US20010016726A1 - Dilating and support apparatus with disease inhibitors and methods for use - Google Patents
Dilating and support apparatus with disease inhibitors and methods for use Download PDFInfo
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- US20010016726A1 US20010016726A1 US09/298,279 US29827999A US2001016726A1 US 20010016726 A1 US20010016726 A1 US 20010016726A1 US 29827999 A US29827999 A US 29827999A US 2001016726 A1 US2001016726 A1 US 2001016726A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/104—Balloon catheters used for angioplasty
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L29/00—Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
- A61L29/14—Materials characterised by their function or physical properties, e.g. lubricating compositions
- A61L29/16—Biologically active materials, e.g. therapeutic substances
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0067—Means for introducing or releasing pharmaceutical products into the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
- A61L2300/416—Anti-neoplastic or anti-proliferative or anti-restenosis or anti-angiogenic agents, e.g. paclitaxel, sirolimus
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M2025/0057—Catheters delivering medicament other than through a conventional lumen, e.g. porous walls or hydrogel coatings
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1052—Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1081—Balloon catheters with special features or adapted for special applications having sheaths or the like for covering the balloon but not forming a permanent part of the balloon, e.g. retractable, dissolvable or tearable sheaths
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1011—Multiple balloon catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/20—Applying electric currents by contact electrodes continuous direct currents
- A61N1/30—Apparatus for iontophoresis, i.e. transfer of media in ionic state by an electromotoric force into the body, or cataphoresis
- A61N1/303—Constructional details
- A61N1/306—Arrangements where at least part of the apparatus is introduced into the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/327—Applying electric currents by contact electrodes alternating or intermittent currents for enhancing the absorption properties of tissue, e.g. by electroporation
Definitions
- the present invention relates to medical devices and their methods of use. More specifically, the present invention relates to devices which are particularly useful for repairing and/or serving as a conduit for body passageways requiring reinforcement, dilatation, disease prevention or the like. Such devices are utilized to deliver a therapy, that therapy being from a family of devices, drugs, or any of a variety of other elements to a specific location within the body.
- the present invention provides a system of combining a novel deployment and/or drug delivery therapy with existing balloon dilatation therapy into one device. This combination will yield a significant decrease in cost to the healthcare system as well as providing a therapy to the patient with increased safety and efficacy. Further, the instant invention provides a novel and improved platform for synthetic/tissue interface between the device and the body.
- Occlusive vascular disease is a common ailment in people resulting in enormous costs to the health care especially with the ‘Graying of America’ due to the baby boomers of the 50's.
- the common procedure of dilatation of these occluded vessels of the body has been studied for several years and many techniques (devices and methods) have been studied and practiced.
- One of the more common techniques is one referred to as balloon angioplasty or Percutaneous Transluminal Angioplasty (PTA).
- PTA is the most common treatment of atherosclerotic plaque deposition.
- this PTA has significant drawbacks; some of which are the cost of the catheter and the potential for the stenotic vessel to ‘recoil’ or narrow back down after the procedure.
- scaffolds have been designed that stay in place to keep the vessel ‘propped open’ after dilatation.
- PTA drugs pre, during and post dilation.
- Balloons have been designed with permeable membranes to aid with this delivery.
- the balloons have been designed with imperfections in the surface of the balloon that aid in breaking up the plaque matrix during dilation (tiny cutters for example have been impregnated into the exterior wall of the balloon).
- energy dispersal systems have been employed to deliver energy to the site pre, during or post therapy (e.g. radiation, electrical stimulation, RF, etc.).
- energy dispersal systems have been employed to deliver energy to the site pre, during or post therapy (e.g. radiation, electrical stimulation, RF, etc.).
- Even further, innovative perfusion systems have been developed with the dilatation systems so that blood can flow during the therapy.
- the present invention allows all of these enhancements to occur with an overall reduction in the manufacturing resources required for the device since one device/catheter is required as opposed to two or more. Even more important, is the time efficiencies created during the procedure by obviating the need to exchange the devices/catheters to perform the acts which may include angioplasty, stent deployment, and drug delivery. Safety to the patient is enhanced, as well, by obviating the time consuming exchanges and diminishing the time of the procedure.
- stenting prevents the mechanical events which contribute to re-stenosis, i.e., suboptimal results, acute mechanical recoil, and geometric remodeling.
- stenting has been shown to accelerate or incite smooth muscle proliferation, thrombosis and platelet deposition, and matrix production. These events may be grouped together and referred to as neointimal hyperplasia. Exuberant neointimal hyperplasia may lead to stenosis within a stent, referred to as in-stent re-stenosis.
- stents may improve the re-stenosis rate, but at a significant financial cost, potential risk to the patient, and a possibility of developing in-stent stenosis.
- a novel invention that allows safer, less expensive and more efficacious dilatation and stent deployment is described in the present invention.
- stenting is not the cure all.
- pharmacological therapy has not been shown efficacious in significantly reducing neointimal hyperplasia, for several different reasons.
- One reason is related to the systemic intolerances of doses required to achieve local beneficial effects within the arterial wall.
- a local drug delivery device which would deliver higher drug concentration to the target while avoiding systemic toxicity's or side effects would be advantageous.
- there are several patented local drug delivery devices including balloon catheters, coated stents, and even needle catheters.
- most are plagued with the rather uniform problem of low transfer efficiency, rapid washout/poor retention, and the potential of additional vessel injury.
- the first objective is to reduce cost. This is particularly important in recent years where it is clear for safety and sanitary reasons that these will be single use devices. A device, even though it performs a function in some improved manner, will not be widely used if it is considerably more costly than the alternatives available.
- a second objective is to provide a device that is simple to use and in a very real sense simple to understand. This will encourage its adoption and use by medical personnel. It will also tend to keep cost low.
- the third objective is to provide a device that entails a procedure with which the medical profession is familiar so that the skills that have been learned from previous experience will continue to have applicability.
- a fourth objective relates to the effectiveness and thoroughness with which the blockage is removed. It is important that a maximum amount of the blockage be removed; recognizing that no device is likely to provide one hundred percent removal.
- a fifth objective concerns safety; a matter which is often so critical as to trump the other considerations. It is important to avoid tissue trauma. In many circumstances, it is critically important to avoid breaking up a blockage in a fashion that leads to flushing elements of the blockage throughout the body involved.
- a major object of this invention is to provide an improved device for treatment or prevention of disease of a body passageway, which achieves the objectives of, reduced cost, enhanced simplicity, a standard procedure, high effectiveness and a high degree of safety. Most particularly, it is an object of the present invention to achieve these objectives with an enhanced trade-off value for the combined objectives.
- a novel device description is set forth in the instant invention that allows for treatment of fully or partially occluded vessels within the body; usually those vessels being blood vessels.
- the instant invention allows multiple therapies to be provided with a single device.
- One embodiment of the instant invention is to provide a single device/catheter/guide wire that allows for balloon angioplasty of a stenotic lesion in the vasculature and deployment of a device for propping open the vessel with that same device. This is often referred to as an endoprosthesis, but more frequently referred to as a stent or stent-graft.
- stenosis of a blood vessel is treated by placing a balloon in the narrowed/stenosed area of the vessel and expanding the balloon, which subsequently expands the narrowed vessel, at least temporarily or partly.
- This balloon expansion is referred to as balloon angioplasty.
- the vessel returns to its original ‘narrowed’ condition. This is referred to as recoil, if it occurs acutely.
- Subacute or late narrowing may be secondary to restenosis, a complex process described more fully elsewhere in this document. These processes occur in a large percentage of ‘ballooned’ vessels, sometimes upward of fifty percent.
- balloon angioplasty is frequently used in addition to, or in conjunction with, other therapies such as placement of a stent, stent-graft, or subsequent drug delivery to the area of stenosis or re-stenosis.
- additional therapies will hopefully prevent the re-closure of the vessel after balloon angioplasty.
- subsequent therapies require the addition of new devices after balloon angioplasty.
- a device that can expand the vessel via a balloon angioplasty device, but also provide a system that can simultaneously or subsequently deliver a therapy such as a stent or stent-graft or deliver agents/drugs without the removal of the original angioplasty device/catheter.
- a novel therapeutic device is described in the instant invention that can dilate the narrowed vessel without the use of a balloon and can then deploy a stent or stent-graft with a balloon or with another novel mechanism on the same device.
- another preferred embodiment of the instant invention allows for a therapeutic delivery of a drug or other agent to tissue to prevent or treat disease. In particular, during balloon angioplasty, this is accomplished without an additional device being used for this therapy.
- the instant invention is primarily, though not exclusively, oriented to the use of technology referred to as tubular braid or braided sleeving.
- tubular braid or braided sleeving The basic design of tubular braid is well defined later in the patent under a particular ‘comments’ section entitled The Tubular Braid or Braided Sleeve Element.
- Intraluminal devices or endovascular prostheses are known for treating stenosis, stricture, aneurysm conditions and the like. Often these devices are implanted or used via LIS (Least Invasive Surgery); whereby a small percutaneous access into the vessel is accomplished (usually remote to the diseased area). Alternatively, they are installed via an ‘open surgery’ approach. Advantages of the LIS approach (over conventional surgery) are significant from a cost as well as a patient care and recovery point of view.
- Balloon catheters have found an increased use in medical procedures such as percutaneous transluminal angioplasty (PTA), percutaneous transluminal nephrostomy, ureteral dilatation, biliary duct dilatation, percutaneous transluminal renal angioplasty and the like.
- PTA percutaneous transluminal angioplasty
- ureteral dilatation ureteral dilatation
- biliary duct dilatation percutaneous transluminal renal angioplasty and the like.
- Patents deemed relative are described.
- Gruntzig et al in U.S. Pat. No. 4,195,637 and Simpson et al in U.S. Pat. No. 4,323,071 are two very well known patents that have been said to initiate the onslaught of intellectual property that is realized with balloon angioplasty.
- Self-Expanding Stents have come of favor recently over balloon expandable stents for reasons not completely understood by the author, but likely due to the perceived decrease in effort to deploy the stent since there is only the initial balloon dilatation and then stent deployment instead of balloon dilatation, and balloon dilation/stent deployment a second time to implant the stent or stent-graft.
- multiple catheter exchanges must be made to dilate the lesion with the angioplasty catheter, deliver the self expanding stent with another catheter or delivery device, and then reinsert the angioplasty balloon catheter to tack the stent down properly.
- Intraluminal scaffolding devices such as stents are often used in combination with grafts and vice versa.
- the graft is usually, but not always a an elastic or inelastic material and often a textile/fabric type material that is used to cover a greater area of the scaffolding as well as aid in neo-intimal formation after placement.
- the two (stents and grafts) are often designed into one device called a stent-graft.
- One embodiment of the present invention allows balloon dilation and stent deployment to be accomplished with one device. In and of itself, this technique as well as other inventions have tried to accomplish the same, but have been met with limited success.
- LeVeen, LeVeen and LeVeen in U.S. Pat. No. 4,404,971 describe a dual balloon catheter to control bleeding to facilitate surgical closure of the blood vessel. Taking this multiple balloon concept further, Hegde et al in U.S. Pat. No. 5,725,535 describe a method for using a multiple balloon catheter that allows balloon dilatation of the stricture and then stent deployment using the same catheter.
- Hegde et al disclose a method for a complex and expensive device. Further, using balloons for dilatation and for stent deployment require a significant amount of time for inflation/filling and subsequent deflation/un-filling of the balloons. The rate of inflation and deflation of the balloons bears directly on the stress induced on the heart during the procedure.
- U.S. Pat. No. 5,725,535 Hegde et al describes the multiple balloon device in detail in the body as well as in the claims.
- the device described in this patent has the obvious drawbacks of requiring a separate lumen for each balloon.
- Marin and Marin in U.S. Pat. No. 5,456,694 describe an essential catheter similar to the Hegde patent whereby multiple balloons are used to accomplish the same as in the Hegde patents.
- Marin and Marin disclose a guiding sheath in cooperation with their multiple balloon system that has a variable stiffness that is made available through their design that reportably decreases trauma to the patient.
- Marin and Marin recognize the limitations of multiple balloons in their design and make mention of alternative mechanical linkages to deploy the stents. These linkages are described in Marin's U.S. Pat. Nos. 5,618,300 and 5,443,477.
