3809 results about "Guide wires" patented technology

Disclosed is a valve implanting device comprising a collapsible frame, inner and outer guide wires removably connected to the collapsible frame, and a plurality of valve flaps attached to the collapsible frame. The collapsible frame is inserted into a patient's femoral vein or artery, guided to a deployment position using the guide wires, expanded using the guide wires, and stabilized using the guide wires to manipulate fixating hubs on the collapsible frame. The collapsible frame includes a central hub, a plurality of spokes, fixating hubs, gripping members, and a plurality of valve flaps.

According to the present invention, a catheter having at least one multi-purpose lumen formed through the catheter terminates proximal a relatively complex-shaped distal portion thereof. In one form of this embodiment, the relatively complex-shaped distal portion comprises a looped portion having diagnostic- and/or ablation-type electrodes coupled thereto and an elongated diameter-adjusting member coupled proximal the distal end of the looped portion. The multi-purpose lumen may be used to alternately accommodate a variety of dedicated materials; such as, (i) a guide wire for initial deployment or later repositioning of the catheter, (ii) a volume or flow of a contrast media and the like, (iii) a deployable hollow needle or tube and the like used to biopsy adjacent tissue or dispense a therapeutic agent into a volume of tissue, and (iv) a cooling fluid, such as saline solution and the like dispensed at least during therapeutic tissue ablation procedures.

Methods and apparatus for implanting a stimulation lead in a patient's sacrum to deliver neurostimulation therapy that can reduce patient surgical complications, reduce patient recovery time, and reduce healthcare costs. A surgical instrumentation kit for minimally invasive implantation of a sacral stimulation lead through a foramen of the sacrum in a patient to electrically stimulate a sacral nerve comprises a needle and a dilator and optionally includes a guide wire. The needle is adapted to be inserted posterior to the sacrum through an entry point and guided into a foramen along an insertion path to a desired location. In one variation, a guide wire is inserted through a needle lumen, and the needle is withdrawn. The insertion path is dilated with a dilator inserted over the needle or over the guide wire to a diameter sufficient for inserting a stimulation lead, and the needle or guide wire is removed from the insertion path. The dilator optionally includes a dilator body and a dilator sheath fitted over the dilator body. The stimulation lead is inserted to the desired location through the dilator body lumen or the dilator sheath lumen after removal of the dilator body, and the dilator sheath or body is removed from the insertion path. If the clinician desires to separately anchor the stimulation lead, an incision is created through the entry point from an epidermis to a fascia layer, and the stimulation lead is anchored to the fascia layer. The stimulation lead can be connected to the neurostimulator to delivery therapies to treat pelvic floor disorders such as urinary control disorders, fecal control disorders, sexual dysfunction, and pelvic pain.

Devices, methods, kits, and methods remove obstructive material from the vasculature and other body lumens. Expansible baskets may be used as cooperating radially expansible shearing members. Helically oriented struts of each basket may wind in a uniform circumferential direction. The struts can be independently flexible, allowing the shearing members to flex axially together. The inner basket may be rotatably driven and may use an axial pump extending proximally from the shearing members and/or a distal penetrator for advancing into an occlusion which inhibits guidewire access. The struts may slide substantially continuously across each other, and may be sufficiently aggressive for highly effective thrombectomy. A rotationally static and axially flexible outer basket may provide a safe, limited atherectomy treatment.

Sinusitis and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches with flexible or rigid instruments. Various methods and devices are used for remodeling or changing the shape, size or configuration of a sinus ostium or duct or other anatomical structure in the ear, nose or throat; implanting a device, cells or tissues; removing matter from the ear, nose or throat; delivering diagnostic or therapeutic substances or performing other diagnostic or therapeutic procedures. Introducing devices (e.g., guide catheters, tubes, guidewires, elongate probes, other elongate members) may be used to facilitate insertion of working devices (e.g. catheters e.g. balloon catheters, guidewires, tissue cutting or remodeling devices, devices for implanting elements like stents, electrosurgical devices, energy emitting devices, devices for delivering diagnostic or therapeutic agents, substance delivery implants, scopes etc.) into the paranasal sinuses or other structures in the ear, nose or throat. Specific devices (e.g., tubular guides, guidewires, balloon catheters, tubular sheaths) are provided as are methods for manufacturing and using such devices to treat disorders of the ear, nose or throat.

