal hub;a proximal hub,the distal hub and the proximal hub defining a longitudinal axis therebetween;an actuatable support frame which includes a plurality of struts extending from the distal hub to the proximal hub,wherein the actuatable support frame has a radially collapsed configuration and a radially expanded configuration defining an interior volume sized and configured to fit within the left atrial appendage;a substantially impermeable covering supported by the actuatable support frame,wherein the substantially impermeable covering prevents blood from entering or leaving the interior volume of the radially expanded configuration of the actuatable support frame; anda plurality of anchoring members which extend radially outward from the plurality of struts of the actuatable support frame,wherein the plurality of anchoring members is configured and adapted to anchor and position the volume reducing device in a spaced-apart relationship with a lateral wall ...

MEDICAL DEVICE FOR CLOSING AN OPENING OR ISOLATING A STRUCTURE IN THE CARDIOVASCULAR SYSTEM

An apparatus for closure of an opening or isolation of a structure in the cardiovascular system. The apparatus generally includes an occluding segment, a delivery segment and a control segment. The occluding segment may be composed of one or more independently inflatable members which are detachably or permanently attached to a distal portion of the delivery segment. The occluding segment may contain a stem-like member, which constrains expansion of the inflatable member in one or more directions. The apparatus is intended to enable a combination of the following: inflation of the occluding segment, ‘over the wire’ advancement, detachment of a portion of the device, and steerability. Finally, the control segment may contain components such as ports, handles, and other mechanisms which enable safe and effective implantation of the device. 1. An occlusive device for placement in the cardiovascular system , comprising:one or more inflatable member(s), each having a proximal and distal end, and containing at least one valve;a catheter portion with two or more lumens, each having a proximal and distal end; andat least one elongate member, movably disposed within each lumen.2. An occlusive device in accordance with claim 1 , further comprising a patch claim 1 , made of an elastic material claim 1 , covering said inflatable member(s).3. An occlusive device in accordance with claim 1 , wherein at least one stem-like member is attached to the distal and proximal ends of each inflatable member.4. An occlusive device in accordance with claim 3 , wherein said stem-like member contains one or more lumens.5. An occlusive device in accordance with claim 3 , wherein said stem-like member contains one or more valves and one or more transversely placed holes.6. An occlusive device in accordance with claim 3 , wherein said stem-like member contains portions of different elastic modulus.7. An occlusive device in accordance with claim 3 , whereby following deployment of the device claim ...

Blood pump

Apparatus and methods are described including a catheter ( 20 ), a first pump ( 24 U) disposed on the catheter, and a second pump ( 24 D) disposed on the catheter, proximally to the first pump. A control unit ( 52 ) is configured to control activation of the first and second pumps. The first and second pumps are configured, when activated, to pump fluid in opposite directions from one another. Other applications are also described.

Methods And Systems For Establishing Retrograde Carotid Arterial Blood Flow

Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. The flow control assembly includes one or more components that interact with the blood flow through the shunt. 1. A method of treating a lesion in a carotid artery of a patient having an arterial blood system and a venous blood system , comprising:positioning an arterial access sheath into a common carotid artery via an insertion site in the patient's neck;blocking blood flow in at least a portion of the common carotid artery to establish retrograde blood flow through the common carotid artery such that blood flows into a lumen of the arterial access device;shunting blood from the common carotid artery to a femoral vein of the patient via the arterial access sheath; andtreating the lesion by deploying a stent on the lesion.2. The method of claim 1 , further comprising making an incision at the insertion site to expose a region of the common carotid artery.3. The method of claim 1 , further comprising deploying a filter in the arterial blood system at a location distal of the lesion.4. The method of claim 1 , wherein the arterial access device comprises a working length of 5 cm to 15 cm.5. The method of claim 2 , further comprising forming a penetration in a wall of a common carotid artery via the incision claim 2 , the penetration being located at distance of around 5 cm to 7 cm below a bifurcation location where the patient's common carotid artery bifurcates into an internal carotid artery and external carotid artery.6. The method of ...

Adjustable Flow Narrow Profile Balloon for Use With a Catheter and Methods of Use

An adjustable flow narrow profile balloon device for use in an aorta has a catheter and an adjustable flow device comprising a scaffold having an anchored end fixed to the catheter, a movable end distal to the fixed end and support extending between the anchored end and the movable end, and a flexible tube attached to the support and at least one tension wire attached to the movable end and extending through the catheter such that the at least one tension wire is accessible to move the movable end of the balloon towards the anchored end when the catheter is positioned in the aorta. The adjustable flow device has a collapsed configuration; a fully occluded configuration in which the length of the support lies flat against the catheter and the flexible tube is inflated; and adjustable flow configurations allowing for a desired amount of fluid flow past the device. 1. An adjustable flow narrow profile balloon device for use in an aorta comprising:a catheter; and [ an anchored end fixed to the catheter;', 'support extending between the anchored end and the movable end,', 'a movable end distal to the fixed end; and'}], 'a scaffold circumscribing the catheter and comprising, 'the support having a first joint and a second joint along a length of the support;', 'at least one tension wire attached to the movable end and extending through the catheter such that the at least one tension wire is accessible to move the movable end of the balloon towards the anchored end when the catheter is positioned in the aorta,', 'a flexible tube attached to the support between the first joint and the second joint and circumscribing the support, the flexible tube configured to be inflated to varying degrees; and'}], 'an adjustable flow device comprising a collapsed configuration in which the first joint and second joint are straight such that the length of the support lies flat against the catheter and the flexible tube is deflated;', 'a fully occluded configuration in which the first joint ...

MULTI-LAYER BRAIDED STRUCTURES FOR OCCLUDING VASCULAR DEFECTS

A collapsible medical device and associated methods of occluding an abnormal opening in, for example, a body organ, wherein the medical device is shaped from plural layers of a heat-treatable metal fabric. Each of the fabric layers is formed from a plurality of metal strands and the assembly is heat-treated within a mold in order to substantially set a desired shape of the device. By incorporating plural layers in the thus-formed medical device, the ability of the device to rapidly occlude an abnormal opening in a body organ is significantly improved. 1103-. (canceled)104. A medical device for occluding a target site , the medical device comprising:a tubular fabric structure having proximal and distal ends and a preset, expanded configuration, wherein the tubular fabric structure comprises at least one layer of braided fabric comprising a plurality of braided strands, the plurality of braided strands having ends secured together at each of the proximal and distal ends, the tubular fabric structure configured to be constrained to a reduced configuration for delivery to the target site and to at least partially return to the preset, expanded configuration within the target site when unconstrained, wherein the preset, expanded configuration comprises at least three expanded volume sections and a plurality of intermediate clamps arranged in a repeating pattern with each intermediate clamp extending between a pair of expanded volume sections, and each expanded volume section having a cross-sectional dimension that is larger than a cross-sectional dimension of a respective intermediate clamp, and wherein at least one expanded volume section has a cross-sectional dimension at least as large as that of the target site and is generally spherical or ovaloid in shape in the preset, expanded configuration.105. The medical device of claim 104 , wherein a plurality of the expanded volume sections are generally spherical or ovaloid in shape in the preset claim 104 , expanded ...

Mechanotransductive bowel extender device having local delivery of medically relevant liquids

A mechanotransductive bowel extender device that can be used to correct short bowel syndrome by applying tension to the bowel tissue which, via the process of mechanotransduction, grows in length in response to the applied tension. Such a device is placed within the small bowel and applies tension over a period of several days or weeks by attaching to the lumen of the bowel at two different locations and moving those two points apart, stretching the tissue between. The extender device further capable of localized application and/or evacuation of medically relevant liquid and other material within the bowel.

BALLOON DILATION ASSEMBLY

A balloon dilation assembly for use in balloon valvuloplasty is disclosed, which includes at least three outer balloons arranged around a central balloon and fixed to the central balloon, wherein each balloon has a supply tube for inflation and flow channels are provided between each adjacent pair of outer balloons, whereby at least one of the outer balloons is shorter in length than the remaining outer balloons and the central balloon. 1. A balloon dilation assembly for use in balloon valvuloplasty comprising:at least three outer balloons arranged around a central balloon and fixed thereto, wherein each balloon has a supply tube for inflation and flow channels are provided between each adjacent pair of outer balloons, whereby at least one of the outer balloons is shorter in length than the other outer balloons and the central balloon.2. The balloon dilation assembly according to claim 1 , having three to six outer balloons.3. The balloon dilation assembly according to claim 1 , wherein all outer balloons are shorter in length than the central balloon.4. The balloon dilation assembly according to claim 1 , wherein one of the outer balloons is an arrangement of two balloons arranged one after the other.5. The balloon dilation assembly according to claim 4 , wherein the two balloons are movable relative to each other along a longitudinal axis of the supply tube connecting the balloons.6. The balloon dilation assembly according to claim 1 , further comprising a protective element in form of a filter placed in the area of the aortic arch in a use position.7. The balloon dilation assembly according to claim 1 , further comprising a protective element in form of an occluder placed in the area of the aortic arch in a use position.8. A method of performing balloon valvuloplasty using a transfemoral approach comprising the steps of:a) providing a balloon dilation assembly having at least three outer balloons arranged around a central balloon and fixed thereto;b) inserting a ...