- Marin and Marin indeed describe an alternative mechanical linkage device for stent deployment in these subsequent patents, however again only at the cost of losing cost effectiveness in the manufacture of the catheter as well as the potential increase in size of the diameters of the catheters and potential flexibility of the catheter/device. Further, in U.S. Pat. No. 4,585,000, Harold Hershenson describes a mechanical linkage type dilator that is similar to that of Marin and Marin in that it is complicated for manufacture and difficult for size reduction which is of paramount importance.
- the inventors describe a multiple use device/catheter, that can be made in a low cost manufacturing environment while keeping diameter of the device to a minimum, but keeping safety and efficacy to the patient at a maxinum.
- the present invention utilizes a manufacturing technique known as tubular braid or braided sleeving to accomplish either dilatation or stent deployment.
- the instant invention may be used with a dilation balloon on the device in combination with the tubular braid. When the tubular braid is put into compression, the braid expands radially for dilation and/or stent deployment.
- the inventors disclose a novel device and method for using a single device for dilatation and stent deployment without the need for balloons at all. Embodiments are described which will provide the capability of balloon dilation and deployment of an expandable stent or a self-expanding stent.
- tubular braid as a device to deliver drug/agent/therapy to passageways as well.
- tubular braid for use in the tubular vessels of the body is not new and is described in several issued U.S. Patents.
- Anderson et al in U.S. Pat. No. 4,706,670 describes a unique use of tubular braid in conjunction with balloon angioplasty.
- Anderson et al describe the use of tubular braid that is molded into an elastomeric catheter shaft so that upon expansion of the catheter from within, the shaft only expands and dilates to a fixed diameter that is predetermined by the inelastic tubular braid filaments within the walls of the catheter. When pressure is removed from the device the diameter contracts back to its original, ‘undilated’ diameter.
- Hillstead discusses the use of the tubular braid for stent deployment, filtering and centering characteristics in the body of his disclosure, but limits his invention to drainage of the device wherein fluid accumulation occurs in the expanded tubular braid or with other flushing lumens there-through with regard to using the device for the compression and or removal of material during an angioplasty.
- Hillstead recognize the advantage of combining the tubular braid with balloon angioplasty, nor it is obvious to anyone normally skilled in the art. Hillstead describes an intricate device for expanding the tubular braid.
- Garrison et al discloses an angioplasty device with a temporary stent that may be fabricated from tubular braid. This temporary stent in the Garrison et al patent is used to help prevent the problems that are realized with instantaneous recoil subsequent to angioplasty/balloon dilatation.
- tubular braid in the fabrication of embolic containment devices as well as tubular braid use for a bifurcated stent. Further yet, the current inventors use tubular braid in the design and disclosure of devices and methods for entrapping, occlusion, flow direction, tensioning and/or anchoring devices in U.S. Ser. Nos. 09/248,088 09/248,083 and PCT/US Nos. 99/02856 and 99/02853.
- tubular braid in conjunction with an angioplasty balloon (or other dilatation means) for concurrent balloon angioplasty and drug delivery/therapy.
- This instant invention uses a tubular braid or other similar material that may have an absorbent nature such as Dacron, cotton etc.
- the absorbent material is placed over a balloon or other dilation device. Prior to placing the balloon into the diseased lesion, the absorbable material is allowed to absorb a therapeutic agent into the individual filaments or in between the filaments and the outer wall of the balloon or other dilatation device.
- the drug or other agent is then driven into the vessel wall at the site of the lesion, where it is needed most.
- the covering material such as the tubular braid, will act as a means for penetrating the lesion and potentially breaking up the plaque matrix that exists there.
- the drug/agent/therapy will at very least be delivered into the lesion/diseased site, again where it is need most.
- U.S. Pat. No. 4,994,033 by Shockey describes an intravascular drug delivery dilatation catheter that disclosed a plurality of minute holes within a set of balloons for subsequent delivery of a drug during angioplasty.
- Shockey et al describes a device that is costly and complicated to manufacture.
- Wolinsky et al in U.S. Pat. No. 5,087,244 describes a method and catheter with minute holes (approximately 25 microns) through the balloon wall as well for concurrent drug delivery during angioplasty.
- the repeatability of the sized 25 micron holes in the balloon coupled with the potential restrictions of the drug used for perfusion through these holes lend itself to these disadvantages.
- Klein et al describes a device and method for infusing an agent to the treatment site as well.
- Klein et al discloses a rather complex device that would lend itself to costly manufacture if it would be put to practice.
- Fahrad Khosravi in U.S. Pat. No. 5,415,637 discloses a temporary stenting device with drug delivery capabilities.
- Khosravi describes a device that will deliver drugs while propping open a narrowed vessel using an elaborate set of hypotubes with holes drilled in them. As compared with the instant invention, this device will greatly exceed manufacturing costs as well as decrease flexibility of the catheter, which described earlier, is of paramount importance.
- the drug or therapeutic agent delivery system of the instant invention similarly to the aforementioned and novel dilatation system of this patent uses a very ‘manufacturing friendly’ process that will allow simple fabrication on a production basis. Further and like the aforementioned dilatation system, this drug or agent delivery system yields characteristics that allow for high safety and efficacy to the patient while minimizing the efforts and time of the clinician.
- Dilation balloons are also commonly used to deploy stents or stent-grafts. Even further, many stents or stent-grafts are configured with a multi-stranded, braided, sleeve or tube. One of the descriptions of the present invention is similar to that of the braided sleeve.
- the present device can be used such that the stent or stent-graft can be mounted on the inner/outer system described below and when put into compression; the stent or stent-graft expands radially (just as it does when it is mounted on a dilatation/deployment balloon).
- the system could be modified so that the tubular braid is ‘detachable’ from the elongate shaft of the catheter or wire. In this case, it could be left in place as a stent or stent-graft.
- the ‘detachable’ tubular braid could be put into compression so that it expands. This may be accomplished by having reinforcements on both sides of the tubular braid that can be moved inward relative to one another to cause the compressive force on the tubular braid. Once the forces are withdrawn, the tubular braid would remain in place in the vessel. Additional dilatation from a balloon could be added now to ‘set’ the stent or stent-graft in place. Often, a stent or stent-graft only needs a ‘nudge’ to start its expansion both in the case of self-expanding and balloon expanding endoprostheses.
- This improved medical device provide a new configuration that will eliminate some of those problems and methods for their use, which facilitate removal of vascular and other vessel obstructions, narrowing, constrictures, disease prevention, etc. in the operating room or interventional suite.
- a first embodiment of the present invention provides an improved device (guide wire or catheter) of the type having an elongate flexible shaft with a proximal end and a distal end.
- the improvement comprises configuring at least a distal portion of the flexible shaft so that it can assume a shape(s) along its shaft (proximally, mid-section or distally) that will act as a dilator.
- This guide wire or catheter can be moved along the lumen (artery, vein, intestine, stent, graft, or other hollow vessel or organ, etc.) and to the obstruction area (clot, plaque, or other obstruction).
- the user can easily actuate the dilation mechanism(s) so that it is enlarged beyond its original size/diameter and dilate the narrowed passageway.
- a similar mechanism can be deployed distal to the obstruction so that when the dilatation is occurring and fragments are dislodged during the therapy, the distal mechanism can trap them from moving downstream. These emboli can be trapped and then obliterated or removed at some later time.
- a second embodiment of the instant invention concerned with delivery or a drug/agent/solvent to the vessel wall, is directed to a tubular device, which has proximal and distal ends, constructed of monofilament or multifilament braids for use in the vascular system of the body.
- the braid in a collapsed configuration, is elongated and would fit over the deflated balloon of an angioplasty catheter in a relaxed manner. Although it may be essentially the same length as the angioplasty balloon (or other dilatation device), it would likely extend proximal to and distal to the balloon on the shaft of the catheter, being of greater length than the balloon.
- It may extend to the distal tip of the catheter and may be affixed to the catheter shaft at or near the tip, either permanently or releasably. It may also be affixed to the catheter shaft proximally. It may have an attachment for engagement by a guide wire at its distal end or may be affixed to a wire or thread proximally. As will become apparent subsequently, a means for deploying the braid device and undeploying, or contracting, the device other than the balloon may be necessary.
- the braids are made of a material, which has physical properties, which allow absorption of fluids or drugs into the braid material in the relaxed or non-expanded configuration. This would be performed outside the body before insertion of the device. After insertion and when the dilatation device is distended/expanded, the braid would expand with the device or as part of the device, be placed into a stretching tension and be compressed against the vessel wall. These two forces, stretching and compression, will cause the fluid, drug, solvent or other therapy residing within the absorbent material of the braid to be displaced from the braid. This agent would the diffuse into the wall, in the case of the passive diffusion configuration. In the case of the active transport system, electrical charges would be utilized to either draw the agent into the wall or to pump the agent into the wall. Similarly, the agent could be located between the dilatation mechanism and the outer braid or other material coating the dilatation mechanism.
- the braid may be constructed of tiny tubular filaments, which may not have absorbent properties.
- these filaments are tubular in nature, fluids containing drugs or other materials may be injected into them and delivered through them to the vessel wall. It is obvious that a means of injecting fluid into the filaments, such as another lumen in the catheter carrying the device, may be necessary.
- the exit site of the tubular filaments could take the form of small holes, porous material, slits, or just weakened areas of the filaments, just to name a few configurations.
- the tubular design of the filaments of the braid would also add strength to the device so that the outward radial forces needed for scaffolding purposes, described below, would be enhanced.
- the braid may have other physical properties other than absorbency.
- the braid may possess enough rigidity to remain expanded after the initial balloon distention, providing scaffolding to prevent, or significantly lessen, elastic recoil of the dilated vessel.
- the braid is multi-stranded and may be either mono or multifilament braid.
- the aforementioned tubular braided mechanism is easily adapted for use at the exit site for a long term or indwelling catheter or other tube.
- This exit site is problematic for a variety of reasons; the most important of which is that it is a site when infection can occur.
- the problems of this ‘exit site’ are greatly reduced. It is a simple matter to manufacture the yarns/strands of the tubular braid using bio-resorbable materials well known to the medical device industry such as, but not limited to de-hydrated collagen strands. These strands readily absorb solvents/solutions and concurrently could be designed to be reabsorbed by the body in a pre-determined period of time.
- the device is augmented with several novel features to reduce disease and facilitate the angioplasty procedure, i.e., local drug delivery, scaffolding, ridges causing micro-fractures, flow through the porous braid, and single catheter insertion, any one of these features may be used alone or in combination with any of the other features to inhibit disease and facilitate the angioplasty procedure.
- the device may be utilized in the form described, or in a modified form, within other passageways in the body for local delivery of drugs, radiation, and other materials, scaffolding, hemostasis, disease treatment or prevention as well as other uses.
- FIG. 1-A is an illustration of a standard angioplasty catheter 1 with a standard angioplasty balloon 4 .
- the angioplasty balloon 4 is shown un-inflated as shown by the wrinkles 5 on the un-inflated balloon 4 located near the distal end 3 of the device.
- This drawing is not exemplary of any preferred embodiment of the instant invention, but rather serves as a platform for additional FIGS. 1 -B through 4 . It is important to note that this drawing is only a representation of all angioplasty catheters and is not intended to be specific. In this figure as well as all other figures where an angioplasty balloon 4 is represented, specific design parameters have not been added such as the Y-Port adapter/valve that would usually be on an angioplasty balloon catheter. Such a Y-Port is usually used for feeding a guide wire through the axial port and subsequent inflation/deflation of the balloon through the Y port. Said Y-Port is located on the proximal end 2 of the device 1 .
- FIG. 1-B is an illustration of angioplasty balloon catheter of the present invention where a material 7 has been placed over the balloon 4 to trap drugs or other agents or therapy during said angioplasty.
- the drawing illustrates braid 7 covering the balloon 4 , however the instant invention describes other materials other than braid. Further, the angioplasty balloon 4 is completely covered in the drawing with the material. Complete coverage is not mandatory for the instant invention.
- FIG. 2 is an illustration of one preferred embodiment of the instant invention where an angioplasty balloon 4 and another mechanical dilator or deployment mechanism 9 is located on the same catheter/device 8 .
- a stent 10 is also located on the proximal mechanical dilator/deployment mechanism 9 .
- FIG. 3 is a schematic illustration of an embodiment of the instant invention whereby the combination catheter of FIG. 2 is located in a narrowed vessel of the body.
- FIG. 4 is a schematic illustration of an embodiment of the instant invention whereby that by moving an inner wire or mandril in the direction of the arrow, the distal aspect of the guide wire enlarges so that it may engage the distal aspect of the device to expand the mechanism there.