A non-cannulated dilator that is designed with a rigid elongated solid body and with a judiciously configured tip is utilized as the first dilator of a series of dilators which are inserted into the body of a patient for minimally invasive spinal surgery and is made from a solid elongated body, that could be round, ovoid or other cross sectional configuration whose diameter is greater than one and a half (1½) millimeter, and that includes a tool engaging end portion at the proximal end is sufficiently rigid so as not to bend and has a pointed shaped insertion end portion at the distal end with the point of the pointed end being discreetly blunted and utilized in a surgical procedure as a replacement of the typical guide wire and is characterized as providing a “fee” to the surgeon as it penetrates through the tissue and muscle of the patient as it proceeds toward the target.

Spinal stabilization devices and their methods of insertion and use to treat degenerated lumbar, thoracic or cervical spinal discs in minimally invasive, outpatient procedures are described. In one embodiment, the spinal stabilization device is an expandable cage made of a coil or perforated cylindrical tube with a bulbous or bullet-shaped distal end and a flat or rounded proximal end. In a preferred embodiment, the spinal stabilization device is mechanically expanded to a larger diameter or is made of a superelastic nickel-titanium alloy which is thermally programmed to expand to a relatively larger diameter when a pre-determined transition temperature below body temperature is reached. To treat a degenerated disc, a guide wire is inserted into the disc and an endoscope is inserted through a posterolateral puncture in the back and advanced up to the facet of the spine. Mechanical tools or laser energy, under endoscopic visualization, are used to remove or vaporize a portion of the facet bone, creating an opening into the foraminal space in the spine for insertion of an endoscope, which enables the disc, vertebra and nerves to be seen. The passageway is expanded, mechanical tools or laser of RF energy are used to make a tunnel into the disc, and a delivery cannula is inserted up to the opening of the tunnel. An insertion tool is used to insert one or more spinal stabilization devices into the tunnel in the disc, preserving the mobility of the spine, while maintaining the proper space between the vertebra. Laser or radio frequency (RF) energy is used to coagulate bleeding, vaporize or remove debris and shrink the annulus of the disc to close, at least partially, the tunnel made in the disc.

A method of performing a medical procedure is disclosed which involves the use of a balloon catheter in combination with an angioscope to monitor an intravascular stent before, during or after deploying the stent. Specifically, the method may include the steps of (1) delivering an intravascular stent into the vasculature of a patient, (2) positioning a balloon catheter in the vasculature such that the inflatable balloon is adjacent the stent, (3) inserting an angioscope into the balloon catheter such that the distal end of the angioscope is adjacent an optically-transparent tube traversing the interior of the balloon, and (4) visually monitoring the stent before, during or after deploying the intravascular stent. The optically-transparent tube may define a guide wire lumen for use with a guide wire and the angioscope may be inserted into the guide wire lumen. The intravascular stent may be a balloon-expandable stent, a self-expanding stent, or a stent made of a photo-responsive polymer.

A method of treating a constricted sinus passageway of a patient includes traversing the canine fossa region of the patient so as to form a passageway in the sinus cavity. A cannula is positioned in the passageway. A visualization tool such as an endoscope is passed through a lumen or channel in the cannula to aid in visualization of the anatomical site of interest. A balloon dilation catheter is then deployed through or along the cannula so as to place the balloon within or across the constricted anatomical space (e.g., ostium). The balloon is then expanded so as to expand at least a portion of the constricted anatomical space. Alternative embodiments include the use of an optional guide wire and incorporating a endoscope lumen through the balloon dilation catheter.

An apparatus for sealing a passage through tissue includes a plug including external threads, a lumen extending between its proximal and distal ends, and an annular collet slidably disposed within the lumen. The plug is carried on a distal end of a handle device that includes an inner member with a distal end that is slidable axially within the lumen of the body for moving the collet into a reduced cross-sectional region of the lumen, thereby compressing the collet to seal the lumen, and for deploying the plug from the handle device. During use, the plug is threaded into a passage through tissue over a guide wire. Once a desired location is reached, the plug is deployed from the handle device, thereby compressing the collet and sealing the lumen. The guide wire and handle device are removed, leaving the plug to seal the passage.

A catheter system for localized or semi-localized administration of agents through the wall of a blood vessel is provided. Various catheter system constructions which use at least one expandable occluding device to create an isolated region are provided. Constructions using one catheter and one occlusion device are provided, along with constructions using two catheters and multiple occlusion devices. The catheter system may include a catheter with a variable stiffness along its length. The catheter system may also include a guide wire integrated with an inner catheter. The catheter can infuse the agent into the blood vessel in a pressure regulated manner. Methods for delivery and infusion of the agent within a blood vessel are also provided.