Occlusion perfusion catheter

Catheters for occluding, visualizing, irrigating, evacuating, and delivering agents to a treatment area are disclosed. The catheters comprise a catheter body comprising five lumens, first and second occlusion balloons coupled to the catheter body, an optional space-occupying balloon coupled to the catheter body and disposed between the first and second occlusion balloons, and an optional visualization means that enables visualization between the first and second occlusion balloons. Methods for using these catheters are also disclosed. A method comprises inflating the first and second occlusion balloons, inflating the space-occupying balloon, allowing fluid to exit via an evacuation lumen, optionally irrigating or aspirating to facilitate fluid exit via said lumen, and delivering an agent to a treatment area via the agent lumen.

ENDOVASCULAR CATHETER WITH MULTIPLE CAPABILITIES

An endovascular catheter combination configured to have multiple capabilities is disclosed. These capabilities include proximal and distal occlusion of a segment of a target blood vessel (such as the carotid artery) thus excluding the segment of the blood vessel from circulation for purposes such as surgical consideration. Another capability includes intravascular shunting of the blood through the excluded portion of the artery during a procedure such as an endarterectomy. Additionally, a microsensor provides a measurement of the rate/volume of blood flow through the distal end of the catheter. In one embodiment, a guidewire is provided with a filtration mesh as an anti-embolic mechanism both at the time of initial positioning of the catheter and after reversing the occlusion. 1. An endovascular catheter comprising:a flexible lumen with a leading end, a trailing end and a central portion disposed between the leading end and the trailing end with an outside surface and an internal surface;a first syringe and a second syringe, each disposed proximate the trailing end of said flexible lumen;at least one aperture in the central portion of said flexible catheter, the at least one aperture being fluidly connected to an opening at the leading end thereby providing a bypass;a common carotid balloon operatively connected to the first syringe;an internal carotid balloon operatively connected to the second syringe;a blood flow sensor disposed at the leading end of said bypass that monitors blood flow through the at least one aperture wherein said sensor includes a means to wirelessly transmit flow readings to an external receiver, andwherein the internal carotid balloon is disposed proximate the leading end and the common carotid balloon is disposed between the internal carotid balloon and the at least one aperture, the internal carotid balloon and the common carotid balloon being spaced apart by a distance that when said internal carotid balloon and said common carotid ...

Method and Apparatus for Treating a Carotid Artery

One disclosed embodiment comprises a method for treating lesions in the carotid artery of a mammalian body. The method comprises transcervical access and blocking of blood flow through the common carotid artery (with or without blocking of blood flow through the external carotid artery), shunting blood from the internal carotid artery and treating the lesion in the carotid artery. 1. A method of treating a carotid artery , comprising:forming a puncture opening through a wall of the common carotid artery;positioning through the puncture an arterial access sheath and dilator system, wherein the arterial access sheath and dilator system comprises an arterial access sheath and a dilator inside the arterial access sheath, wherein the arterial access sheath comprises a first occlusion element adapted to occlude the carotid artery and wherein the dilator comprises a tapered distal end; andremoving the dilator from the arterial access sheath; and expanding the first occlusion element to occlude the carotid artery.2. A method as in claim 1 , wherein forming the puncture opening comprises making the puncture opening directly into the common carotid artery accessed through a transcervical surgical incision.3. A method as in claim 1 , wherein forming the puncture opening comprises performing a percutaneous puncture into the common carotid artery.4. A method as in claim 1 , further comprising:reversing the direction of natural blood flow in the carotid artery; andshunting blood from the carotid artery to a venous system of the patient via the arterial access sheath.5. A method as in claim 1 , further comprising:introducing a therapeutic catheter through the arterial access sheath; andtreating the carotid artery.6. A method as in claim 5 , wherein the therapeutic catheter is a stent delivery catheter and treating the carotid artery comprises deploying a stent using the stent delivery catheter.7. A method as in claim 1 , wherein the arterial access sheath comprises a second ...

Multi-layer braided structures for occluding vascular defects

A collapsible medical device and associated methods of occluding an abnormal opening in, for example, a body organ, wherein the medical device is shaped from plural layers of a heat-treatable metal fabric. Each of the fabric layers is formed from a plurality of metal strands and the assembly is heat-treated within a mold in order to substantially set a desired shape of the device. By incorporating plural layers in the thus-formed medical device, the ability of the device to rapidly occlude an abnormal opening in a body organ is significantly improved.

Micro-Macro Endovascular Occlusion Device and Methodology

A vascular plug comprises a superstructure expandable from a collapsed percutaneous insertion configuration to an expanded deployment or use configuration. The superstructure is comprised of both primary and secondary three-dimensional shapes allowing for the occlusion of a wide range of vessel sizes from small to large through a disproportionately small delivery catheter. The plug includes a shape memory element for the generation of radial force and the creation of the larger secondary three-dimensional twisting or helical superstructure as is needed for target vessel occlusion. 1. A medical device comprising a superstructure expandable from a collapsed insertion configuration to a fully expanded deployment or use configuration ,said insertion configuration being sufficiently small to enable percutaneous introduction into a patient's vascular system,said fully expanded deployment or use configuration being sufficiently large to extend across a target blood vessel and engage an endothelial surface of such blood vessel,said insertion configuration of said superstructure taking the form of a collapsed self-expanding tubular structure expandable to said fully expanded deployment or use configuration, said fully expanded deployment or use configuration being a three-dimensional twisted or helical form of said tubular structure,said twisted or helical form of said tubular structure having a plurality of turns or windings of respective outer diameters,said plurality of turns or windings including at least one terminal turn or winding at at least one of two opposite ends of said twisted or helical form of said tubular structure and further including at least one center turn or winding intermediate said two opposite ends,said at least one center turn or winding having an outer diameter that is larger than a largest outer diameter of said at least one terminal turn or winding,said fully expanded deployment or use configuration having an arcuate envelope or shape that tapers ...

METHODS AND SYSTEMS FOR ESTABLISHING RETROGRADE CAROTID ARTERIAL BLOOD FLOW

Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. The flow control assembly includes one or more components that interact with the blood flow through the shunt. 114.-. (canceled)15. A system for use in accessing and treating a carotid artery , said system comprising:an arterial access sheath formed of an elongated body sized and shaped to be introduced into a common carotid artery, the arterial access sheath having an internal lumen that can receive blood flow;a shunt that fluidly communicates with the arterial access sheath, wherein the shunt provides a pathway for blood to flow from the arterial access sheath; anda flow control assembly mechanically attached to the pathway of the shunt, wherein the flow control assembly defines two or more parallel flow paths and a valve to open or close one or more of the flow paths to selectively direct blood flow through one or more of the flow paths.16. A system as in claim 15 , further comprising a port fluidly communicating with the shunt claim 15 , wherein the port may be used to connect an aspiration device to the shunt.17. A system as in claim 16 , further comprising an control valve that controls fluid communication between the shunt and the port.18. A system as in claim 17 , wherein the control valve automatically opens upon attachment of an aspiration or injection device claim 17 , and wherein the control valve automatically closes with removal of the aspiration or injection device.19. A system as in claim 16 , wherein the aspiration ...

OCCLUDING CATHETER AND DYNAMIC METHOD FOR PREVENTION OF STROKE

A system for use in prevention of stroke is provided that has a shaft that carries an occluding balloon. The occluding balloon is inflated to occlude blood flow through at least one of a right carotid artery and a left carotid artery. An actuation device for causing inflation of the occluding balloon is present. The inflation is applied in a cyclical nature based upon a cardiac cycle. The cyclical inflation of the occluding balloon in turn causes a resulting cyclical occlusion. 1. A system for use in prevention of stroke , comprising:a shaft that carries an occluding balloon, wherein the occluding balloon is inflated to occlude blood flow through, at least one of a right carotid artery and a left carotid artery; andan actuation device for causing inflation of the occluding balloon, wherein the inflation is applied in a cyclical nature based, upon a cardiac cycle, wherein the cyclical inflation of the occluding balloon in turn causes a resulting cyclical occlusion.2. The system as set forth in claim 1 , wherein the inflation to cause the occlusion is applied during a systole phase of the cardiac cycle claim 1 , and wherein a lesser degree of inflation is applied to the occluding balloon during a diastole phase of the cardiac cycle.3. The system as set forth in claim 2 , wherein the lesser degree of inflation applied to the occluding balloon during the diastole phase is no inflation such that the occluding balloon is fully deflated during the diastole phase.4. The system as set forth in claim 2 , wherein the systole phase has an early portion claim 2 , and wherein the lesser degree of inflation is applied to the occluding balloon during the early portion of the systole phase claim 2 , wherein the inflation to cause the occlusion is applied during the remaining portion of the systole phase that is not the early portion of the systole phase.5. The system as set forth in claim 1 , wherein the occluding balloon claim 1 , is inflated to such a degree that blood flow ...