- the present invention is used for intervention into the tubular channels (arteries, veins, biliary tract, urological tract, gastrointestinal tract, stents, grafts, sinuses, nasopharynx, heart, ears, etc.) or hollow cavities (stomach, gall bladder, urinary bladder, peritoneum, etc.) of the body. Further, it may be used in iatragenically created passageways. It is particularly convenient to use in an environment of an operating room, surgical suite, interventional suite, Emergency Room, patient's bedside, etc.
- One preferred embodiment of this device is that the elongate, flexible shaft is inserted into the tubular channel or hollow cavity of the body usually through pecutaneous access or via a surgical incision.
- the device may enter through one of those entry or exit paths (i.e. rectal opening, mouth, ear, etc.).
- the expandable dilation mechanism(s) is deployed (usually actuated by the physician outside the body) so that the configuration(s) on the device opens/deploys.
- the dilating mechanism As the dilating mechanism is expanded, it pushes outward with a radial force that dilates or compresses the tissue. In the case of blood vessels, this is often referred to PTA (Percutaneous Transluminal Angioplasty).
- the deployment mechanism(s) on the system can be configured so that it is ‘detachable’ so that when dilation has occurred, the mechanism(s) (or part of it) can be left in place for scaffolding of the passageway.
- This scaffolding is often referred to as an endoprosthesis, stent or stent-graft.
- a stent or stent-graft (or other scaffolding prosthesis) can be mounted onto the mechanism(s) and then left in place post deployment/dilation.
- the dilator mechanism(s) described herein are usually inserted into the patient in an un-deployed (smaller) fashion. It may arrive in the package in a deployed or un-deployed state.
- FIG. 1-A illustrated is a standard dilatation catheter 1 .
- This particular catheter 1 is a balloon catheter as is illustrated by the uninflated balloon 4 located near the distal end 3 of the catheter 1 .
- the proximal end 2 of the catheter is generic and does not specify other parameters usually seen with a balloon dilatation catheter.
- not illustrated is the usual Y-Port that is located near the proximal end 2 of the catheter.
- the balloon 4 of this figure is shown un-inflated or deflated in the illustration as is represented by the wrinkles 5 in the balloon 4 .
- the wrinkles in the wall of the empty balloon indicated that likely an inelastic material is used to make the balloon 4 .
- the instant invention may use an elastic, relatively inelastic or inelastic material for the balloon.
- FIG. 1-A is an illustration of a non-specific dilation device to serve as a basis for delineating the preferred embodiments of the instant invention.
- FIG. 1-B a dilation catheter 6 of the instant invention is illustrated.
- tubular braid 7 is mounted near the distal end 3 of the catheter 6 .
- the tubular braid 7 is mounted over a dilation balloon 4 .
- the dilatation balloon 4 is difficult to see in the drawing due to the braid 7 covering it.
- the tubular braid 7 alone could be illustrated whereby no balloon 4 is required. In such a case (in contrast to inflating a balloon), the braid would likely be put into a compressive state to expand the tubular braid 7 radially outward.
- the tubular braid 7 may be made of an absorbent material so that a drug, agent or other therapy can become impregnated or absorbed into the individual yarns of the braid or within the interstitial spaces between the braid or in the space between the braid 7 and the balloon 5 . Further, a coating (not shown) could be applied over or within the braid to accomplish the same.
- the agent can be delivered ‘locally’ to the narrowed tissue.
- the exterior material on the dilatation mechanism may have coarse or otherwise characteristics so that the material will have a tendency to be greater or otherwise impregnated into the narrowed tissue. This may have several advantages.
- FIG. 2 another embodiment of the instant invention is illustrated.
- an elongate device 8 with two separate dilators ( 4 and 9 ) is shown.
- the device 8 shows two dilation mechanisms located near the distal end 3 of the device.
- the most distal dilation mechanism illustrated in this figure is a dilatation balloon 4 .
- Somewhat proximal to the balloon is a second dilatation mechanism 9 .
- the proximal dilatation mechanism 9 illustrated here is a tubular braid type. Again, radial expansion outward of the dilatation mechanism 9 is usually accomplished by putting the tubular braid into a compressive state.
- a scaffolding endoprosthesis 10 mounted onto the proximal dilatation mechanism 9 is a scaffolding endoprosthesis 10 often referred to as a stent or stent-graft. It is noted that the stent and stent deployment is not illustrated here.
- One embodiment of the instant invention is that the device 8 will be inserted into a narrowed space, usually with the aid of a guide wire (not shown) and when the distal dilatation mechanism 4 is radially expanded, the narrowed space is expanded. Once the space is somewhat enlarged, the device 8 is moved forward so that the proximal dilatation mechanism 9 and endoprosthesis 10 are oriented into the area.
- the proximal dilation mechanism 9 is then expanded radially so that the endoprosthesis 10 is deployed into the once narrowed area to help keep the area propped open or otherwise scaffolded.
- the dilation mechanisms 4 and 9 on device 8 can be interchanged with respect to location along the device 8 .
- the device may have two balloon dilatation mechanisms or two other types of dilatation mechanisms.
- the tubular braid 7 or 9 may be designed so that is ‘detachable’ from the device 8 so that it may act as both the dilator 9 and the endoprosthesis 10 or either.
- a multi-stranded (mono or multi filament) tubular braid also referred to as braided sleeving is illustrated.
- the braid or the other mechanism can have a permanent set put into in so that it is normally open with the larger diameter. In this case, when it is put into tension (usually from some inner (or outer) core wire or mandril), it collapses down to the diameter of the shaft of the device 8 .
- tension usually from some inner (or outer) core wire or mandril
- these ‘normally open/deployed’ mechanisms could be constrained to a smaller ‘unopened’ diameter with a slideable over tube.
- This braided sleeve/tubing described is similar to a common child's toy of years ago, known as Chinese Finger Cuffs.
- the braided assembly enlarges radially. It can enlarge with significant outward radial force. Hence, this outward radial force can cause the dilation.
- this braided configuration can have a roughened surface that may be very useful in breaking up the matrix of the stenosis. In other words, as mentioned above in the prior art, the braid can act as a cutter as would the tiny cutters on the balloon.
- the braid may be porous, drugs or other therapies can be dispensed during dilatation or other placement (in the case of an exit site catheter/device for example). Further, the interstitial porosity allows other mechanisms to be passed through the wall of the braid for therapy.
- the expansile mechanism of the dilation system can be fabricated from several materials and configurations.
- the strands (of the braid) can be made of any material that would be useful for a particular application (polymers like polyester, nylon, Mylar, etc.) or, metal (stainless steel, Nickel Titanium Alloy (Nitinol), platinum, etc.). The same is true for the malecot (not illustrated and described below).
- the materials of the present invention are not constrained to those materials listed.
- the mechanism may be coated or encased in an elastomeric, inelastic or other covering. Further, the mechanism may be fabricated of a material that will enlarge due to different forces than that of the braid mentioned previously.
- One other such force derived mechanism could be a material that swells/enlarges when put into a moist environment.
- Another such forced derived mechanism is one that swells/enlarges when put in a temperature differential.
- another may be one that occurs from an electrical, magnetic or other mechanical configuration/design/force.
- the dilation mechanisms could be radially expanded in their relaxed state or radially compressed in their relaxed state.
- Another preferred embodiment of the present invention is the availability of different porosities. This is critical. As the braid is made up of filaments, the porosity can be varied. This can allow drugs to be passed through the wall (which is made up of individual filaments). Equally important or maybe more important, when conventional dilating balloons are used, the vessel is totally occluded for the period of therapy that dilation is occurring. As previously, mentioned, lavish perfusion balloons have been developed so that perfusion (blood flow) can occur during dilation. As one expands the braid (or the malecot), as it expands to its fullest diameter, the porosity on the outer wall decreases and becomes ‘solid’ in nature. However, both ends of the expanding braided mechanism remain porous. Hence while the dilation is occurring, blood can flow through the dilating member.
- the filaments of the braid change orientation, as they are expanded/enlarged. This changed orientation may be helpful in breaking up the matrix of the underlying disease.
- the porosity of the braid (or malecot) changes during the dynamics of the enlarging process. This too may be helpful in that the filaments will ‘grab’ part of the intimal wall while enlarging/expanding. Further, it will continue to grab the inner wall and stress it or change it somehow so that re-stenosis is greatly decreased.
- tubular braid 9 or 7 and balloon 4 mechanisms are varied.
- Another such mechanism and a preferred embodiment of the present invention use a configuration known as a malecot (not illustrated).
- This malecot is a common configuration used in catheters for holding them in place (in the case of feeding tubes in the intestines or stomach). It is usually a polymeric (but may also be metal) tube that has more than one, but usually two or more slits symmetrically opposed.
- the distal tip of the malecot is put into compression (usually by pulling an inner wire or mandrel or tube), the sides of the polymer are pushed outward so as to create a larger diameter on the distal tip.
- This enlarged distal malecot diameter is larger than the body/shaft of the device.
- the surface of the malecot could be roughened or a separate membrane (attached or not) could be put over or under the malecot so that it is roughened or strengthened or added for another reason.
- FIG. 3-A the device 8 of FIG. 2 is partially illustrated in a narrowed blood vessel 11 .
- the narrowing of the blood vessel 11 is indicated by the formation of plaque 12 attached to the intimal lining 13 of the vessel.
- the device 8 has been inserted into the body and blood vessel 11 until the distal dilation mechanism 4 is oriented appropriately in the narrowed space.
- the dilatation mechanism is a dilatation balloon 4 .
- the device 8 and balloon 4 are oriented to the correct location with the aid of image intensification (x-ray, ultrasound, MRI, etc.). Once in the appropriate location, the dilation mechanism is deployed/dilated to expand the narrowed vessel 11 . This dilatation process is not illustrated.
- the dilatation mechanism 4 is un-deployed and the catheter/device 8 is advanced further into the vessel as illustrated in FIG. 3-B.
- the plaque 12 of FIG. 3-A has been compressed and the vessel is somewhat expanded so that the narrowing is decreased.
- This compressed plaque 15 has a tendency to recoil so often an endoprosthesis/stent/stent-graft 10 is desired to be placed into the dilated vessel 14 to help keep it propped open.
- the second dilation/deployment mechanism 9 is oriented appropriately in the dilated vessel 14 , it is deployed.
- the second dilation mechanism illustrated is a tubular braid 9 with a stent 10 mounted onto it. Once deployed, the stent 10 remains in place in the newly dilated vessel 14 .
- the first dilatation mechanism in this case a balloon 4
- the first dilatation mechanism 4 can be dilated (inflated) a second time to further expand and/or embed the stent 10 into the dilated wall 16 of the vessel 14 .
- this is often the case in normal practice for the interventionalist, especially in the case where self-expanded stents are used.
- the scaffold 10 and or the dilating mechanisms 9 or dilating mechanism 4 is preferably coated with a medical grade substance having low thrombogenicity or other medicament that helps prevent deleterious effects that may accompany these procedures.
- the scaffold 10 may be coated with any of a variety of fabrics/textiles that allow tissue growth into it, other stabilization or other preferred characteristic.
- the scaffold 10 or dilating mechanisms 4 and 9 may be impregnated with radioactivity, monoclonal anti-bodies or a variety of other medicaments that may inhibit re-stenosis or other deleterious effects that wish to be avoided.
- the braid can be coated with an elastomer or plastically deformable material so that it might go from a small size to a large size and the interstitial spaces are coated with some porous or non-porous material.
- One, but certainly not the only way to accomplish this coating is to first dilate the braid to a larger diameter by placing an inner rod or mandril inside the tubular braid/braided sleeving. At this point, the assembly is coated with a liquid dispersion and allowed to dry/volatilize. Once dry, the inner rod is removed and the system can be put into tension and the diameter will decrease to the original small diameter. This process can be accomplished by impregnating the tubular braid with a thermoplastic material as well as thermoset.
- the dilation mechanism is a tubular braid/braided sleeving 9 .
- the distal end 17 of tubular braid 9 is bonded to the distal end 17 of the inner wire or tube 20 .
- the proximal end 18 of the tubular braid 9 is bonded to the outer tube 19 which will likely end at 18 .
- moving the inner mandril or tube 20 relative to the outer tube 19 to expand the dilator 9 actuates the dilator.
- a second outer tube (not shown) can be slid over the dilation mechanism to keep it in the smaller diameter and then removed to allow it to expand. This might be the deployment mechanism used when the normal relaxed condition of the dilator is in the expanded/larger condition.
- FIG. 4-B the inner mandril or tube 20 has indeed been moved relative to the outer tube 19 as indicated by the arrow 21 .