A device for rotatably driving a cannulated tool along a guide wire. In one aspect, the device includes a coupling assembly for receiving the tool and guide wire as well as a ratchet mechanism permitting selective rotation between the device and the tool. The device further includes an elongate gripping portion extending transversely to the coupling assembly to provide a levered mechanical advantage while positioning the gripping portion out of the path of the guide wire. In another aspect, the device includes a handle having a through bore shorter than a predetermined length of a connection assembly through bore so that only a short portion of the guide wire is covered by the device. A method of driving a cannulated tool along a guide wire is also provided that includes rotating a gripping portion of a handle assembly about the tool in an arcuate path spaced from the tool.

An inflatable circulation assist device is disclosed consisting of an inflatable stator housing an impeller with inflatable blades of varying shapes and sizes. The invention is introduced into the patient percutaneously. The circulation assist device is a small pump packaged into a compact form that is attached to a long flexible driveshaft. The pump is inserted along a guidewire to a target location, and then the pump is inflated. The circulation assist device's exterior is designed to expand only so much as to closely fit whatever cardiovascular system element in which it is placed for operation. The vascular assist device can be expanded either by inflation with a fluid. The driveshaft, which connects to the circulation assist device's impeller and extends outside the patient's body, is rotated by an external motor. After the circulation assist device is no longer needed, it is collapsed into a compact form and removed from the patient percutaneously.

An apparatus for sealing a passage through tissue includes a bioabsorbable, threaded plug carried by a delivery device. A guide wire is receivable through lumens in the plug and delivery device that includes wings on a bioabsorbable distal portion. With the wings collapsed, the guide wire is advanced through the passage into a blood vessel, the wings expanding once located within the vessel, and the guide wire is withdrawn until the wings contact the vessel wall. The plug is threaded into the passage over the guide wire until the plug is disposed adjacent the wings. The distal portion of the guide wire is secured to the plug, e.g., by compressing a collet within the plug lumen that seals the lumen, and is severed from a proximal portion thereof. Thus, the plug and distal portion are deployed with the plug sealing the passage.

A wire control catheter for aligning and guiding a guide wire through a lesion in a vessel is provided. The wire control catheter includes a shaft having a guide wire lumen and a control wire lumen. A control wire passes through the control wire lumen and is used in combination with an articulation structure to deflect or curve a distal tip portion of the catheter. The distal catheter shaft may include a centering device for centering the catheter within the vessel. The distal catheter shaft also may include a pre-dilation balloon for dilating the lesion prior to performing angioplasty or other treatment on the lesion. Additionally, a sliding sheath catheter may be used to provide additional support to the guide wire. The sliding sheath catheter is sized to fit within the guide wire lumen of the control catheter and to allow the guide wire to pass through it. A method of treatment of a blood vessel includes inserting a guide wire into the blood vessel and advancing a control catheter over the guide wire until the distal tip of catheter is near the occlusion in the blood vessel. The tip of the catheter then is deflected via a control wire and an articulation structure. The guide wire is then advanced across the occlusion. The control catheter also may be advanced across the occlusion simultaneously with the guide wire or subsequent to the guide wire crossing. Prior to crossing the occlusion, the wire control catheter may be centered using a centering device. Subsequent to crossing the occlusion, the occlusion may be pre-dilated with a pre-dilation balloon of the wire control catheter.

Apparatus for delivering a sleeve into a puncture through tissue includes a tubular sheath including a lumen extending between its proximal end and an opening in its distal end. The sleeve includes a hub on a first end thereof disposed adjacent the distal end of the sheath, and a second end extending into the opening and lumen of the sheath. The hub is slidable along an exterior of the sheath for drawing the sleeve out of the opening and along an exterior of the sheath. During use, a guide wire is placed through the puncture into a blood vessel, and sealing compound is introduced into the puncture around the guide wire. The sheath is advanced into the puncture over the guidewire while maintaining the hub adjacent the patient's skin, causing the sleeve to be deployed from the sheath and line the puncture as the sheath is advanced into the puncture.