Catheter for prevention of stroke and method of use

A catheter for prevention of stroke by diverting and filtering the blood flow to carotid and vertebral arteries is provided. The catheter includes at least one balloon with an outer mesh cover that expands upon the balloon inflation and collapses upon balloon deflation. Partial inflation of balloons provides for full mesh expansion in the target vessel with resulting capturing and retrieval of embolic particles. The inflation of the balloon in the aortic arch or head vessels expands the balloon associated filtering mesh leading to both filtering and deflection of embolic particles from the cerebral circulation, while balloon deflation triggers the mesh collapse and promotes its recapturing and retrieval while minimizing the risk of spillage of captured emboli.

ASSIST DEVICE FOR SCLEROSING TREATMENT OF VARICOSE VEINS

Assist device () for sclerosing treatment of varicose veins, aimed at being partially inserted into a blood vessel (), including a tubular element (), which has at least three ways (), at least two of which () are connected to at least one related inflatable balloon element () by at least one through hole (), and at least one remaining way () of said three ways () has at least one hole () for the passage of a sclerosing substance (), aimed at reaching a wall () of said blood vessel (), in which at least one () of said at least two balloon elements () has an elongated shape extending toward at least another balloon element (′) and a volume comprised in the range of 30% to 99% of the space inside said blood vessel. 114-. (canceled)15. A method for the sclerosing treatment of a blood vessel wall , comprising:providing a catheter comprising at least two inflatable balloons, said at least two inflatable balloons comprising an elongated inflatable balloon and a second inflatable balloon, said at least two inflatable balloons being connected through a tubular element and being inflatable and/or deflatable through said tubular element;inserting the catheter in a blood vessel to be treated;inflating said elongated inflatable balloon through said tubular element in order to dislocate the blood contained in said blood vessel;while the elongated inflatable balloon is inflated, inflating the second inflatable balloon of said at least two inflatable balloons through said tubular element to form a second inflated balloon to close a portion of said blood vessel along a length substantially defined by said elongated inflated balloon and said inflated second balloon to form a residual volume between (a) said elongated inflated balloon and said second inflatable balloon and (b) said blood vessel wall; andinjecting a sclerosing drug into the blood vessel through said tubular element to substantially fill said residual volume between (a) said inflated elongated balloon and said second ...

MULTI-LAYER BRAIDED STRUCTURES FOR OCCLUDING VASCULAR DEFECTS

A collapsible medical device and associated methods of occluding an abnormal opening in, for example, a body organ, wherein the medical device is shaped from plural layers of a heat-treatable metal fabric. Each of the fabric layers is formed from a plurality of metal strands and the assembly is heat-treated within a mold in order to substantially set a desired shape of the device. By incorporating plural layers in the thus-formed medical device, the ability of the device to rapidly occlude an abnormal opening in a body organ is significantly improved. 183-. (canceled)84. A collapsible medical device comprising an outer fabric layer surrounding at least one inner fabric layer , each of the outer and inner fabric layers comprising proximal and distal ends and a central axis extending therebetween , each of the outer and inner fabric layers comprising a plurality of braided metal strands having proximal and distal ends , the outer and inner fabric layers having an expanded preset configuration comprising proximal and distal geometrically shaped end sections coaxial with a central geometrically shaped part therebetween , the proximal and distal geometrically shaped end sections and the geometrically shaped central part being disposed along the central axis and the proximal and distal ends of the outer and inner fabric layers corresponding to the proximal and distal ends of the plurality of braided metal strands , at least one of the proximal and distal geometrically shaped end sections and the central geometrically shaped part coupled by at least one connector having a cross-sectional area smaller than the cross-sectional area of each of the proximal and distal geometrically shaped end sections and the central geometrically shaped part such that the at least one of the proximal and distal geometrically shaped end sections and the central geometrically shaped part are configured to articulate about the at least one connector.85. The collapsible medical device according ...

Floating, multi-lumen-catheter retractor system for a minimally-invasive, operative gastrointestinal treatment

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

SUBSTANTIALLY RIGID AND STABLE ENDOLUMINAL SURGICAL SUITE FOR TREATING A GASTROINTESTINAL LESION

Exemplary embodiments of devices and method for affecting at least one anatomical tissue can be provided. A configuration can be provided that includes a structure which is expandable (i) having and/or (ii) forming at least one opening or a working space through which the anatomical tissue(s) is placed in the structure. For example, the structure, prior to being expanding, can have at least one partially rigid portion. In addition, or as an alternative, upon a partial or complete expansion thereof, the structure can be controllable to have a plurality of shapes. Further, the structure can be controllable to provide the working space with multiple shapes and/or multiple sizes. 133-. (canceled)34. An endoscopic system , comprising:an endoscope receiving member having a proximal balloon inflatable along a distal portion of the multi-lumen endoscope receiving member, a first lumen configured to receive an endoscope therethrough;a distal balloon positioned distal of the proximal balloon and inflatable beyond a distal end of the endoscope receiving member to form a chamber between the proximal and distal balloons;first and second strips between the proximal and distal balloons; andan endoscope slidably disposed within the first lumen such that a distal tip of the endoscope is extendable into the chamber.35. The endoscopic system of claim 34 , wherein the system is suitable for accessing tissue along a wall of a body lumen claim 34 , and wherein the chamber comprises an expanded portion of the proximal and distal balloons when inflated.36. The endoscopic system of claim 34 , further comprising a handle at a proximal portion of the endoscope receiving member actuatable to move the first and second strips.37. The endoscopic system of claim 34 , further comprising a first instrument slidably disposed within a second lumen in the endoscope receiving member or the endoscope claim 34 , wherein a distal end of the first instrument is insertable into the chamber formed between the ...

METHOD AND APPARATUS FOR TREATING AN ARTERIAL LESION

One disclosed embodiment comprises a method for treating lesions in the carotid artery of a mammalian body. The method comprises transcervical access and blocking of blood flow through the common carotid artery (with or without blocking of blood flow through the external carotid artery), shunting blood from the internal carotid artery and treating the lesion in the carotid artery. 1. A method of treating a lesion in a carotid artery of a patient , comprising:inserting an arterial access device into an artery through an arterial access location wherein the arterial access sheath comprises a first, expandable occlusion element adapted to occlude the common carotid artery;positioning at least a portion of the arterial access device into a common carotid artery;expanding the first occlusion element to occlude the common carotid artery;actively pumping blood from the common carotid artery to a return location via the arterial access device and a shunt connected to the arterial access device, wherein the arterial access device comprises an elongate member defining an internal lumen that extends from a distal opening at a distal region of the arterial access device to a proximal opening at a proximal region of the arterial access device, wherein the internal lumen receives blood flow through the distal opening from the common carotid artery, and wherein the shunt comprises a shunt lumen connected to the arterial access device at a location between the distal and proximal openings of the arterial access device, and wherein the shunt provides a pathway for blood to flow out of the internal lumen of the arterial access device at a location between the distal and proximal openings of the arterial access device; andtreating the lesion by deploying a stent on the lesion.2. The method of claim 1 , wherein actively pumping blood comprises using a syringe fluidly connected to the arterial access device to aspirate the blood from the arterial access device.3. The method of claim 1 , ...

Coronary Sinus Cannulation

A method of visually locating a vessel within a body lumen comprises displacing an opaque fluid with an inflatable member contained within an open area of a barrier or membrane. The method also comprises positioning the inflatable member against or adjacent to a tissue region at a first location and visually assessing the tissue region at the first location through the inflatable member. The method also comprises repositioning the inflatable member against or adjacent to the tissue region at a second location. 112-. (canceled)13. A method of visually locating a vessel within a body lumen , comprising: 'positioning the inflatable member against or adjacent to a tissue region at a first location;', 'displacing an opaque fluid with an inflatable member contained within an open area of a barrier or membrane;'} 'repositioning the inflatable member against or adjacent to the tissue region at a second location.', 'visually assessing the tissue region at the first location through the inflatable member; and'}14. The method of further comprising collapsing the inflatable member such that the open area is unobstructed.15. The method of further comprising displacing opaque fluid with a transparent fluid through a fluid delivery lumen defined through a catheter through which the barrier or membrane extends from the open area defined by the barrier or membrane and the tissue region at the second location.16. The method of wherein displacing opaque fluid with a transparent fluid comprises pumping saline claim 15 , plasma claim 15 , water claim 15 , or perfluorinated liquid into the open area such that blood is displaced from therefrom.17. The method of further comprising advancing the barrier or membrane into a left atrial chamber of a heart prior to displacing an opaque fluid with an inflatable member.18. The method of wherein repositioning comprises moving the inflatable member along the tissue region while visualizing the tissue region through the inflatable member.19. The ...