- the dilating mechanism is thus expanded as indicated by 22 .
- the mechanism illustrated in FIG. 4 is a tubular braid mechanism, however, the malecot design could also be used.
- FIG. 1 Drawings of the device of the present invention are included in the appendix.
- An exemplary device has the following characteristics:
- the inner wire/mandril of the present invention has an outer diameter that ranges from 0.006 to 0.150 inches, usually in the range of 0.008 to 0.035 inches but can extend to smaller and larger sizes as technology and procedures require.
- the outer tube /shaft of the instant invention has an inner diameter that will accept the inner wire/mandril, an outer diameter in the range of 0.020 top 0.400 inches usually in the range of 0.030 to 0.200 inches but can extend to smaller and larger sizes as technology and procedures require.
- the dilation mechanism of the present invention would be small in its un-deployed state (similar to that of the wire or tube mentioned above, depending on the configuration), but would be expandable to diameters of 0.010 to 0.500 inches, but usually in the range of 0.030 to 0.400 inches, but can extend to smaller and larger sizes as technology and procedures require or even larger.
- the dilatation mechanism will usually have two diameters, a smaller/undeployed diameter which would be in the range of 0.010 to 0.100 inches or even larger.
- the larger/deployed state of the mechanism may extend from 0.050 to 2.00′′ inches or even larger depending upon the vessel being dilated.
- the device of the present invention may have conventional lubricious coatings to enhance introduction into the target body lumen, e.g. hyaluronic or other equivalent coatings. Further, the technician may apply a lubricious coating just prior to surgery. As an advantage of the present invention, the device will be less difficult to feed it to the desired location in the body due to its decreased size. Another advantage of the present invention would be the ease with which obstructions can be snared for removal or obliteration.
- This decreased difficulty will decrease cost due to time in the Operating Room (Operating Rooms costs are estimated in excess of $90 dollars per minute in the U.S.) Additionally, there will be realized a decrease in difficulty for perfusion during treatment that will aid in patient care/recovery and the potential in deleterious effects due to the total occlusion during conventional treatment.
- FIGS. 1 - 4 An exemplary device having dilating mechanism(s) located on its distal tip is illustrated in FIGS. 1 - 4 .
- the mechanism(s) may be at the tip or somewhere else in the distal portion of the device or even in the middle of the device. Additionally, this mechanism(s) may be any of a number of mechanisms that will help aid in dilating the tissue.
- the dilation mechanism/system is illustrated in its un-deployed condition. In FIG. 4-B, it is in its deployed condition.
- emboli can become loosened during many of these therapies and these emboli can have deleterious affects ‘downstream’. This occurrence would appear to be increased with a LIS approach due to the fact that in an open procedure, the site of revision is in direct view so that this particulate should be more easily detected and removed. Conversely, in a LIS procedure the physician is dependent upon image intensification and his or her actual skill to not allow emboli from being dislodged and causing ‘downstream’, distal problems. The instant invention may likely be used with a distal protection system as described.
- the preferred version of this embodiment relies on a passive system of drug delivery, in concert with the objectives to keep the device simple, inexpensive, and easy to operate.
- the passive system for delivery of the drug or other agent will rely primarily on diffusion of the concentrated drug into the vessel wall.
- An active system may use a process referred to as iontophoresis, which because of a differential in electric charges essentially pumps the drug into the vessel wall and perivascular soft tissues.
- One embodiment employs a novel method of iontophoresis, which uses the normal negative resting potential of the heart and the normal depolarization/repolarization cycle to draw the drug into the vessel wall and perivascular tissues.
- the device is simply soaked in a container of fluid which contains a drug or other material, absorbing a quantity of the fluid determined by the size and composition of the braid and, to a lesser extent, the type of fluid.
- the fluid may contain any drug or other material approved for use within the body by the Food and Drug Administration.
- the device including the angioplasty balloon, is inserted into the blood vessel, the angioplasty balloon positioned appropriately, and the balloon inflated in a standard manner. The distention of the angioplasty balloon stretches and compresses the braid so that the braid releases the fluid containing the drug or other material adjacent to the arterial wall, where it is absorbed into the arterial wall by passive diffusion.
- an active transport mechanism may be provided to better facilitate the transfer of the drug or material into the vessel wall.
- One active transport system is Iontophoresis, which uses a differential in electrical charges to either pull the drug or material into the vessel wall or to pump it from the inner surface of the vessel into the vessel wall.
- the configuration of the electrodes within the device, the catheter, or the body may take any one of several forms. There may be an external electrode on the patient's body and an internal electrode within the braid device or the angioplasty catheter. There may be two internal electrodes, one within the braid device and one within the angioplasty catheter. The electrodes may be placed elsewhere, i.e., on the guiding catheter or on the guide wire.
- the stent may act as an electrode and the second electrode may be incorporated into any one of the locations described.
- One configuration involves a single electrode in the braid device or any of the other locations, and uses the normal negative resting potential of the heart to draw the drug or material into the vessel wall. In fact, there may be any combination of the above configurations.
- the device will be synchronized with the electrocardiogram to deliver tiny pulses of electrical charge. These pulses may be delivered in the depolarization phase, the repolarization phase, the resting phase, or the refractory phase or period.
- a separate programmable device would control the delivery time, amplitude, voltage, current, etc., and the synchronization with the electrocardiogram.
- the operator would initiate the iontophoretic components at the onset of balloon inflation, typically, although initiation after or during balloon inflation is also possible. If the braid device remains expanded after the initial balloon dilatation, the iontophoretic components may be activated continuously even after the angioplasty balloon is deflated. This will allow the process to continue while allowing for blood flow through the site of the lesion because of the porous nature of the braid device. In the case of the passive diffusion configuration, the braid device will maintain contact with the vessel wall continuously, allowing more material to diffuse into the vessel wall.
- the braid device will also act as scaffolding to prevent elastic recoil during the balloon deflations. This is secondary to the radial forces caused by the braid device being shortened during the balloon inflation. Therefore, the braid device would diminish elastic recoil by acting as scaffolding and because of the micro-fractures caused in the plaque matrix. These micro-fractures would disrupt the structure of the plaque it would not tend to reassume its pre-dilated shape.
- the present invention may be utilized with a stent to provide pharmacological and mechanical means of combating re-stenosis.
- a self-expandable or balloon expandable stent may be used, and the stent may or may not be designed and packaged for use with the device.
- the device may have the properties of a scaffold or stent and actually act as means to mechanically counteract the forces of elastic recoil without the presence of a separate stent.
- the discussion centers on braid design, it is the express intent that this patent should cover any material whether braided, woven, molded, pressed, sliced, compressed, expanded, or any other material which has the capacity to absorb a drug or other substance containing a physiologically active ingredient, and release that drug or material when compressed.
- the device may be constructed of a sponge material or foam material, which would absorb the drug or other substance, and then release that drug or material when compressed by the expanding balloon. In fact, some other force other than compression may accomplish the release of the absorbed drug or material.
- the texture of the braid over the angioplasty balloon will create tiny micro-fractures within the plaque matrix which will reduce damage to the vessel wall, diminish the incidence of dissections, diminish the elastic recoil of the wall, and allow for more uniform compressibility of the plaque. All of these factors have been implicated in the re-stenosis process. This action, even without the drug delivery features, may diminish re-stenosis. However, by creating the tiny micro-fractures within the plaque, the drug is able to be delivered in a better proximity to the vessel wall than without this property.
- the braid will likely become slightly and temporarily imbedded within the micro-fractures of the plaque, creating a desirable situation which enhances delivery of the drug or material into the plaque and vessel wall because of proximity, and, concomitantly, decreases the amount of drug or material which is washed away by the flowing blood.
- the operator would inflate the angioplasty balloon a single or multiple times, while simultaneously delivering the drugs, fracturing the plaque, and preserving the distention of the lesion with the braid device.
- the drug delivery and other actions are accomplished essentially during the angioplasty procedure and there is no need for a second catheter insertion to deliver the drug or other material or to effect the other actions of the device with the embodiment described. Obviating the need to reinsert another catheter to accomplish this action saves a significant amount of time, expense, and potential risk to the patient.
- the drug delivery and other actions could be performed with a device separate from the angioplasty catheter or on another balloon on or separate from the initial angioplasty catheter.
- the actions could be performed in concert with a stent deployment. The operation of these other embodiments will not be described, but are similar to the operation of the preferred embodiment.
- the un-deployment or contraction of the braid device from the vessel wall deserves special attention since the braid device will not contract to its original state when the balloon is deflated, at least in the preferred embodiment in which it acts as a scaffold while the balloon is deflated.
- the braid device may be returned to its original low profile shape over the deflated angioplasty balloon by one of several means, which by mention, are incorporated into the present invention.
- the distal end of the braid device may be constructed so that it engages a guide wire, so that by advancing the guide wire, withdrawing the catheter, or a combination of these motions, the braid device elongates and returns to its original undeployed shape and state.
- the guide wire may contain an expanded portion that will engage the braid device or there may be a portion of the guide wire, which expands because of traction on an inner core of the guide wire.
- This expandable portion of the guide wire may be constructed of a flexible braid or other material.
- the braid device may be collapsed or contracted by holding the catheter in place and pulling on a wire or thread attached to the proximal portion of the braid device.
- a wire or thread attached to the proximal portion of the braid device.
- Still another means of collapsing the braid device after use may be to use a shaped memory alloy within the braid.
- the shaped memory alloy would be formed so that it would cause the braid to seek a collapsed, elongated, tubular shape after expansion when the distending balloon is deflated.
- This alloy may be used as a filament within the braid, but also may be disposed as longitudinal lay-ins between the braided filaments. Horizontal lay-ins may also be utilized to aid in returning the braid device to its original undeployed state.
- a combination of any of the collapsing means may be used, as well.
- This is a device to be used on any long term indwelling catheter in the lumens or cavities of the body at the site the catheter exits the patients skin. There is a need to stabilize the catheter and prevent its withdrawal and to promote healing of the skin around the exit site to prevent infection, irritation, need for daily care, weeping, inability to shower, etc.
- the exit site device of the instant invention addresses and solves these problems with a unique expandable braid of collagen yarns which can be attached to the synthetic material of the catheter and will allow the ingrowth of skin into the device. In other words, the skin will not grow into or attach itself to the foreign catheter material directly.
- This new exit site device in constructed so it can be affixed to the catheter and the skin will then grow into the device creating a seal between the skin and the catheter.
- This exit site device is usually constructed of a braid, similar to the drug delivery device above, and is meant to be placed over or on the catheter just beneath the skin. The purpose of this device is to encourage the skin to heal over the catheter and produce a tight seal preventing the ingress of bacteria, fungus, and contaminants into the catheter tract.
- the indwelling catheter creates a crevice in the tissues and the epidermis tends to grow down this tract, frequently carrying bacteria with them. This results in infection in the catheter tract.
- This device would create a bond between the skin and the catheter utilizing braided crosslinked collagen attached to the outer portion of the catheter in a tubular matter.
- the collagen lattice will provide an optimal framework for the ingrowth of normal tissues, which would be affixed to a membrane, such as silicone, which in turn, would be affixed to the catheter. If the device were constructed from a braid, foreshortening the braid would cause diametric expansion of portions of the braided device, causing it to initially assume a football like shape and subsequently a plate like shape, depending on the forces applied.
- the device may be constructed of material other than collagen and may not necessarily be of braided construction.
- a spiral or helical configuration is possible and this patent is to cover any expansile configuration, i.e., the device maintains a low profile shape upon insertion but is changed to a diametrically expanded shape after insertion for anchoring purposes.
- the preferred embodiment being a braided collagen device, may have only one end of its tubular configuration attached to the catheter. Forcing the non-attached end of the tubular braid toward the attached end will cause the braid to deform into the shapes above.
- the device may be in a football or plate-like shape initially, and tension may be required to cause it to assume a tubular shape for insertion, for example.
- the braided sleeve or tubular braid apparatus described herein include an expandable tubular braid.
- an inner mandril or wire may be used o contact the tubular braid.
- the elongate mandril extends from the proximal end of the device to the distal end of the tubular braid.
- the distal end of the tubular braid is bonded/attached to the distal end of the inner elongate mandril.
- the mandril may extend beyond the tubular braid.
- the proximal end of the tubular braid is bonded to the distal end of an elongate tube.
- the tubular braid may or may not be attached to the substrate catheter. In this case, the tubular braid will be used as a means to deliver the drug or other agent to the lesion or to break up the matrix of plaque in the lesion.