A medical device (1210) comprises a generally cylindrical treatment element (1220) for location between a pair of valve leaflets (1212) situated between an atrium (1214) and a ventricle (1216) of a heart. The treatment element (1220) supports the valve leaflets (1212) at the region of co-aptation of the valve leaflets (1212) and occludes the valve opening to resist fluid flow in the retrograde direction through the valve opening. The device (1210) comprises a support (1222) to support the treatment element (1210) at the region of co-aptation of the valve leaflets (1212). The support has an anchor (1224) and a tether (1226), the tether (1226) being provided at the end of a guide wire (1228) which is initially utilised in the percutaneous insertion of the treatment element (1220). The anchor (1224) is secured, in use, to a septal wall (1230), while the guide wire (1228) exits the atrium (1214) through a vein adjacent a rear wall (1224) thereof. The treatment element (1220) includes a remotely actuatable clamp therein, in order to allow the treatment element (1220) to be secured to the guide wire (1228) or the tether (1226).

A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The system comprises an atherectomy catheter having a working head, e.g., a rotary impacting impeller, and a debris extraction sub-system. The atherectomy catheter is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head and withdraws that liquid and some blood at a second and higher flow rate, through the guide catheter to create a differential flow adjacent the working head, whereupon the debris is withdrawn in the infusate liquid and blood for collection outside the being's body. The introduction of the infusate liquid may also be used to establish an unbalanced flow adjacent the working head to enable the atherectomy catheter to be steered hydrodynamically. A guide wire having an inflatable balloon on its distal end may be used with the atherectomy catheter to block the flow of debris distally, while enabling distal tissues to be perfused with an oxygenating liquid. At least one flow control port may be provided in the guide catheter to prevent collapse of the vessel being revascularized. A cradle is provided to fix the guide catheter and guide wire in position within the body of the being while enabling the atherectomy catheter to be advanced along the guide wire and through the guide catheter.

A guide wire combined with a catheter or medical device for moving through a body lumen to a desired position in the body with the aid of an applied magnetic field. The guide wire is provided with a magnet on its distal end that can be oriented or oriented and moved by the application of a magnetic field to the magnet. A catheter or other medical device can be advanced over the guide wire. Once the medical device is in its desired position, the magnet can be withdrawn through the lumen of the catheter. Alternatively, a guide wire with a magnet on its distal end can be docked at the distal end of a catheter or medical device and can be oriented, or oriented and moved by the application of a magnetic field.

A tool-carrying catheter, comprising: an elongate body adapted for insertion into a blood vessel; a tool section attached to a distal side of said body; and a guide-channel adapted to carry at least a guide-wire, wherein said catheter includes an entry port into said guide-channel for said guide wire and wherein said tool includes a distal exit for said guide wire from said guide-channel, defined in a side of said tool.

Methods and apparatus are provided for removing emboli during an angioplasty, stenting or surgical procedure comprising a catheter having an occlusion element, an aspiration lumen, and a blood outlet port in communication with the lumen, a guide wire having a balloon, a venous return sheath with a blood inlet port, and tubing that couples the blood outlet port to the blood inlet port. Apparatus is also provided for occluding the external carotid artery to prevent reversal of flow into the internal carotid artery. The pressure differential between the artery and the vein provides reverse flow through the artery, thereby flushing emboli. A blood filter may optionally be included in-line with the tubing to filter emboli from blood reperfused into the patient.

A stent locating device that includes leading wires, a pushing rod for holding the leading wires, and a sheath for loading the pushing rod. The pushing rod includes inner and outer tubes. The inner tube is used as a guiding wire channel. An annular portion between the inner and outer tubes is used as a leading wire channel. The pushing rod may be a single tube having a hollow portion that is used as a guiding wire channel and a plurality of leading wire channels arranged in the body thereof at regular intervals circumferentially. The pushing rod may have a plurality of leading wires, crossing leading wires, or a combination of leading wires and auxiliary leading wires which are distributed at regular intervals circumferentially and are derived from the tip of a leading wire channel(s).

A system for delivery of an intraluminal treatment device is provided. A guide wire having a recessed portion is combined with an intraluminal treatment device having a mechanism for securing the intraluminal treatment device to the recessed portion. This system permits an intraluminal treatment device to be secured to the guide way prior to or after the intraluminal delivery of the guide wire.

An implantable stimulation lead is disclosed for placement in the coronary sinus region and its associated coronary vessels overlying the left side of a patient's heart. The lead comprises at least one proximal connector; at least one tissue stimulation electrode; at least one conductor coupled between the at least one proximal connector and the at least one stimulation electrode; and a lead body including a housing of insulating material enclosing the at least one conductor, the lead body having a relatively flexible distal portion of, for example, silicone rubber, having a length corresponding to the coronary sinus region of the heart, and a stiffer proximal portion of, for example, polyurethane. A robust transition joint comprising telescoped sections of the distal and proximal portions of the lead body couples the two portions of the lead body.