VENA-CAVAL OCCLUSION ELEMENT

Apparatus and methods are described including a catheter, a first pump disposed on the catheter, and a second pump disposed on the catheter, proximally to the first pump. A control unit is configured to control activation of the first and second pumps. The first and second pumps are configured, when activated, to pump fluid in opposite directions from one another. Other applications are also described. 168-. (canceled)69. Apparatus , comprising:an occlusion element configured to be placed inside a vena cava of a subject at a first location that is upstream of junctions of the vena cava with all renal veins of the subject, and to partially occlude the vena cava at the location;one or more sensors configured to detect one or more physiological parameter of the subject; anda computer processor configured to modulate an extent to which the occlusion element occludes the vena cava at the location, responsively to the one or more detected physiological parameters of the subject.70. The apparatus according to claim 69 , wherein the one or more sensors comprise one or more sensors selected from the group consisting of: a pressure sensor configured to detect venous blood pressure at a second location that is upstream of the occlusion element claim 69 , a pressure sensor configured to detect venous blood pressure at a third location that is downstream of the occlusion element claim 69 , a flow sensor claim 69 , a thermal flow sensor claim 69 , and an oxygen-saturation sensor.71. The apparatus according to claim 69 , wherein the occlusion element comprises a balloon claim 69 , and wherein the computer processor is configured modulate the extent to which the occlusion element occludes the vena cava at the location by controlling inflation of the balloon.72. The apparatus according to claim 69 , wherein the occlusion element comprises a frame that is covered in a blood-impermeable material claim 69 , and wherein the computer processor is configured modulate the extent to which ...

Methods and systems for establishing retrograde carotid arterial blood flow

Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. The flow control assembly includes one or more components that interact with the blood flow through the shunt.

Endoluminal device with retractor system

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

Methods And Systems For Establishing Retrograde Carotid Arterial Blood Flow

Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. The flow control assembly includes one or more components that interact with the blood flow through the shunt. 1. A method for treating a carotid artery , comprising:forming an access location in an entry artery of a patient;positioning an arterial access sheath into the entry artery and to a common carotid artery, wherein the access sheath includes an expandable element;expanding the expandable element so that the expandable element blocks blood flow through the common carotid artery past the sheath and establish retrograde blood flow through the internal carotid artery and into the sheath, wherein blood flows into a shunt of the sheath while the common carotid artery remains blocked;actively assisting blood flow from the common carotid artery into the sheath and into the shunt;flowing the blood from the shunt to a return location.2. A method as in claim 1 , wherein the entry artery is the femoral artery.3. A method as in claim 1 , wherein the entry artery is the common carotid artery.4. A method as in claim 3 , wherein forming an axis location in an entry artery of the patient comprises forming a penetration in a wall of a common carotid artery via a transcervical incision claim 3 , the penetration being located at distance of around 5 cm to 7 cm below a bifurcation location where the patient's common carotid artery bifurcates into an internal carotid artery and external carotid artery;5. A method as in claim 4 , wherein positioning ...

Method and Apparatus for Treating a Carotid Artery

One disclosed embodiment comprises a method for treating lesions in the carotid artery of a mammalian body. The method comprises transcervical access and blocking of blood flow through the common carotid artery (with or without blocking of blood flow through the external carotid artery), shunting blood from the internal carotid artery and treating the lesion in the carotid artery.

Blood pump

Apparatus and methods are described including a blood pump that includes a catheter, a first impeller disposed on the catheter, and a second impeller disposed on the catheter, proximally to the first impeller. A control unit drives the first and second impellers to pump blood of a subject, by driving the first and second impellers to rotate. The blood pumps is configured such that (a) the first and second impellers are shaped differently from each other when the first and second impellers are in non-radially-constrained configurations, (b) the first and second impellers are sized differently from each other when the first and second impellers are in non-radially-constrained configurations, and/or (c) the first and second impellers are driven by the control unit to rotate under respective rotation conditions that are different from each other. Other applications are also described.

FISTULA MANAGEMENT DEVICE AND METHOD

A fistula management device for preventing enteric contents from leaking out of a bowel via a fistula opening in the bowel. The device comprises a tubular body that defines a main fluidic passageway extending from a first axial end to a second axial end of the tubular body. Inflatable cuffs are located at each of the first and second axial ends of the tubular body for creating a fluid seal between the first and second axial ends of the tubular body and inner walls of a bowel. 1. A fistula management device , comprising:a tubular body extending from a first axial end to a second axial end and defining a main fluidic passageway between said first and second axial ends;inflatable cuffs located at each of said first and second axial ends of said tubular body, said inflatable cuffs being configured to seal against inner walls of a bowel.2. A fistula management device as defined in claim 1 , further comprising:at least one inflation gas tube in fluidic communication with said inflatable cuffs for supplying inflation gas to and from said inflation cuffs.3. A fistula management device as defined in claim 2 , wherein said at least one inflation gas tube extends axially along said tubular body.4. A fistula management device as defined in claim 1 , further comprising:an auxiliary tube extending from said tubular body at a location between said first and second axial ends, said auxiliary tube having an external port fluidly connected to said main fluidic passageway.5. A fistula management device as defined in claim 4 , wherein said tubular body has a reinforcing rib extending axially from said auxiliary tube to said inflatable cuffs.6. A fistula management device as defined in claim 5 , further comprising:at least one inflation gas tube in fluidic communication with said inflatable cuffs for supplying inflation gas to and from said inflatable cuffs, said at least one inflation gas tube extending along said rib from said auxiliary tube to said inflatable cuffs and laterally away ...

MEDICAL DEVICES

Medical devices, and related components and methods, are disclosed. 1. A method for treating a target site in the body , the method comprising: a tubular member having a proximal portion, a distal portion and a lumen extending therein; and', 'an inflatable member disposed on the distal portion of the tubular member;, 'inserting a catheter into a body lumen of a patient, the catheter comprisinginflating the inflatable member such that at least a portion of the distal portion of the tubular member substantially aligns with a longitudinal axis of the body lumen;delivering an embolic material into the body lumen to form a first occlusion at a first location;deflating the inflatable member;rotating the tubular member within the body lumen such that the embolic material may be injected in a second direction different from the first direction.2. The method of claim 1 , wherein the inflatable member is eccentrically disposed on the distal portion of the tubular member.3. The method of claim 2 , wherein the inflatable member has a first wall portion having a first thickness and a second wall portion having a second wall thickness claim 2 , the second wall thickness being greater than the first wall thickness.4. The method of claim 3 , wherein the inflating the inflatable member includes inflating the first wall portion at a greater rate than the second wall portion claim 3 , and wherein inflating the second wall portion at a greater rate forms a curve in the distal portion of the tubular member.5. The method of claim 1 , wherein the embolic material is selected from the group consisting of embolic gels claim 1 , embolic particles claim 1 , embolic coils claim 1 , and combinations thereof.6. The method of claim 1 , wherein the embolic material comprises embolic particles.7. The method of claim 1 , wherein the embolic material comprises an embolic gel.8. The method of claim 1 , wherein the body lumen comprises one or more branches of the portal vein.9. The method of claim 1 , ...

Methods And Systems For Establishing Retrograde Carotid Arterial Blood Flow

Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. The flow control assembly includes one or more components that interact with the blood flow through the shunt. 1. A method for accessing and treating a carotid artery , comprising:inserting an arterial access sheath into a patient's neck and through a wall of a common carotid artery at an arterial access site, wherein the arterial access sheath has a structural configuration that limits a depth of insertion of a distal portion of the arterial access sheath into the common carotid artery;positioning a filter in an internal carotid artery distal of a location of treatment;inserting an interventional device into the common carotid artery via the arterial access sheath.2. The method of claim 1 , wherein structural configuration of the arterial access sheath limits the distal portion the from being inserted into the common carotid artery beyond a length such that the distal portion would contact a bifurcation location where the patient's common carotid artery bifurcates into an internal carotid artery and external carotid artery.357. The method of claim 1 , wherein the arterial access site is located at distance of cm to cm below the bifurcation location where the patient's common carotid artery bifurcates into an internal carotid artery and external carotid artery.4. The method of claim 1 , wherein structural configuration of the arterial access sheath limits the distal portion the from being inserted into the common carotid artery beyond ...

Kits and methods for visualizing a cardiac chamber for connection to a mechanical circulatory support device

Systems, kits, and methods that provide direct visualization of a patient's surgical field and intracardiac structures during implantation of a mechanical circulatory support device. Kits and methods can provide for seamless implantation of such devices, which reduces the risks and time associated with mechanical circulatory support device implantation. Further, methods are provided that can avoid cardiopulmonary bypass.