- the braid may be open, but may be laminated or covered with a coating of elastic, generally inelastic, plastic or plastically deformable material, such as silicone rubber, latex, polyethylene, thermoplastic elastomers (such as C-Flex, commercially available from Consolidated Polymer Technology), polyurethane and the like.
- elastic, generally inelastic, plastic or plastically deformable material such as silicone rubber, latex, polyethylene, thermoplastic elastomers (such as C-Flex, commercially available from Consolidated Polymer Technology), polyurethane and the like.
- the inventors of the instant invention have disclosed a method of coating the interstitial pores of the tubular braid without adding to the overall wall thickness of the tubular braid.
- This manufacturing invention is disclosed in pending provisional submission Ser. No. 60/121,640.
- the assembly of tube, mandril and braid is introduced percutaneously in its radially compressed state. In this state, the outside diameter of the braid is close to the outside diameter of the elongate
- the tubular braid is preferably formed as a mesh of individual non-elastic filaments (called “yarns” in the braiding industry). Nevertheless, it can have some elastic filaments interwoven to create certain characteristics.
- the non-elastic yarns can be materials such as polyester, PET, polypropylene, polyamide fiber (Kevlar, DuPont), composite filament wound polymer, extruded polymer tubing (such as Nylon II or Ultem, commercially available from General Electric), stainless steel, Nickel Titanium (Nitinol), or the like so that axial shortening causes radial expansion of the braid. These materials have sufficient strength so that the engaging element will retain its expanded condition in the lumen of the body while removing the obstruction therefrom.
- the individual filaments may be absorbent in nature or as stated earlier, the drug or other agent may be merely trapped in between the tubular braid and the underlying dilating member.
- the braid may be of conventional construction, comprising round filaments, flat or ribbon filaments, square filaments, or the like.
- Non-round filaments may be advantageous to decrease the axial force required for expansion to create a preferred surface area configuration or to decrease the wall thickness of the tubular braid.
- the filament width or diameter will typically be from about 0.5 to 25 mils, usually being from about 5 to 10 mils.
- Suitable braids are commercially available from a variety of commercial suppliers.
- the tubular braids are typically formed by a “Maypole” dance of yarn carriers.
- the braid consists of two systems of yarns alternately passing over and under each other causing a zigzag pattern on the surface.
- One system of yarns moves helically clockwise with respect to the fabric axis while the other moves helically counter-clockwise.
- the resulting fabric is a tubular braid.
- Common applications of tubular braids are lacings, electrical cable covers (i.e. insulation and shielding), “Chinese hand-cuffs” and reinforcements for composites.
- To form a balanced, torque-free fabric (tubular braid) the structure must contain the same number of yarns in each helical direction.
- the tubular braid may also be pressed flat so as to form a double thickness fabric strip.
- the braid weave used in the tubular braid of the present invention will preferably be of the construction known as “two dimensional, tubular, diamond braid” that has a 1/1 intersection pattern of the yarns which is referred to as the “intersection repeat”.
- a Regular braid with a 2/2 intersection repeat and a Hercules braid with an intersection repeat of 3/3 may be used.
- the helix angle that being the angle between the axis of the tubular braid and the yarn
- Lay-Ins can be added within the braid yarns and parallel to the axis to aid with stability, improve tensile and compressive properties and modulus of the fabric.
- the tubular braid is known as an elastic braid.
- the fabric is called a rigid braid.
- Biaxially braided fabrics such as those of the present invention are not dimensionally stable. This is why the braid can be placed into an expanded state from a relaxed state (in the case of putting it into the compressive mode). Alternatively this could be a decreased/reduced (braid diameter decreases) state when put into tension from the relaxed state.
- the braid When put into tension (or compression for that matter) the braid eventually reaches a state wherein the diameter will decrease no more. This is called the “Jammed State”. On a stress strain curve, this corresponds to increase modulus.
- Much of the engineering analysis concerning braids is calculated using the “Jammed State” of the structure/braid. These calculations help one skilled in the art to design a braid with particular desired characteristics. Further, material characteristics are tensile strength, stiffness and Young's modulus. In most instances, varying the material characteristics will vary the force with which the expanded condition of the tubular can exert radially. Even further, the friction between the individual yarns has an effect on the force required to compress and un-compress the tubular braid.
- friction should be relatively low for a chosen yarn so that the user will have little trouble deploying the engaging element. This is particularly important when the engaging element is located a significant distance from the user. Such is the case when the percutaneous entry is the groin (Femoral Artery for vascular interventions) and the point of engaging the engaging element is some distance away (i.e. the Carotid Artery in the neck). Similarly, this is true for long distances that are not vascular or percutaneous applications.
- the use of the device is relatively simple and adds little time to the procedure and potentially a significant benefit to the patient.
- the drug or other material is delivered at the same time and with the same catheter as the angioplasty and the device is removed with the angioplasty balloon, in the preferred embodiment.
- other actions occur at this time (scaffolding and micro-fractures) which also contributes significantly to inhibit the re-stenosis process.
Abstract
Description
- The present invention is a continuation of provisional patent applications Ser. No. 60/083,178 filed on and claiming priority of Apr. 27, 1998, No. 60/095,106 filed on and claiming priority of Aug. 3, 1998 and No. 60/115,548 filed on and claiming priority of Jan. 12, 1999, the full disclosures of which is incorporated herein by reference.
- 1. Field of the Invention
- The present invention relates to medical devices and their methods of use. More specifically, the present invention relates to devices which are particularly useful for repairing and/or serving as a conduit for body passageways requiring reinforcement, dilatation, disease prevention or the like. Such devices are utilized to deliver a therapy, that therapy being from a family of devices, drugs, or any of a variety of other elements to a specific location within the body.
- The present invention provides a system of combining a novel deployment and/or drug delivery therapy with existing balloon dilatation therapy into one device. This combination will yield a significant decrease in cost to the healthcare system as well as providing a therapy to the patient with increased safety and efficacy. Further, the instant invention provides a novel and improved platform for synthetic/tissue interface between the device and the body.
- Occlusive vascular disease is a common ailment in people resulting in enormous costs to the health care especially with the ‘Graying of America’ due to the baby boomers of the 50's. The common procedure of dilatation of these occluded vessels of the body has been studied for several years and many techniques (devices and methods) have been studied and practiced. One of the more common techniques is one referred to as balloon angioplasty or Percutaneous Transluminal Angioplasty (PTA). PTA is the most common treatment of atherosclerotic plaque deposition. However, this PTA has significant drawbacks; some of which are the cost of the catheter and the potential for the stenotic vessel to ‘recoil’ or narrow back down after the procedure. Hence scaffolds (stents or stent-grafts) have been designed that stay in place to keep the vessel ‘propped open’ after dilatation. Other significant design changes have occurred with PTA such as the use of drugs pre, during and post dilation. Balloons have been designed with permeable membranes to aid with this delivery. Further, the balloons have been designed with imperfections in the surface of the balloon that aid in breaking up the plaque matrix during dilation (tiny cutters for example have been impregnated into the exterior wall of the balloon). Further energy dispersal systems have been employed to deliver energy to the site pre, during or post therapy (e.g. radiation, electrical stimulation, RF, etc.). Even further, extravagant perfusion systems have been developed with the dilatation systems so that blood can flow during the therapy. All of these proposed ‘enhancements’ add significantly to the cost and complexity of the dilation or stent device. The present invention allows all of these enhancements to occur with an overall reduction in the manufacturing resources required for the device since one device/catheter is required as opposed to two or more. Even more important, is the time efficiencies created during the procedure by obviating the need to exchange the devices/catheters to perform the acts which may include angioplasty, stent deployment, and drug delivery. Safety to the patient is enhanced, as well, by obviating the time consuming exchanges and diminishing the time of the procedure.
- Also, despite the evolution of a variety of mechanical techniques and adjunctive therapies, approximately 30-45% of patients treated with balloon angioplasty will develop a recurrent stenosis within six months. Stenting of the lesion will decrease the re-stenosis rate to 20-30%, although with additional cost and risks. The cost of treating patients with re-stenosis which require another revascularization procedure or additional therapy and has been estimated to cost 2500 lives and $4 billion. Re-stenosis is a complex process, which is due to some combination of suboptimal results, acute mechanical recoil, thrombosis and platelet deposition, smooth muscle proliferation, extracellular matrix production, and geometric remodeling as well as other reasons not reported here. Because of the improvement in the re-stenosis rate with intraluminal stents, it is likely that stenting prevents the mechanical events which contribute to re-stenosis, i.e., suboptimal results, acute mechanical recoil, and geometric remodeling. However, stenting has been shown to accelerate or incite smooth muscle proliferation, thrombosis and platelet deposition, and matrix production. These events may be grouped together and referred to as neointimal hyperplasia. Exuberant neointimal hyperplasia may lead to stenosis within a stent, referred to as in-stent re-stenosis. Therefore, stents may improve the re-stenosis rate, but at a significant financial cost, potential risk to the patient, and a possibility of developing in-stent stenosis. Hence, a novel invention that allows safer, less expensive and more efficacious dilatation and stent deployment is described in the present invention.
- As stated, stenting is not the cure all. Moreover, pharmacological therapy has not been shown efficacious in significantly reducing neointimal hyperplasia, for several different reasons. One reason is related to the systemic intolerances of doses required to achieve local beneficial effects within the arterial wall. A local drug delivery device which would deliver higher drug concentration to the target while avoiding systemic toxicity's or side effects would be advantageous. In fact there are several patented local drug delivery devices, including balloon catheters, coated stents, and even needle catheters. However, most are plagued with the rather uniform problem of low transfer efficiency, rapid washout/poor retention, and the potential of additional vessel injury. Most also require insertion of a separate and specialized catheter separate from the angioplasty balloon catheter, which is a time consuming, costly, and potentially a risky maneuver.
- There are many techniques and devices known in the art for removing blockages, repairing occlusions and otherwise preventing or treating disease in the passageways of the human body. Further, many approaches exist to treat the synthetic/tissue interface that exists when using medical devices and implants in the body. However, there is a continuing need for improved devices to meet at least the following objectives.
- The first objective is to reduce cost. This is particularly important in recent years where it is clear for safety and sanitary reasons that these will be single use devices. A device, even though it performs a function in some improved manner, will not be widely used if it is considerably more costly than the alternatives available.
- A second objective is to provide a device that is simple to use and in a very real sense simple to understand. This will encourage its adoption and use by medical personnel. It will also tend to keep cost low.
- The third objective is to provide a device that entails a procedure with which the medical profession is familiar so that the skills that have been learned from previous experience will continue to have applicability.
- A fourth objective relates to the effectiveness and thoroughness with which the blockage is removed. It is important that a maximum amount of the blockage be removed; recognizing that no device is likely to provide one hundred percent removal.
- A fifth objective concerns safety; a matter which is often so critical as to trump the other considerations. It is important to avoid tissue trauma. In many circumstances, it is critically important to avoid breaking up a blockage in a fashion that leads to flushing elements of the blockage throughout the body involved.
- There are trade-offs in design considerations to achieve the above five interrelated objectives. Extreme simplicity and a very simple procedure might over compromise safety. Addressing all of these considerations calls for some trade-off between the objectives.
- Accordingly, a major object of this invention is to provide an improved device for treatment or prevention of disease of a body passageway, which achieves the objectives of, reduced cost, enhanced simplicity, a standard procedure, high effectiveness and a high degree of safety. Most particularly, it is an object of the present invention to achieve these objectives with an enhanced trade-off value for the combined objectives.
- A novel device description is set forth in the instant invention that allows for treatment of fully or partially occluded vessels within the body; usually those vessels being blood vessels. In brief, the instant invention allows multiple therapies to be provided with a single device. One embodiment of the instant invention is to provide a single device/catheter/guide wire that allows for balloon angioplasty of a stenotic lesion in the vasculature and deployment of a device for propping open the vessel with that same device. This is often referred to as an endoprosthesis, but more frequently referred to as a stent or stent-graft. Usually stenosis of a blood vessel is treated by placing a balloon in the narrowed/stenosed area of the vessel and expanding the balloon, which subsequently expands the narrowed vessel, at least temporarily or partly. This balloon expansion is referred to as balloon angioplasty. Unfortunately, too often after balloon angioplasty, the vessel returns to its original ‘narrowed’ condition. This is referred to as recoil, if it occurs acutely. Subacute or late narrowing may be secondary to restenosis, a complex process described more fully elsewhere in this document. These processes occur in a large percentage of ‘ballooned’ vessels, sometimes upward of fifty percent. Because of this limited long-term success, balloon angioplasty is frequently used in addition to, or in conjunction with, other therapies such as placement of a stent, stent-graft, or subsequent drug delivery to the area of stenosis or re-stenosis. The additional therapies will hopefully prevent the re-closure of the vessel after balloon angioplasty. These subsequent therapies require the addition of new devices after balloon angioplasty. Hence, it is standard procedure to remove the angioplasty device only to replace it with another device that either delivers the stent or stent-graft, and even another device, which delivers the drug or other therapy. Hence it is the preferred embodiment of the instant invention to provide a device that can expand the vessel via a balloon angioplasty device, but also provide a system that can simultaneously or subsequently deliver a therapy such as a stent or stent-graft or deliver agents/drugs without the removal of the original angioplasty device/catheter.