Also provided is a versatile lead delivery system including a stylet stop disposed within the distal portion of the lead body. The stylet stop defines an aperture dimensioned to pass a guide wire but not the enlarged distal tip of a stylet. The lead includes a tip electrode having a longitudinally extending bore dimensioned to permit passage of the guide wire through the tip electrode.

Methods and apparatus are provided for removing emboli during an angioplasty, stenting or surgical procedure comprising a catheter having an occlusion element, an aspiration lumen, and a blood outlet port in communication with the lumen, a guide wire having a balloon, a venous return catheter with a blood inlet port, and tubing that couples the blood outlet port to the blood inlet port. Apparatus is also provided for occluding the external carotid artery to prevent reversal of flow into the internal carotid artery. The pressure differential between the artery and the vein provides reverse flow through the artery, thereby flushing emboli. A blood filter may optionally be included in-line with the tubing to filter emboli from blood reperfused into the patient.

The present invention relates to medical devices for implantation or insertion into body lumens, for example, catheters, guidewires, stents and aneurysm coils. The devices of the present invention comprise electrically actuated materials, such as electroactive polymers and piezoelectric and electrostrictive materials, which enhance or expand their functionality.

Apparatus for bone reinforcement, fixation and treatment of diseased or fractured bones including a supporting structure optionally coated with therapeutic agent is provided. The supporting structure or device may be collapsible upon deployment at the surgical site, and include fixation features such as anchors to securely position in place once deployed. Bone cement or other material may be provided to alternatively secure the positioned supporting structure for treatment. A lockable bone fixation device is described that comprises: a sleeve adapted to be positioned in a space formed in a bone; a guidewire adapted to guide movement of the sleeve; and an actuable lock adapted to secure the sleeve within the space of the bone from an end of the device.

A sheath attached to a guide wire, a tubular shaft member slidable on the guide wire and a filtering assembly constricted within the sheath are movable in a vessel to a position distal to a lesion in the direction of fluid flow. The filtering assembly may be formed from a plurality of angularly spaced splines and a mesh disposed on the splines having properties of passing fluid in the vessel while blocking the passage of emboli in the fluid. The splines may be provided with shape memory for expanding against the wall of the vessel when released from constriction by the sheath. The sheath may be moved relative to the filtering assembly and the support member to release the filter for expansion against the vessel wall. An interventional device can be used to treat the lesion. Any emboli released into the vessel as a result of the interventional treatment are blocked by the filter member while fluid is allowed to pass there through.

A tissue ablation system for ablating human tissue wherein sensing and ablation procedures are performed and controlled independently. A sensing wire is positioned distally to the ablation region and is adapted to pass thorough the ablation device such that it may move with or independently of the ablation device without obstructing the surface tissue interface of the ablation energy. The ablation device can ablate a substantial portion of a circumferential region of tissue, for example at or near the location where the pulmonary vein extends from the atrium. The tissue ablation system comprises an ablation device comprised of an elongated catheter with a proximal region and a distal region and an ablation element located proximate the distal region of the catheter. A sensing device having an elongated body with a proximal portion and a distal portion is adapted to be positioned within a vessel at or near a vessel ostium, wherein the sensing device is adapted to be slidably received within a lumen of the ablation device. The sensing device, a guide wire for example, may be shaped in various configurations to allow sensing device such as electrodes disposed thereon to contact the vessel wall near the ablation region. In this fashion, the sensing and ablation procedures are de-coupled such that the sensing device does not interfere or obstruct the ablation member's interface with the tissue.

A method and apparatus for caged stent delivery is provided herein. The device can be used to position and deliver any type of stent to a preselected treatment site within an intraluminal cavity. The device comprises a tubular portion, a plurality of arms attached to the distal end of the tubular portion, and a mechanism to open the arms. In operation, the caged device carries a stent in a constricted form to the treatment site for deployment. The arms of the cage are then opened, the stent released and deployed, and the device withdrawn. Several methods are provided to open the arms, including various pullwires, a piston, an electrolytic joint, and an activator. The arms may be constructed of a shape memory alloy and opened when shape memory behavior is effected. The device may be used with conventional catheters or used with a stent-loaded guidewire.