Sustantially rigid and stable endoluminal surgical suite for treating a gastrointestinal lesion

Exemplary embodiments of devices and method for affecting at least one anatomical tissue can be provided. A configuration can be provided that includes a structure which is expandable (i) having and/or (ii) forming at least one opening or a working space through which the anatomical tissue(s) is placed in the structure. For example, the structure, prior to being expanding, can have at least one partially rigid portion. In addition, or as an alternative, upon a partial or complete expansion thereof, the structure can be controllable to have a plurality of shapes. Further, the structure can be controllable to provide the working space with multiple shapes and/or multiple sizes.

ENDOLUMINAL DEVICE WITH RETRACTOR SYSTEM

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner. 1. An endoluminal device , comprising:a tubular member; anda chamber extending beyond a distal end of the tubular member;wherein the chamber is formed at least in part by a plurality of flexible elements, at least one of the plurality of flexible elements movable from an insertion position to an expanded position to contact target tissue in a body lumen to create a working space around the target tissue; anda substantially rigid beam movable from a first position to a second position within a lumen of a first flexible element of the plurality of flexible elements to stabilize the chamber in the expanded position.2. The endoluminal device of claim 1 , wherein the substantially rigid beam is reversibly movable within the lumen of the first flexible element.3. The endoluminal device of claim 1 , wherein the substantially rigid beam is reversibly movable along a longitudinal axis of the chamber.4. The endoluminal device of claim 1 , wherein the tubular member has a lumen dimensioned to receive an endoscopic instrument and an endoscope channel dimensioned to receive an endoscope.5. The endoluminal device of claim 4 , wherein at least one of the plurality of flexible elements extends radially outward on one side of a longitudinal axis of the tubular member when the at least ...

Electrophysiology mapping and visualization system

Electrophysiology mapping and visualization systems are described herein where such devices may be used to visualize tissue regions as well as map the electrophysiological activity of the tissue. Such a system may include a deployment catheter and an attached hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. A position of the catheter and/or hood may be tracked and the hood may also be used to detect the electrophysiological activity of the visualized tissue for mapping.

DEVICES AND METHODS FOR TREATING AN ARTERY

A method for treating tissue of at least one of an internal carotid artery, an ophthalmic artery, or an ostium between the internal carotid artery and the ophthalmic artery of a subject may include expanding a first expandable device of a first device in the internal carotid artery. The method also may include delivering a second device in the ophthalmic artery via the first device and expanding a second expandable device of the second device in the ophthalmic artery. Further, the method may include adjusting a radial position of the second expandable device relative to the first expandable device. 1. A method for treating tissue of at least one of an internal carotid artery , an ophthalmic artery , or an ostium between the internal carotid artery and the ophthalmic artery of a subject , the method including:expanding a first expandable device of a first device in the internal carotid artery;delivering a second device in the ophthalmic artery via the first device and expanding a second expandable device of the second device in the ophthalmic artery; andadjusting a radial position of the second expandable device relative to the first expandable device from a first radial position to a second radial position different than the first radial position.2. The method of claim 1 , wherein adjusting a radial position of the second expandable device relative to the first expandable device includes pivoting the second device relative to the first device via a hinge.3. The method of claim 2 , wherein pivoting the second device relative to the first device includes proximally tightening a loop around the second device.4. The method of claim 1 , wherein adjusting a radial position of the second expandable device relative to the first expandable device includes looping the second device around the first device.5. The method of claim 1 , after the adjusting a radial position of the second expandable device relative to the first expandable device claim 1 , returning the second ...

METHODS AND SYSTEMS FOR PREVENTING BLEEDING FROM THE LEFT ATRIAL APPENDAGE

The disclosure presents methods and systems for applying a suction force to a surface of a left atrial appendage (LAA) with a tube attached to an exterior surface of an inflatable balloon. The disclosure also presents methods and systems for inflating a first inflatable balloon within a cavity of a left atrial appendage (LAA). A method may include applying a suction force with at least one tube coupled to the first inflatable balloon to attract the first inflatable balloon to an interior surface of the LAA or to a second inflatable balloon. A method may include puncturing, using a tissue-penetrating tip, a target surface of the LAA. 1. A method for treating and preventing bleeding arising from a left atrial appendage (LAA) , comprising the steps of:inflating a first inflatable balloon coupled to a catheter, the first inflatable balloon having an exterior surface;exerting, using a first tube attached to the exterior surface of the first inflatable balloon, a suction force onto a first surface of the LAA that is adjacent to the first inflatable balloon;inflating a second inflatable balloon coupled to the catheter, the second inflatable balloon having an exterior surface; andexerting, using a second tube attached to the exterior surface of the second inflatable balloon, a suction force onto a second surface of the LAA that is adjacent to the second inflatable balloon.2. The method of claim 1 , further comprising the step of:puncturing, using a tissue-penetrating tip, a target surface of the LAA.3. The method of claim 2 , wherein the suction forces are being exerted while the target surface of the LAA is being punctured.4. The method of claim 1 , wherein the first inflatable catheter balloon is located distal to an ostium of the LAA.5. The method of claim 4 , wherein the second inflatable catheter balloon is located proximal to an ostium of the LAA.6. The method of claim 1 , wherein the first surface and the second surface of the LAA are surfaces of an ostium of the LAA ...

Endoluminal system for gastrointestinal treatment

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

Endoluminal system and method for gastrointestinal treatment

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

DEVICES FOR THE TREATMENT OF VASCULAR ANEURYSM

Devices for the treatment of vascular aneurysms are described. The treatment is achieved through the delivery of an effective amount of elastin stabilization agent to an isolated volume at the aneurysm. The elastin stabilization agent maybe embedded in a delivery composition. The device optionally has an aspiration means to improve the effectiveness of the treatment. 120-. (canceled)21. A device for treating an isolated volume in a blood vessel , the device comprising:a shaft comprising a proximal end, a distal end, and a lumen extending from at or near the proximal end to at or near the distal end, wherein the lumen connects with a port at its proximal end;a proximal extendable balloon positioned on the shaft;a distal extendable balloon positioned on the shaft distally to the proximal extendable balloon; anda fluid exchange port disposed on a side of one of the proximal and distal extendable balloons and in fluid communication with the lumen for delivering a therapeutic composition introduced into the lumen from the port to the isolated volume of the blood vessel,wherein the proximal and distal extendable balloons have a lower profile configurations and extended configurations having shapes configured to push against the blood vessel wall to fluidly seal the blood vessel and form the isolated volume between the proximal and distal extendable balloons, andwherein the fluid exchange port is positioned to be in fluid communication with the isolated volume when the proximal and distal extendable balloons are in an extended configuration.22. The device of claim 21 , wherein the lumen is configured to provide fluid to extend at least one of the proximal and distal extendable balloons.23. The device of claim 22 , wherein the device is configured to slowly leak the therapeutic composition into the isolated volume while maintaining pressure in the at least one of the proximal and distal extendable balloons to keep the at least one of the proximal and distal extendable ...

ASSIST DEVICE FOR SCLEROSING TREATMENT OF VARICOSE VEINS

Assist device () for sclerosing treatment of varicose veins, aimed at being partially inserted into a blood vessel (), including a tubular element (), which has at least three ways (), at least two of which () are connected to at least one related inflatable balloon element () by at least one through hole (), and at least one remaining way () of said three ways () has at least one hole () for the passage of a sclerosing substance (), aimed at reaching a wall () of said blood vessel (), in which at least one () of said at least two balloon elements () has an elongated shape extending toward at least another balloon element (′) and a volume comprised in the range of 30% to 99% of the space inside said blood vessel. 114.-. (canceled)15. A method for sclerosing treatment of a blood vessel comprising the steps of:dislocating blood contained in an initial volume of a blood vessel to be treated;isolating from blood circulation a residual volume of the initial volume of the blood vessel to be treated, wherein said residual volume contacts an inner wall of the blood vessel;injecting a sclerosing drug in said residual volume; andcontrolling contact time between the sclerosing drug and the inner wall of the blood vessel.16. The method according to claim 15 , wherein said residual volume contacts the entire inner wall of the blood vessel.17. The method according to claim 15 , wherein the residual volume is independent from the initial volume of the blood vessel.18. The method according to claim 17 , wherein the quantity of the sclerosing drug to be injected in the residual volume is independent from the initial volume of the blood vessel.19. The method according to claim 15 , wherein the step of controlling the contact time is carried out by moving the residual volume in the blood vessel while the residual volume contains the sclerosing drug.20. The method according to claim 15 , comprising the step of repeating treatment along an axis of the blood vessel.21. The method ...