- Conversely, a novel therapeutic device is described in the instant invention that can dilate the narrowed vessel without the use of a balloon and can then deploy a stent or stent-graft with a balloon or with another novel mechanism on the same device.
- Further, another preferred embodiment of the instant invention allows for a therapeutic delivery of a drug or other agent to tissue to prevent or treat disease. In particular, during balloon angioplasty, this is accomplished without an additional device being used for this therapy.
- The instant invention is primarily, though not exclusively, oriented to the use of technology referred to as tubular braid or braided sleeving. The basic design of tubular braid is well defined later in the patent under a particular ‘comments’ section entitled The Tubular Braid or Braided Sleeve Element.
- 2. Description of Background Art
- Intraluminal devices or endovascular prostheses are known for treating stenosis, stricture, aneurysm conditions and the like. Often these devices are implanted or used via LIS (Least Invasive Surgery); whereby a small percutaneous access into the vessel is accomplished (usually remote to the diseased area). Alternatively, they are installed via an ‘open surgery’ approach. Advantages of the LIS approach (over conventional surgery) are significant from a cost as well as a patient care and recovery point of view. Balloon catheters have found an increased use in medical procedures such as percutaneous transluminal angioplasty (PTA), percutaneous transluminal nephrostomy, ureteral dilatation, biliary duct dilatation, percutaneous transluminal renal angioplasty and the like. Intellectual property regarding balloon dilatation is extensive and shall not be exhaustively reported here, however, certain patents deemed relative are described. Gruntzig et al in U.S. Pat. No. 4,195,637 and Simpson et al in U.S. Pat. No. 4,323,071 are two very well known patents that have been said to initiate the onslaught of intellectual property that is realized with balloon angioplasty. These two patents describe initial intellectual property associated with balloon angioplasty and are often referenced as a basis for such discussions, however have little relevancy to the inventions disclosed herein except for that basis. U.S. Pat. Nos. 4,448,195, 4,637,396, 4,608,984 and 4,646,742 describe balloons reinforced with fabric and/or multi-layer construction to increase strength and control expansion. Levi U.S. Pat. No. 4,490,421 is a well-discussed patent that disclosed the use of PET materials in the fabrication of angioplasty balloons that allow high pressures without rupture. Stents and stent-grafts have in-depth coverage in the intellectual forefront as well. A predominant stent patent by Palmaz, U.S. Pat. No. 4,776,337 discloses a well-known device frequently referred to as a Self-Expanding Stent. Self-Expanding Stents have come of favor recently over balloon expandable stents for reasons not completely understood by the author, but likely due to the perceived decrease in effort to deploy the stent since there is only the initial balloon dilatation and then stent deployment instead of balloon dilatation, and balloon dilation/stent deployment a second time to implant the stent or stent-graft. However, multiple catheter exchanges must be made to dilate the lesion with the angioplasty catheter, deliver the self expanding stent with another catheter or delivery device, and then reinsert the angioplasty balloon catheter to tack the stent down properly. Further, because stent placement is still relatively new in medicine, the interventionalist is always left with the question of long-term reliability (with regard to re-stenosis) of all stent placements. Intraluminal scaffolding devices such as stents are often used in combination with grafts and vice versa. The graft is usually, but not always a an elastic or inelastic material and often a textile/fabric type material that is used to cover a greater area of the scaffolding as well as aid in neo-intimal formation after placement. Further, the two (stents and grafts) are often designed into one device called a stent-graft.
- One embodiment of the present invention allows balloon dilation and stent deployment to be accomplished with one device. In and of itself, this technique as well as other inventions have tried to accomplish the same, but have been met with limited success. LeVeen, LeVeen and LeVeen in U.S. Pat. No. 4,404,971 describe a dual balloon catheter to control bleeding to facilitate surgical closure of the blood vessel. Taking this multiple balloon concept further, Hegde et al in U.S. Pat. No. 5,725,535 describe a method for using a multiple balloon catheter that allows balloon dilatation of the stricture and then stent deployment using the same catheter. However, the resulting multiple balloon device is more than complicated and Hegde et al disclose a method for a complex and expensive device. Further, using balloons for dilatation and for stent deployment require a significant amount of time for inflation/filling and subsequent deflation/un-filling of the balloons. The rate of inflation and deflation of the balloons bears directly on the stress induced on the heart during the procedure. In U.S. Pat. No. 5,725,535, Hegde et al describes the multiple balloon device in detail in the body as well as in the claims. However, in addition to the inflation and deflation times mentioned above, the device described in this patent has the obvious drawbacks of requiring a separate lumen for each balloon. In addition to increasing the cost of manufacture, this requirement requires the overall diameter of the catheter to be increased. Marin and Marin in U.S. Pat. No. 5,456,694 describe an extravagant catheter similar to the Hegde patent whereby multiple balloons are used to accomplish the same as in the Hegde patents. Marin and Marin disclose a guiding sheath in cooperation with their multiple balloon system that has a variable stiffness that is made available through their design that reportably decreases trauma to the patient. Marin and Marin recognize the limitations of multiple balloons in their design and make mention of alternative mechanical linkages to deploy the stents. These linkages are described in Marin's U.S. Pat. Nos. 5,618,300 and 5,443,477. Marin and Marin indeed describe an alternative mechanical linkage device for stent deployment in these subsequent patents, however again only at the cost of losing cost effectiveness in the manufacture of the catheter as well as the potential increase in size of the diameters of the catheters and potential flexibility of the catheter/device. Further, in U.S. Pat. No. 4,585,000, Harold Hershenson describes a mechanical linkage type dilator that is similar to that of Marin and Marin in that it is complicated for manufacture and difficult for size reduction which is of paramount importance.
- Further, all of these mechanical linkages lend themselves to an inflexibility characteristic. Because of the tortuous paths realized in the vasculature, flexibility of the catheter/device is critical. It is often the case that narrowing of vessels in the body often occur at tortuous curves or bifurcations similar to shallows in a stream or river.
- Hence in the present invention, described herein, the inventors describe a multiple use device/catheter, that can be made in a low cost manufacturing environment while keeping diameter of the device to a minimum, but keeping safety and efficacy to the patient at a maxinum. The present invention utilizes a manufacturing technique known as tubular braid or braided sleeving to accomplish either dilatation or stent deployment. The instant invention may be used with a dilation balloon on the device in combination with the tubular braid. When the tubular braid is put into compression, the braid expands radially for dilation and/or stent deployment. Further, the inventors disclose a novel device and method for using a single device for dilatation and stent deployment without the need for balloons at all. Embodiments are described which will provide the capability of balloon dilation and deployment of an expandable stent or a self-expanding stent.
- Additionally, the inventors disclose the use of tubular braid as a device to deliver drug/agent/therapy to passageways as well.
- The use of tubular braid for use in the tubular vessels of the body is not new and is described in several issued U.S. Patents. Anderson et al in U.S. Pat. No. 4,706,670 describes a unique use of tubular braid in conjunction with balloon angioplasty. In this disclosure, Anderson et al describe the use of tubular braid that is molded into an elastomeric catheter shaft so that upon expansion of the catheter from within, the shaft only expands and dilates to a fixed diameter that is predetermined by the inelastic tubular braid filaments within the walls of the catheter. When pressure is removed from the device the diameter contracts back to its original, ‘undilated’ diameter. In U.S. Pat. No. 4,650,466, Ronald Luther describes a tubular braided device for use in angioplasty where the expanded braid is used for removal and trapping of debris during said angioplasty. In U.S. Pat. No. 4,572,186, Gould et al describe a dilation catheter using tubular braid. Gould describes the objectives of his inventions to replace angioplasty balloon for providing improved dilating forces, decreased costs, and radiopacity and improve upon balloon dilation limitations such as the forces realized with balloon catheters are not realized until the balloon is almost filled with filling agent. Hence Gould describes a dilatation device using braid that does not necessarily go from a very small diameter to a very large diameter that is evidenced by these objects as well as are realized in his illustrations. Further, and again, Gould did not invent the use of the tubular braid in conjunction with other dilation or deployment. In fact due to the description that the author gives in the patent, it is likely that the inventors could not determine a design that would transmit significant force to a blood vessel so as to actually dilate the vessel and the underlying stenotic, atheroma/plaque which tends to be a hard and sinuous material that is not too receptive to dilatation without constraining his design to small incremental dilations from said small catheter shaft to only a slightly larger diameter shaft after deployment. The same Applicant with a different Inventor, Richard Hillstead in U.S. Pat. No. 4,921,484 describes a Mesh Balloon Catheter device. Hillstead discusses the use of the tubular braid for stent deployment, filtering and centering characteristics in the body of his disclosure, but limits his invention to drainage of the device wherein fluid accumulation occurs in the expanded tubular braid or with other flushing lumens there-through with regard to using the device for the compression and or removal of material during an angioplasty. Certainly nowhere does Hillstead recognize the advantage of combining the tubular braid with balloon angioplasty, nor it is obvious to anyone normally skilled in the art. Hillstead describes an intricate device for expanding the tubular braid. The mechanism described in the Hillstead patent misses the importance of decreased diameter of the catheter, decreased manufacturing costs, the importance of physical flexibility of the catheter and importantly the invention of coupling the more than one tubular braid mechanism with another or with a balloon dilator to decrease the overall cost of the devices required for dilatation and stent placement or the increase in safety and efficacy that such a design gives to the patient. Wholey et al in U.S. Pat. No. 4,723,549 describes a method and apparatus for dilating blood vessels. Wholey describes a tubular braid being used as a filter or trap to collect emboli that may become dislodged during the intervention. A balloon is used to expand tubular braid that remains expanded as a filter or trap during the PTA procedure. Further, in U.S. Pat. No. 5,034,001, Garrison et al discloses an angioplasty device with a temporary stent that may be fabricated from tubular braid. This temporary stent in the Garrison et al patent is used to help prevent the problems that are realized with instantaneous recoil subsequent to angioplasty/balloon dilatation.
- In fact, the present inventors have several patents some of which have issued and some of which are pending that use the tubular braids for medical devices. In U.S. Pat. Nos. 5,498, 5,280,273, 5,713,848 and Continuation of these issued patents, Ser. No. 098/005,217, the current inventor discloses the use of tubular braid as an occluder and as a filter and trap for dislodged emboli and blood particulate. Further, the current inventor in U.S. Pat. No. 5,431,676 uses tubular braid to facilitate a radially expanding trocar. Even further, the current inventors in pending U.S. and PCT submissions (U.S. Ser. No. 09/063,735 and PCT/US Ser. No. 98/08194) disclose tubular braid in the fabrication of embolic containment devices as well as tubular braid use for a bifurcated stent. Further yet, the current inventors use tubular braid in the design and disclosure of devices and methods for entrapping, occlusion, flow direction, tensioning and/or anchoring devices in U.S. Ser. Nos. 09/248,088 09/248,083 and PCT/US Nos. 99/02856 and 99/02853.
- However, none of the references mentioned above disclose a new device that can be used as a combination dilatation device and stent deployment device that allows increase patient safety and efficacy with an overall reduction in the manufacturing costs and complexity of the combined device or its use by the physician as does the novel invention disclosed herein.
- Turning now to another embodiment of the instant invention, that of utilizing the tubular braid in conjunction with an angioplasty balloon (or other dilatation means) for concurrent balloon angioplasty and drug delivery/therapy. This instant invention uses a tubular braid or other similar material that may have an absorbent nature such as Dacron, cotton etc. The absorbent material is placed over a balloon or other dilation device. Prior to placing the balloon into the diseased lesion, the absorbable material is allowed to absorb a therapeutic agent into the individual filaments or in between the filaments and the outer wall of the balloon or other dilatation device. When the dilatation device is placed into the constricted area/lesion of the vessel and the dilated, the drug or other agent is then driven into the vessel wall at the site of the lesion, where it is needed most. Further, the covering material, such as the tubular braid, will act as a means for penetrating the lesion and potentially breaking up the plaque matrix that exists there. Certainly, the drug/agent/therapy will at very least be delivered into the lesion/diseased site, again where it is need most.
- U.S. Pat. No. 4,994,033 by Shockey describes an intravascular drug delivery dilatation catheter that disclosed a plurality of minute holes within a set of balloons for subsequent delivery of a drug during angioplasty. However, Shockey et al describes a device that is costly and complicated to manufacture. Wolinsky et al in U.S. Pat. No. 5,087,244 describes a method and catheter with minute holes (approximately 25 microns) through the balloon wall as well for concurrent drug delivery during angioplasty. The repeatability of the sized 25 micron holes in the balloon coupled with the potential restrictions of the drug used for perfusion through these holes lend itself to these disadvantages. In U.S. Pat. No. 5,279,565, Klein et al describes a device and method for infusing an agent to the treatment site as well. Klein et al discloses a rather complex device that would lend itself to costly manufacture if it would be put to practice. Fahrad Khosravi in U.S. Pat. No. 5,415,637 discloses a temporary stenting device with drug delivery capabilities. In his disclosure, Khosravi describes a device that will deliver drugs while propping open a narrowed vessel using an elaborate set of hypotubes with holes drilled in them. As compared with the instant invention, this device will greatly exceed manufacturing costs as well as decrease flexibility of the catheter, which described earlier, is of paramount importance.
- The use of drug/agent/therapy devices to be used concurrently with angioplasty has been studied significantly due to the frequent re-stenosis that occurs. The addition of stents to help prevent this re-stenosis has merit and is gaining favor quickly, but does not stop re-stenosis and adds significantly to the treatment costs. In fact, significant development has occurred that deliver drug/agents/therapy to stents, again to prevent re-stenosis. The use of drugs to help prevent restenosis shows great value. Stephen R. Bailey reports upon the significant development and reasons for such development in his article entitledLocal Drug Delivery: Current Applications, published in Progress in Cardiovascular Diseases, Vol. 40, No. 2 (September/October), 1997: pp183-204. In fact, this is merely one several publications regarding the developments and research in this regard.
- The drug or therapeutic agent delivery system of the instant invention similarly to the aforementioned and novel dilatation system of this patent uses a very ‘manufacturing friendly’ process that will allow simple fabrication on a production basis. Further and like the aforementioned dilatation system, this drug or agent delivery system yields characteristics that allow for high safety and efficacy to the patient while minimizing the efforts and time of the clinician.
- The five objectives first described in the BACKGROUND OF THE INVENTION are important to a successful invention in today's complicated medical device industry and health care arena and bear repeating. They are reducing cost and complexity, using a procedure that the healthcare professional is familiar with and maximizing/optimizing safety and efficacy. The preferred embodiments of the instant invention address all five of these objectives where the background art does not.
- Dilation balloons are also commonly used to deploy stents or stent-grafts. Even further, many stents or stent-grafts are configured with a multi-stranded, braided, sleeve or tube. One of the descriptions of the present invention is similar to that of the braided sleeve. Hence, the present device can be used such that the stent or stent-graft can be mounted on the inner/outer system described below and when put into compression; the stent or stent-graft expands radially (just as it does when it is mounted on a dilatation/deployment balloon). Alternatively, when the tubular braid dilatation system is used, the system could be modified so that the tubular braid is ‘detachable’ from the elongate shaft of the catheter or wire. In this case, it could be left in place as a stent or stent-graft. The ‘detachable’ tubular braid could be put into compression so that it expands. This may be accomplished by having reinforcements on both sides of the tubular braid that can be moved inward relative to one another to cause the compressive force on the tubular braid. Once the forces are withdrawn, the tubular braid would remain in place in the vessel. Additional dilatation from a balloon could be added now to ‘set’ the stent or stent-graft in place. Often, a stent or stent-graft only needs a ‘nudge’ to start its expansion both in the case of self-expanding and balloon expanding endoprostheses.
- For these reasons, it is desirable to provide improved devices that may circumvent some of the problems associated with previous techniques. This improved medical device provide a new configuration that will eliminate some of those problems and methods for their use, which facilitate removal of vascular and other vessel obstructions, narrowing, constrictures, disease prevention, etc. in the operating room or interventional suite.
- In a first embodiment of the present invention provides an improved device (guide wire or catheter) of the type having an elongate flexible shaft with a proximal end and a distal end. The improvement comprises configuring at least a distal portion of the flexible shaft so that it can assume a shape(s) along its shaft (proximally, mid-section or distally) that will act as a dilator. This guide wire or catheter can be moved along the lumen (artery, vein, intestine, stent, graft, or other hollow vessel or organ, etc.) and to the obstruction area (clot, plaque, or other obstruction). Once it is in the vicinity of the obstruction/constriction/narrowing, the user (physician/technician) can easily actuate the dilation mechanism(s) so that it is enlarged beyond its original size/diameter and dilate the narrowed passageway. Further, a similar mechanism can be deployed distal to the obstruction so that when the dilatation is occurring and fragments are dislodged during the therapy, the distal mechanism can trap them from moving downstream. These emboli can be trapped and then obliterated or removed at some later time.
- A second embodiment of the instant invention, concerned with delivery or a drug/agent/solvent to the vessel wall, is directed to a tubular device, which has proximal and distal ends, constructed of monofilament or multifilament braids for use in the vascular system of the body. The braid, in a collapsed configuration, is elongated and would fit over the deflated balloon of an angioplasty catheter in a relaxed manner. Although it may be essentially the same length as the angioplasty balloon (or other dilatation device), it would likely extend proximal to and distal to the balloon on the shaft of the catheter, being of greater length than the balloon. It may extend to the distal tip of the catheter and may be affixed to the catheter shaft at or near the tip, either permanently or releasably. It may also be affixed to the catheter shaft proximally. It may have an attachment for engagement by a guide wire at its distal end or may be affixed to a wire or thread proximally. As will become apparent subsequently, a means for deploying the braid device and undeploying, or contracting, the device other than the balloon may be necessary.
- In a preferred version of this embodiment, the braids are made of a material, which has physical properties, which allow absorption of fluids or drugs into the braid material in the relaxed or non-expanded configuration. This would be performed outside the body before insertion of the device. After insertion and when the dilatation device is distended/expanded, the braid would expand with the device or as part of the device, be placed into a stretching tension and be compressed against the vessel wall. These two forces, stretching and compression, will cause the fluid, drug, solvent or other therapy residing within the absorbent material of the braid to be displaced from the braid. This agent would the diffuse into the wall, in the case of the passive diffusion configuration. In the case of the active transport system, electrical charges would be utilized to either draw the agent into the wall or to pump the agent into the wall. Similarly, the agent could be located between the dilatation mechanism and the outer braid or other material coating the dilatation mechanism.
- Alternatively, the braid may be constructed of tiny tubular filaments, which may not have absorbent properties. However, because these filaments are tubular in nature, fluids containing drugs or other materials may be injected into them and delivered through them to the vessel wall. It is obvious that a means of injecting fluid into the filaments, such as another lumen in the catheter carrying the device, may be necessary. In addition, the exit site of the tubular filaments could take the form of small holes, porous material, slits, or just weakened areas of the filaments, just to name a few configurations. The tubular design of the filaments of the braid would also add strength to the device so that the outward radial forces needed for scaffolding purposes, described below, would be enhanced.
- The braid may have other physical properties other than absorbency. The braid may possess enough rigidity to remain expanded after the initial balloon distention, providing scaffolding to prevent, or significantly lessen, elastic recoil of the dilated vessel. The braid is multi-stranded and may be either mono or multifilament braid.
- Additionally, the aforementioned tubular braided mechanism is easily adapted for use at the exit site for a long term or indwelling catheter or other tube. This exit site is problematic for a variety of reasons; the most important of which is that it is a site when infection can occur. By using the tubular braid with the aforementioned disease inhibiting characteristics, the problems of this ‘exit site’ are greatly reduced. It is a simple matter to manufacture the yarns/strands of the tubular braid using bio-resorbable materials well known to the medical device industry such as, but not limited to de-hydrated collagen strands. These strands readily absorb solvents/solutions and concurrently could be designed to be reabsorbed by the body in a pre-determined period of time.
- While the device is augmented with several novel features to reduce disease and facilitate the angioplasty procedure, i.e., local drug delivery, scaffolding, ridges causing micro-fractures, flow through the porous braid, and single catheter insertion, any one of these features may be used alone or in combination with any of the other features to inhibit disease and facilitate the angioplasty procedure.
- As well, while the discussions have addressed the uses of the device within the vascular system, the device may be utilized in the form described, or in a modified form, within other passageways in the body for local delivery of drugs, radiation, and other materials, scaffolding, hemostasis, disease treatment or prevention as well as other uses.
- FIG. 1-A is an illustration of a standard angioplasty catheter1 with a
standard angioplasty balloon 4. In this illustration, theangioplasty balloon 4 is shown un-inflated as shown by thewrinkles 5 on theun-inflated balloon 4 located near thedistal end 3 of the device. This drawing is not exemplary of any preferred embodiment of the instant invention, but rather serves as a platform for additional FIGS. 1-B through 4. It is important to note that this drawing is only a representation of all angioplasty catheters and is not intended to be specific. In this figure as well as all other figures where anangioplasty balloon 4 is represented, specific design parameters have not been added such as the Y-Port adapter/valve that would usually be on an angioplasty balloon catheter. Such a Y-Port is usually used for feeding a guide wire through the axial port and subsequent inflation/deflation of the balloon through the Y port. Said Y-Port is located on theproximal end 2 of the device 1. - FIG. 1-B is an illustration of angioplasty balloon catheter of the present invention where a
material 7 has been placed over theballoon 4 to trap drugs or other agents or therapy during said angioplasty. The drawing illustratesbraid 7 covering theballoon 4, however the instant invention describes other materials other than braid. Further, theangioplasty balloon 4 is completely covered in the drawing with the material. Complete coverage is not mandatory for the instant invention. - FIG. 2 is an illustration of one preferred embodiment of the instant invention where an
angioplasty balloon 4 and another mechanical dilator ordeployment mechanism 9 is located on the same catheter/device 8. In this figure, astent 10 is also located on the proximal mechanical dilator/deployment mechanism 9. - FIG. 3 is a schematic illustration of an embodiment of the instant invention whereby the combination catheter of FIG. 2 is located in a narrowed vessel of the body.
- FIG. 4 is a schematic illustration of an embodiment of the instant invention whereby that by moving an inner wire or mandril in the direction of the arrow, the distal aspect of the guide wire enlarges so that it may engage the distal aspect of the device to expand the mechanism there.
- These illustrations show only some potential configurations of the present invention. Other parametric changes of the present invention can occur such as location of the described elements on the distal portion of the device as well as the actual type of mechanism(s) used. The location of these mechanisms may vary from the proximal to the distal end although all figures illustrate a distal location. Further, specific design parameters that are not pertinent to the instant invention are not delineated in the figures such as, but not limited to guide wires, valves, syringes, proximal deployment means, etc.
- The present invention is used for intervention into the tubular channels (arteries, veins, biliary tract, urological tract, gastrointestinal tract, stents, grafts, sinuses, nasopharynx, heart, ears, etc.) or hollow cavities (stomach, gall bladder, urinary bladder, peritoneum, etc.) of the body. Further, it may be used in iatragenically created passageways. It is particularly convenient to use in an environment of an operating room, surgical suite, interventional suite, Emergency Room, patient's bedside, etc. One preferred embodiment of this device is that the elongate, flexible shaft is inserted into the tubular channel or hollow cavity of the body usually through pecutaneous access or via a surgical incision. In the case of lumens that enter and exit the body naturally, the device may enter through one of those entry or exit paths (i.e. rectal opening, mouth, ear, etc.). Once the device is in the preferred location (that being where the narrowing or obstruction is located), the expandable dilation mechanism(s) is deployed (usually actuated by the physician outside the body) so that the configuration(s) on the device opens/deploys. As the dilating mechanism is expanded, it pushes outward with a radial force that dilates or compresses the tissue. In the case of blood vessels, this is often referred to PTA (Percutaneous Transluminal Angioplasty).