METHOD AND APPARATUS FOR TREATING AN ARTERIAL LESION

One disclosed embodiment comprises a method for treating lesions in the carotid artery of a mammalian body. The method comprises transcervical access and blocking of blood flow through the common carotid artery (with or without blocking of blood flow through the external carotid artery), shunting blood from the internal carotid artery and treating the lesion in the carotid artery. 111-. (canceled)12. A method of treating a lesion in an artery of a patient , comprising:forming an arterial access location in a common carotid artery;positioning at least a portion of the arterial access device into the common carotid artery via the arterial access location; (1) actively pumping blood from the carotid artery to the return location via the arterial access device and the shunt connected to the arterial access device; and', '(2) occluding blood flow in at least a portion of the carotid artery to form a pressure gradient that establishes retrograde blood flow through the carotid artery such that blood flows into the arterial access device and the shunt connected to the arterial access device;', 'wherein the arterial access device comprises an elongate member defining an internal lumen that extends from a distal opening at a distal region of the arterial access device to a proximal opening at a proximal region of the arterial access device, wherein the internal lumen receives blood flow through the distal opening from the common carotid artery, and wherein the shunt comprises a shunt lumen connected to the arterial access device at a location between the distal and proximal openings of the arterial access device, and wherein the shunt provides a pathway for blood to flow out of the internal lumen of the arterial access device at a location between the distal and proximal openings of the arterial access device; and, 'causing blood to flow from the carotid artery to a return location via the arterial access device and a shunt connected to the arterial access device by at least ...

Intraluminal occlusion device and method

A vascular occlusion device for occluding a blood vessel including a lumen, a resilient deformable member in communication with the lumen, and a fluid-impervious cover surrounding the deformable member, wherein the deformable member has an expanded state at atmospheric pressure and a collapsed state at a second pressure that is lower than atmospheric pressure. Also, a method for occluding a blood vessel using a vascular occlusion device comprised of a lumen, a deformable member in communication with the lumen at the distal end of the lumen, and a fluid impervious cover surrounding the deformable member, including the steps of deflating the deformable member by reducing the pressure therein below atmospheric pressure, inserting the distal end into a blood vessel, and allowing the deformable member to inflate by allowing the pressure in the deformable member to return to atmospheric pressure.

Systems and methods for delivering drugs to selected locations within the body

A method is provided for delivering a drug to a selected tissue region within a patient's body with a catheter having a deployable puncturing element, a drug delivery element and an orientation element on a distal portion thereof. The distal portion of the catheter is percutaneously introduced into a blood vessel, and directed endovascularly to a vessel location adjacent to the selected tissue region. The puncturing element is oriented towards the selected tissue region, and deployed to access the selected tissue region. A drug is delivered with the drug delivery element to the selected tissue region.

Stabilized tissue penetrating catheters

A tissue penetrating catheter that is usable to advance a tissue penetrator from within a blood vessel, through the wall of the blood vessel to a target location. The catheter includes at least one stabilizing device thereon for stabilizing catheter prior to advancing the tissue penetrator. The tissue penetrator may extend through a lumen in the body of the catheter and project transversely through an exit port. The stabilizing device may be located closely adjacent to the exit port, or may surround the exit port. The stabilizing device may be one or more balloons, or other mechanical structure that is expandable into contact with the inner luminal wall of the blood vessel. Desirably, the exit port is forced into contact with the blood vessel wall to shorten the distance that the tissue penetrator projects from the catheter body to the target location. The catheter is particular useful for forming blood flow tracts between blood vessels, in particular in coronary revascularization procedures. Methods of utilizing such a catheter to bypass an arterial obstruction is also disclosed.

Systems and methods for delivering drugs to selected locations within the body

A transvascular system for delivering a drug to a tissue region from a blood vessel, such as a coronary vein, includes a catheter having a distal portion with puncturing, orientation, drug delivery, and imaging elements. The puncturing element is deployable for penetrating the vessel wall to access the tissue region. The orientation element, e.g. a “cage” including a plurality of struts and/or a radiopaque marker, has a predetermined relationship with the puncturing element, the imaging element detecting the location of the orientation element with respect to the tissue region to orient the puncturing element. The catheter is percutaneously introducing into the vessel, the puncturing element is oriented towards the tissue region, the puncturing element is deployed to access the tissue region, and the drug is delivered to the tissue region. An ablation device may also be deployed to create a cavity in the tissue region for receiving the drug therein, or an indwelling catheter may be advanced into and left in the tissue region. An implantable reservoir device is also disclosed, including an enclosed membrane on an expandable frame that defines a reservoir and includes a porous region. The reservoir device may be deployed and expanded within a blood vessel, and may be filled in situ or prefilled with a drug that passes through the porous region. Alternatively, a pair of expandable endovascular blockers may be used to isolate a section of a blood vessel which may be filled with a drug that may be absorbed by the surrounding tissue.

Stabilized tissue penetrating catheters

A tissue penetrating catheter that is usable to advance a tissue penetrator from within a blood vessel, through the wall of the blood vessel to a target location. The catheter includes at least one stabilizing device thereon for stabilizing catheter prior to advancing the tissue penetrator. The tissue penetrator may extend through a lumen in the body of the catheter and project transversely through an exit port. The stabilizing device may be located closely adjacent to the exit port, or may surround the exit port. The stabilizing device may be one or more balloons, or other mechanical structure that is expandable into contact with the inner luminal wall of the blood vessel. Desirably, the exit port is forced into contact with the blood vessel wall to shorten the distance that the tissue penetrator projects from the catheter body to the target location. The catheter is particular useful for forming blood flow tracts between blood vessels, in particular in coronary revascularization procedures. Methods of utilizing such a catheter to bypass an arterial obstruction is also disclosed.

Device, system and method for intersititial transvascular intervention

Method and apparatus for utilizing the vascular system as a conduit to reach other vascular and extravascular locations within the body. Included are methods for revascularization wherein the extravascular passageways are formed to permit blood flow between vascular locations. Also included are methods for performing transvascular interstitial surgery (TVIS) wherein extravascular passageways are formed from a blood vessel to another vascular or non-vascular intracorporeal location. Also disclosed are devices usable for forming extravascular passageways in accordance with the invention, or for modifying, valving, maintaining or closing such passageways.

Method and device for distending a gynecological cavity

Method and device for distending a gynecological cavity. According to one embodiment, a mechanical, non-fluid device is used to distend the gynecological cavity. Such devices include, for example, self-expanding members, such as resilient baskets, coils, whisks, prongs, and loops, or mechanically expanded members, such as inflatable balloons, mechanically-expanded cages and loops, and scissor jacks. The device may serve a purpose in addition to distension, such as illumination, imaging, irrigation, drug delivery, resection and cauterization.

Device for conservative therapy of nose and paranasal sinuses diseases

FIELD: medicine.SUBSTANCE: invention relates to medical equipment, namely to a device for conservative therapy of nose and paranasal sinuses diseases. Device comprises obturators of the posterior and anterior nose openings, each of which is made in the form of an expandable shell of elastic material provided with a delivery tube. Distal end of the shell is coupled to the cavity beneath the shell, and its proximal end is provided with an adapter with a valve mechanism. Shell of the obturator of the posterior nose opening is tightly fixed to the distal part of its delivery tube. Shell of the obturator of the anterior nose opening is tightly fixed to the cuff. There are two channels in the cuff, one of which has a delivery tube of the obturator of the posterior nose opening so that the cuff can move along the entire length of the delivery tube. In the other channel, a catheter is placed to evacuate the pathological secretion from the paranasal sinuses and/or to administrate solutions of medicinal preparations therein for diagnostic or therapeutic purposes. Catheter is placed in said channel with the possibility of moving its distal part into the space between the obturator shells.EFFECT: increased effectiveness of treatment of nose and paranasal sinuses diseases.13 cl, 13 dwg РОССИЙСКАЯ ФЕДЕРАЦИЯ (19) RU (11) (13) 2 663 932 C1 (51) МПК A61B 17/12 (2006.01) A61B 17/24 (2006.01) A61B 1/233 (2006.01) ФЕДЕРАЛЬНАЯ СЛУЖБА ПО ИНТЕЛЛЕКТУАЛЬНОЙ СОБСТВЕННОСТИ (12) ОПИСАНИЕ ИЗОБРЕТЕНИЯ К ПАТЕНТУ (52) СПК A61B 17/12104 (2006.01); A61B 17/12136 (2006.01) (21)(22) Заявка: 2017126150, 21.07.2017 (24) Дата начала отсчета срока действия патента: (73) Патентообладатель(и): Козлов Владимир Сергеевич (RU), Кудряшов Степан Евгеньевич (RU) Дата регистрации: 13.08.2018 (56) Список документов, цитированных в отчете о поиске: SU 1768141 A1, 15.10.1992. WO (45) Опубликовано: 13.08.2018 Бюл. № 23 2 6 6 3 9 3 2 R U (54) УСТРОЙСТВО ДЛЯ КОНСЕРВАТИВНОЙ ТЕРАПИИ ЗАБОЛЕВАНИЙ НОСА И ОКОЛОНОСОВЫХ СИНУСОВ ...

Catheterizing body lumens

A method and related medical devices include delivering a catheter into a lumen of a subject. The catheter can include a generally tubular member having a lumen, a proximal region, and a distal region, and an inflatable member carried by a portion of the generally tubular member. The method can also include curving the portion of the generally tubular member that carries the inflatable member within the lumen of the subject, and disposing a material (e.g., an embolic material or a contrast agent) into the lumen of the generally tubular member.

Blood pump

Apparatus and methods are described including a catheter ( 20 ), a first pump ( 24 U) disposed on the catheter, and a second pump ( 24 D) disposed on the catheter, proximally to the first pump. A control unit ( 52 ) is configured to control activation of the first and second pumps. The first and second pumps are configured, when activated, to pump fluid in opposite directions from one another. Other applications are also described.

Electroactive polymer-based tissue apposition device

本发明提供了用于使组织彼此并置定位的装置。在一个示例性实施方式中，提供了一种组织并置装置，其具有其上连接有至少一个可扩张元件的挠性轴，和适于使该可扩张元件相对于细长轴轴向运动以使通过可扩张元件接合的组织运动的定位元件扩张。在一个示例性实施方式中，定位元件和可扩张元件中的至少一个可以由电活性聚合物形成。

Vein therapy device and method

A vapor delivery and insulation device is provided that may include any of a number of features. One feature of the device is that it can deliver vapor to the veins of a patient. The vapor can be generated within the device, in a handle of the device, or external to the device. Another feature of the device is that it can actively insulate the vapor to minimize heat transfer from a vapor delivery lumen of the device to an exterior surface of the device. The active insulation can be a vacuum or a flowing gas. Methods associated with use of the device are also covered.

Electrophysiology mapping and visualization system

Electrophysiology mapping and visualization systems are described herein where such devices may be used to visualize tissue regions as well as map the electrophysiological activity of the tissue. Such a system may include a deployment catheter and an attached hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. A position of the catheter and/or hood may be tracked and the hood may also be used to detect the electrophysiological activity of the visualized tissue for mapping.

Coronary sinus cannulation

Coronary sinus cannulation apparatus and methods relating to tissue visualization catheters that can locate and/or cannulate a morphological feature within a body lumen, such as the coronary sinus, are described. Such devices can also perform a variety of therapeutic tissue treatments under direct in vivo visualization thereafter. Moreover, such apparatus and methods may also be utilized with guidewires to facilitate delivery into the coronary sinus to eliminate repositioning of the device and/or repeating an entire sequence of operations, consequently improving procedure effectiveness and reducing procedure time.

Apparatus, system and method for inter-tissue transluminal intervention

(57)【要約】 血管系を体内の血管、あるいは血管以外の部位に到達するための導管として用いる方法と装置であって、血管の異なる部位の間に血流を生じさせるために血管外通路を形成することを目的とした、再血管形成の方法を含む。また、血管からもう１個の別の血管、あるいは血管以外の体内の部位に血管外通路を形成するための経血管組織間手術（ＴＶＩＳ）を行う方法を含む。また、本発明に基づき、血管外通路を形成するうえで使用される装置が開示されており、該血管外通路を修整するうえで使用される装置、血管外通路に弁を設けるうえで使用される装置、血管外通路を維持するうえで使用される装置、血管外通路を閉鎖するうえで使用される装置が開示されている。

Treatment of incompetent vessels

An implant device can include a frame and a cover member for delivery to and occlusion of a target body vessel. The frame can include proximal and distal members, coupled by a link member structure, and can expand from a collapsed configuration to an expanded configuration. In the collapsed configuration, a first plane passes through the proximal member and a second plane passes through the distal member, and the link member extends substantially parallel relative to a longitudinal axis of the device. In moving to the expanded configuration, the first and second planes each move angularly, relative to the longitudinal axis, from the collapsed configuration by between about 10 degrees and about 170 degrees, and the link member foreshortens along the longitudinal axis to bias the proximal member toward the distal member.

Fluid delivery device with positionable tube

A fluid delivery device includes a tube coupled to an axial manipulator. The axial manipulator includes an elongate member arranged to move axially in a housing. The tube is in fluid communication with a fluid diverter which is arranged to move axially in the housing upon axial movement of the elongate member. Seals are provided to prevent fluid from leaking out of the housing. A fluid port is in fluid communication with the tube via the fluid diverter, such that fluid can flow in and out of the tube via the fluid port and the fluid diverter.

Occlusion perfusion catheter

公开了一种用于闭塞、可视化、灌注、排空以及将药剂递送到治疗区域的导管。该导管包括导管本体、第一闭塞囊和第二闭塞囊、可选的空间占据囊以及可选的可视化装置，其中导管本体包括五个腔，第一闭塞囊和第二闭塞囊连接到导管本体，可选的空间占据囊连接到导管本体并设置在第一闭塞囊与第二闭塞囊之间，可选的可视化装置能够使第一闭塞囊与第二闭塞囊之间可视化。还公开了使用这些导管的方法。该方法包括：使第一闭塞囊和第二闭塞囊扩张，使空间占据囊扩张，使流体经由排空腔流出，可选地进行灌注或抽吸以便于使流体经由所述腔流出，以及经由药剂腔将药剂递送到治疗区域。

Devices and methods for performing a vascular anastomosis

A system for performing an end-to-side vascular anastomosis, including an anastomosis device, an application instrument and methods for performing a vascular anastomosis. The system is applicable for performing an anastomosis between a vascular graft and the ascending aorta in coronary artery bypass surgery, particularly in port-access CABG surgery. A first aspect of the invention includes a vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the target vessel wall and a coupling member, forming the attachment with the bypass graft vessel. The anastomosis is completed by inserting the coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the coupling member into a one-piece anastomosis staple. A second aspect of the invention includes an anastomotic fitting, having an inner flange over which the graft vessel is everted and an outer flange which contacts the exterior surface of the target vessel. A tailored amount of compression applied by the inner and outer flanges grips the target vessel wall and creates a leak-proof seal between the graft vessel and the target vessel. A third aspect of the invention has a flange to which the graft vessel attaches, by everting the graft vessel over the flange, and a plurality of staple-like members which attach the flange and the everted end of the graft vessel to the wall of the target vessel to form the anastomosis.

Coaxial catheter system

A robotic medical system and method of performing a medical procedure are provided. The robotic medical system comprises a user interface configured for receiving commands, an electromechanical driver configured for being coupled to outer and inner catheters having proximal and distal balloons, a balloon controller configured for being coupled to the proximal and distal balloons, and an electric controller configured for directing the electromechanical driver to linearly translate the outer and inner catheters relative to each other and for directing the balloon controller to inflate and deflate the proximal and distal balloons in response to the command(s). The method may comprise inflating and deflating the proximal and distal balloons, and linearly translating the inner and outer catheters relative to each other in a specified sequence to move the inner and outer catheters along the anatomical vessel.

Approximator for anastomotic surgery

Intravascular system for the treatment of carotid stenosis and catheter for this system

Endoscope device

Catheter for emboli containment

Disclosed herein is a catheter for use in an emboli containment system. In one embodiment, the catheter has a tubular body with a metallic braid construction. Two lumen extend through the tubular body, the lumen being in a side-by-side configuration. One of the lumen functions as an inflation lumen, and is in fluid communication with an inflatable balloon mounted on the distal end of the catheter. The second lumen is adapted to receive other therapeutic catheters which comprise the emboli containment system.

Aortic catheter with porous aortic arch balloon and methods for selective aortic perfusion

A method and device for perfusing an organ system is provided. The device may be further described as a catheter or cannula with an expandable flow control member positioned of the distal portion of the catheter shaft. The flow control member has a porous portion, and at least one impermeable portion, which prevent fluid from flowing out the ends of the flow control member. The flow control member is further characterized as having an interior chamber that is in fluid communication with a perfusion lumen that extends along the length of the catheter shaft and is in fluid communication with an external perfusion pump. The perfusion lumen is configured for providing flow to the interior of the flow control member, to create radial expansion thereof and to provide adequate flow to the arch vessels through said porous portion to sustain the metabolic demands of the brain.

Catheters and related devices for forming passageways between blood vessels or other anatomical structures

The inventions described in this patent application include i) a torqueable introducer sheath which is useable in conjunction with a transvascular passageway forming catheter to effect precise rotational control of the catheter; ii) an anchorable guide catheter which is useable in conjunction with an intravascular imaging catheter and a transvascular passageway-forming catheter to effect precise positioning and aiming of the passageway-forming catheter; iii) a passageway forming catheter having a torqueable proximal portion to facilitate precise rotational positioning of the distal portion of the catheter; iv) a deflectable-tipped passageway forming catheter, v) various markers and other apparatus useable in conjunction with any of the passageway-forming catheters to facilitate precise positioning and aiming of the catheter, and vi) an apparatus which may be formed within a catheter to prevent a member, apparatus of flow of material from being inadvertently advanced through a lumen of the catheter.

In situ stent formation

Apparatus and methods for delivering stents and other prostheses to body lumens include a prosthesis forming and deploying mechanism carried at the distal end of a catheter shaft. The mechanism is adapted to form and deploy prostheses of a variable length, and to form and deploy multiple prostheses during a single interventional procedure.

Intracoronary shunt

Insertion of intracoronary shunts during off-pump coronary artery bypass (OPCAB) surgery can induce a severe endothelial dysfunction. The present invention relates to a novel intracoronary shunt design and the use of this device during surgery as a means to prevent this undesirable effect. Termed the ~Monoshunt~, this intracoronary shunt advantageously avoids distal endothelial denudation and allows distal coronary perfusion.

BLOOD VESSEL OCCLUSION DEVICE, SUITABLE FOR USE IN ANASTOMOSIS

L'invention concerne un dispositif d'occlusion destiné à isoler un tronçon de vaisseau sanguin. Le dispositif 10, en forme de T, comporte une tige 12 munie, à une extrémité, de deux bras 20, 22 formant la barre transversale du T. Des bulbes pleins 24, 26 de forme générale conique sont fixés aux extrémités de la barre. Le dispositif est introduit par une incision dans le vaisseau sanguin de façon que les bras et les bulbes s'étendent dans des directions opposées le long du vaisseau. Application à l'anastomose et notamment au pontage d'une artère coronaire.

Electroactive polymer-based tissue apposition device and methods of use

Methods and devices for positioning tissues in apposition to each other are provided. In one exemplary embodiment, a tissue apposition device is provided having a flexible shaft with at least one expandable element coupled thereto, and a positioning element adapted to axially move the expandable element relative to the elongate shaft to move tissue engaged by the expandable element. In an exemplary embodiment, at least one of the positioning element and the expandable element(s) is formed from an electroactive polymer.

Catheters and related devices for forming passageways between blood vessels or other anatomical structures

The inventions described in this patent application include i) a torqueable introducer sheath which is useable in conjunction with a transvascular passageway forming catheter to effect precise rotational control of the catheter; ii) an anchorable guide catheteer which is useable in conjunction with an intravascular imaging catheter and a transvascular passageway-forming catheter to effect precise positioning and aiming of the passageway-forming catheter; iii) a passageway-forming catheter having a torqueable proximal portion to facilitate precise rotational positioning of the distal portion of the catheter; iv) a deflectable-tipped passageway forming catheter, v) various markers and other apparatus useable in conjunction with any of the passagewayforming catheters to facilitate precise positioning and aiming of the catheter, and vi) an apparatus which may be formed within a catheter to prevent a member, apparatus of flow of material from being inadvertently advanced through a lumen of the catheter.

Occlusion perfusion catheter

Medical nose root tamponment appts - has two separately-inflatable bladders, with breathing tube passing through them

Medical tamponment instrument for nose root space uses inflatable bladders, connected together but separately inflatable, with a breathing tube passing through them.. Pref. one of the bladders is displaceable, and arrestable, on the tube duct of the other. The bladders are suited to the anatomical dimensions, by choice of shape and materials. The nose entry bladder has a conical shape. Secure tamponment and sealing is obtd. of the root space w.r.t. the oral cavity oesophagus and trachea, and blood is prevented from entering these.

A device, system and method for interstitial transvascular intervention

Method and apparatus for utilizing the vascular system as a conduit to reach other vascular and extravascular locations within the body. Included are methods for revascularization wherein the extravascular passageways are formed to permit blood flow between vascular locations. Also included are methods for performing transvascular interstitial surgery (TVIS) wherein extravascular passageways are formed from a blood vessel to another vascular or non-vascular intracorporeal location. Also disclosed are devices usable for forming extravascular passageways in accordance with the invention, or for modifying, valving, maintaining or closing such passageways.

Closed loop catheter photopolymerization system for treating a vascular condition

Endovascular system for the treatment of stenoses of the carotid and catheter for this system

本发明涉及一种特别是用于血管内膜炎的导液管，其包括一个长的柔性中空管状体(1)，所述管状体具有一个插入端(4)和一个保持在其外部的连接端(3)。根据本发明，导液管在插入端(4)至少包括两个元件(9，12)，这两个元件通过外部操作可膨胀/可收缩且彼此隔开设置，一个元件在一个血管的给定部分的上游操作，另一个在下游。对于这种导液管，可在两个可膨胀的元件(9，12)之间的部分中操作，而且如果必要，由于上游和下游的两个元件(9，12)的缘故，在中间的动脉分支中将具有一个零流量。

Aortic catheter with porous aortic arch balloon and methods for selective aortic perfusion

A method and device for perfusing an organ system is provided. The device may be further described as a catheter or cannula with an expandable flow control member positioned of the distal portion of the catheter shaft. The flow control member has a porous portion, and at least one impermeable portion, which prevent fluid from flowing out the ends of the flow control member. The flow control member is further characterized as having an interior chamber that is in fluid communication with a perfusion lumen that extends along the length of the catheter shaft and is in fluid communication with an external perfusion pump. The perfusion lumen is configured for providing flow to the interior of the flow control member, to create radial expansion thereof and to provide adequate flow to the arch vessels through said porous portion to sustain the metabolic demands of the brain.

Coronary artery by-pass forming device

(57)【要約】 【課題】閉塞した冠状動脈に外科的にバイパスを形成す る装置によって、心臓の腔から閉塞した冠状動脈の閉塞 より遠位にある部位へと直接つながる経路であって、心 収縮期と心拡張期のどちらの間も開いたままになってい る経路を確保し、かつ冠状動脈壁に直接衝突する高速度 血流の発生を防止することができる装置を提供する。 【解決手段】冠状動脈30内の閉塞34の下流の心臓壁42に 孔を開け、中空の導管10´を埋め込む。導管10´は第1 末端12a´と第2末端14a´を持ち、第1末端12a´を心臓4 2の腔と血流が連絡するように設置し、第2末端14a´を 冠状動脈30と血流が連絡するように設置する。導管10´ はＬ字管又はＴ字管が好ましく、第1末端12a´の先端を 心臓42の壁から1-3mm突出させて配置するのが好まし い。

Device for percutaneously treating aortic stenosis

Deformable scaffolding multicellular stent

A plastically deformable stent for implantation within a body passage includes a plurality of cylindrical segments, and a plurality of connectors extending between adjacent segments. Each segment has an alternating pattern of curvilinear elements extending about its circumference, including first and second sets of curvilinear elements having different resistances to expansion, and preferably defining “U” shapes with alternating lengths that are connected to one another to define a substantially sinusoidal pattern. The connectors define a sinusoidal shape adapted to extend and compress axially substantially evenly when the adjacent segments are subjected to bending. The stent may be delivered on a device including an elongate member with a nose cone, an expandable member, and a proximal shoulder thereon, and an outer sheath for slidably receiving the elongate member therein. The outer sheath and/or nose cone may have perfusion holes for allowing continued perfusion of fluid during stent delivery. The device may be used in a method for implanting a stent within a curved region of a body passage, particularly for creating and/or maintaining a channel connecting a vein to an adjacent artery, preferably in the coronary system.

Device and method for minimizing heart displacements during a beating heart surgical procedure

A device for minimizing displacements of the heart when performing a beating heart surgical procedure including two heart engaging members. The heart engaging members are slidably coupled to a retractor. The heart engaging members may be rotated and extended as necessary to reach the target site on the patient's heart. The heart engaging members have curved distal ends which are configured to engage a coronary shunt positioned in the coronary artery. A suture extends around the coronary and is coupled to the heart engaging members.

CATHETERS AND RELATED DEVICES FOR FORMING CHANNELS BETWEEN BLOODS AND OTHER ANATOMICAL WEAVES

Cardiac repair, resizing and reshaping using the venous system of the heart

Structurally supportive material is implanted or injected into cardiac veins as discrete masses at various sites in the cardiac venous system to reinforce the myocardium for the purpose of preventing, moderating, stopping or reversing negative cardiac remodeling due to various adverse cardiac conditions, both acute and chronic, or for the purpose of treating localize anomalies of the heart, or for both purposes. The sites may be arranged in a pattern about one or more chambers of the heart such that the masses cooperatively reduce stress in the chamber wall and reduce chamber size. Some patterns also cause a beneficial global reshaping of the chamber. These changes occur quickly and are sustainable, and have a rapid and sustainable therapeutic effect on cardiac function. Patterns of distribution of discrete masses in the heart for global resizing and reshaping may also be used as is or augmented by supplemental patterns to treat localized conditions such as myocardial infarctions and overt aneurysm of the ventricular wall as typically forms in response to large transmural myocardial infarctions. These techniques may also be used to treat localized conditions that may not yet have progressed to cardiomyopathy.

Patent DE69637915D1