- The deployment mechanism(s) on the system can be configured so that it is ‘detachable’ so that when dilation has occurred, the mechanism(s) (or part of it) can be left in place for scaffolding of the passageway. This scaffolding is often referred to as an endoprosthesis, stent or stent-graft. Even further, a stent or stent-graft (or other scaffolding prosthesis) can be mounted onto the mechanism(s) and then left in place post deployment/dilation. The dilator mechanism(s) described herein are usually inserted into the patient in an un-deployed (smaller) fashion. It may arrive in the package in a deployed or un-deployed state.
- Referring to FIG. 1-A, illustrated is a standard dilatation catheter1. This particular catheter 1 is a balloon catheter as is illustrated by the
uninflated balloon 4 located near thedistal end 3 of the catheter 1. Theproximal end 2 of the catheter is generic and does not specify other parameters usually seen with a balloon dilatation catheter. For instance, not illustrated is the usual Y-Port that is located near theproximal end 2 of the catheter. Theballoon 4 of this figure is shown un-inflated or deflated in the illustration as is represented by thewrinkles 5 in theballoon 4. The wrinkles in the wall of the empty balloon indicated that likely an inelastic material is used to make theballoon 4. However, the instant invention may use an elastic, relatively inelastic or inelastic material for the balloon. FIG. 1-A is an illustration of a non-specific dilation device to serve as a basis for delineating the preferred embodiments of the instant invention. - Turning now to FIG. 1-B, a dilation catheter6 of the instant invention is illustrated. In this embodiment,
tubular braid 7 is mounted near thedistal end 3 of the catheter 6. In this illustration, thetubular braid 7 is mounted over adilation balloon 4. Thedilatation balloon 4 is difficult to see in the drawing due to thebraid 7 covering it. However, thetubular braid 7 alone could be illustrated whereby noballoon 4 is required. In such a case (in contrast to inflating a balloon), the braid would likely be put into a compressive state to expand thetubular braid 7 radially outward. In FIG. 1-B, thetubular braid 7 may be made of an absorbent material so that a drug, agent or other therapy can become impregnated or absorbed into the individual yarns of the braid or within the interstitial spaces between the braid or in the space between thebraid 7 and theballoon 5. Further, a coating (not shown) could be applied over or within the braid to accomplish the same. When such an agent is used and thedilatation device - Turning now to FIG. 2, another embodiment of the instant invention is illustrated. In this drawing, an
elongate device 8 with two separate dilators (4 and 9) is shown. Thedevice 8 shows two dilation mechanisms located near thedistal end 3 of the device. The most distal dilation mechanism illustrated in this figure is adilatation balloon 4. Somewhat proximal to the balloon is asecond dilatation mechanism 9. Theproximal dilatation mechanism 9 illustrated here is a tubular braid type. Again, radial expansion outward of thedilatation mechanism 9 is usually accomplished by putting the tubular braid into a compressive state. Further, mounted onto theproximal dilatation mechanism 9 is ascaffolding endoprosthesis 10 often referred to as a stent or stent-graft. It is noted that the stent and stent deployment is not illustrated here. One embodiment of the instant invention is that thedevice 8 will be inserted into a narrowed space, usually with the aid of a guide wire (not shown) and when thedistal dilatation mechanism 4 is radially expanded, the narrowed space is expanded. Once the space is somewhat enlarged, thedevice 8 is moved forward so that theproximal dilatation mechanism 9 andendoprosthesis 10 are oriented into the area. Theproximal dilation mechanism 9 is then expanded radially so that theendoprosthesis 10 is deployed into the once narrowed area to help keep the area propped open or otherwise scaffolded. It is important to note that thedilation mechanisms device 8 can be interchanged with respect to location along thedevice 8. Further, the device may have two balloon dilatation mechanisms or two other types of dilatation mechanisms. Further, thetubular braid device 8 so that it may act as both thedilator 9 and theendoprosthesis 10 or either. - Referring now to the
dilation mechanism 9, a multi-stranded (mono or multi filament) tubular braid, also referred to as braided sleeving is illustrated. When the braid is put into compression, the braid is pulled together and it flares out to create a larger diameter. Alternatively, either the braid or the other mechanism (like the malecot mechanism described below) can have a permanent set put into in so that it is normally open with the larger diameter. In this case, when it is put into tension (usually from some inner (or outer) core wire or mandril), it collapses down to the diameter of the shaft of thedevice 8. Alternatively when these ‘normally open/deployed’ mechanisms could be constrained to a smaller ‘unopened’ diameter with a slideable over tube. This braided sleeve/tubing described is similar to a common child's toy of years ago, known as Chinese Finger Cuffs. In this case, when the tubular braided sleeve is pushed together, the braided assembly enlarges radially. It can enlarge with significant outward radial force. Hence, this outward radial force can cause the dilation. Further, this braided configuration can have a roughened surface that may be very useful in breaking up the matrix of the stenosis. In other words, as mentioned above in the prior art, the braid can act as a cutter as would the tiny cutters on the balloon. Further, because the braid may be porous, drugs or other therapies can be dispensed during dilatation or other placement (in the case of an exit site catheter/device for example). Further, the interstitial porosity allows other mechanisms to be passed through the wall of the braid for therapy. - Alternatively, too much abrasive action on the surface of the dilatation mechanism(s) may be deleterious to the patient as well. In the case of the braided configuration, some smoothener may be required so that just the appropriate amount of surface roughness is realized for effective matrix disorganization/disruption. This surface covering could be total or partial covering of the device as required for the particular application. Further, the realized rigidity of any of the type of mechanism(s)s must be optimized for the particular application. Even further, this smoothener added to the tubular braid may aid a receptacle for holding the agent or as a porous membrane for the agent to pass through.
- The expansile mechanism of the dilation system can be fabricated from several materials and configurations. The strands (of the braid) can be made of any material that would be useful for a particular application (polymers like polyester, nylon, Mylar, etc.) or, metal (stainless steel, Nickel Titanium Alloy (Nitinol), platinum, etc.). The same is true for the malecot (not illustrated and described below). Certainly, the materials of the present invention are not constrained to those materials listed. Additionally, the mechanism may be coated or encased in an elastomeric, inelastic or other covering. Further, the mechanism may be fabricated of a material that will enlarge due to different forces than that of the braid mentioned previously. One other such force derived mechanism could be a material that swells/enlarges when put into a moist environment. Another such forced derived mechanism is one that swells/enlarges when put in a temperature differential. Yet, another may be one that occurs from an electrical, magnetic or other mechanical configuration/design/force. The dilation mechanisms could be radially expanded in their relaxed state or radially compressed in their relaxed state.
- Another preferred embodiment of the present invention is the availability of different porosities. This is critical. As the braid is made up of filaments, the porosity can be varied. This can allow drugs to be passed through the wall (which is made up of individual filaments). Equally important or maybe more important, when conventional dilating balloons are used, the vessel is totally occluded for the period of therapy that dilation is occurring. As previously, mentioned, lavish perfusion balloons have been developed so that perfusion (blood flow) can occur during dilation. As one expands the braid (or the malecot), as it expands to its fullest diameter, the porosity on the outer wall decreases and becomes ‘solid’ in nature. However, both ends of the expanding braided mechanism remain porous. Hence while the dilation is occurring, blood can flow through the dilating member.
- Further, as mentioned briefly above, the filaments of the braid (or malecot) change orientation, as they are expanded/enlarged. This changed orientation may be helpful in breaking up the matrix of the underlying disease. Further, the porosity of the braid (or malecot) changes during the dynamics of the enlarging process. This too may be helpful in that the filaments will ‘grab’ part of the intimal wall while enlarging/expanding. Further, it will continue to grab the inner wall and stress it or change it somehow so that re-stenosis is greatly decreased.
- As taught, possible configurations of the distal mechanism(s) are varied. Illustrated is
tubular braid balloon 4 mechanisms. Another such mechanism and a preferred embodiment of the present invention use a configuration known as a malecot (not illustrated). This malecot is a common configuration used in catheters for holding them in place (in the case of feeding tubes in the intestines or stomach). It is usually a polymeric (but may also be metal) tube that has more than one, but usually two or more slits symmetrically opposed. When the distal tip of the malecot is put into compression (usually by pulling an inner wire or mandrel or tube), the sides of the polymer are pushed outward so as to create a larger diameter on the distal tip. This enlarged distal malecot diameter is larger than the body/shaft of the device. In the case of this malecot type mechanism, the surface of the malecot could be roughened or a separate membrane (attached or not) could be put over or under the malecot so that it is roughened or strengthened or added for another reason. - Turning now to FIG. 3-A, the
device 8 of FIG. 2 is partially illustrated in a narrowed blood vessel 11. The narrowing of the blood vessel 11 is indicated by the formation ofplaque 12 attached to the intimal lining 13 of the vessel. Thedevice 8 has been inserted into the body and blood vessel 11 until thedistal dilation mechanism 4 is oriented appropriately in the narrowed space. In this figure, the dilatation mechanism is adilatation balloon 4. Thedevice 8 andballoon 4 are oriented to the correct location with the aid of image intensification (x-ray, ultrasound, MRI, etc.). Once in the appropriate location, the dilation mechanism is deployed/dilated to expand the narrowed vessel 11. This dilatation process is not illustrated. Once complete thedilatation mechanism 4 is un-deployed and the catheter/device 8 is advanced further into the vessel as illustrated in FIG. 3-B. Theplaque 12 of FIG. 3-A has been compressed and the vessel is somewhat expanded so that the narrowing is decreased. Thiscompressed plaque 15 has a tendency to recoil so often an endoprosthesis/stent/stent-graft 10 is desired to be placed into the dilatedvessel 14 to help keep it propped open. Once the second dilation/deployment mechanism 9 is oriented appropriately in the dilatedvessel 14, it is deployed. In FIG. 3-B the second dilation mechanism illustrated is atubular braid 9 with astent 10 mounted onto it. Once deployed, thestent 10 remains in place in the newly dilatedvessel 14. It may be desired to pull thedevice 8 backward just enough so that the first dilatation mechanism, in this case aballoon 4, is oriented near the position of the newly implantedstent 10. In this case, thefirst dilatation mechanism 4 can be dilated (inflated) a second time to further expand and/or embed thestent 10 into the dilatedwall 16 of thevessel 14. In fact, this is often the case in normal practice for the interventionalist, especially in the case where self-expanded stents are used. - The
scaffold 10 and or the dilatingmechanisms 9 ordilating mechanism 4 is preferably coated with a medical grade substance having low thrombogenicity or other medicament that helps prevent deleterious effects that may accompany these procedures. Alternatively, thescaffold 10 may be coated with any of a variety of fabrics/textiles that allow tissue growth into it, other stabilization or other preferred characteristic. Further, thescaffold 10 or dilatingmechanisms - Turning now to FIG. 4, an embodiment of the instant invention is illustrated where the dilation mechanism is a tubular braid/
braided sleeving 9. In the case of a dilator only, thedistal end 17 oftubular braid 9 is bonded to thedistal end 17 of the inner wire ortube 20. Theproximal end 18 of thetubular braid 9 is bonded to theouter tube 19 which will likely end at 18. In one preferred embodiment, moving the inner mandril ortube 20 relative to theouter tube 19 to expand thedilator 9 actuates the dilator. In another preferred embodiment, a second outer tube (not shown) can be slid over the dilation mechanism to keep it in the smaller diameter and then removed to allow it to expand. This might be the deployment mechanism used when the normal relaxed condition of the dilator is in the expanded/larger condition. - Turning now to FIG. 4-B, the inner mandril or
tube 20 has indeed been moved relative to theouter tube 19 as indicated by thearrow 21. The dilating mechanism is thus expanded as indicated by 22. The mechanism illustrated in FIG. 4 is a tubular braid mechanism, however, the malecot design could also be used. - Drawings of the device of the present invention are included in the appendix. An exemplary device has the following characteristics:
- Working Length
- 10-500 cm
- Working Diameter
- The inner wire/mandril of the present invention has an outer diameter that ranges from 0.006 to 0.150 inches, usually in the range of 0.008 to 0.035 inches but can extend to smaller and larger sizes as technology and procedures require. The outer tube /shaft of the instant invention has an inner diameter that will accept the inner wire/mandril, an outer diameter in the range of 0.020 top 0.400 inches usually in the range of 0.030 to 0.200 inches but can extend to smaller and larger sizes as technology and procedures require. The dilation mechanism of the present invention would be small in its un-deployed state (similar to that of the wire or tube mentioned above, depending on the configuration), but would be expandable to diameters of 0.010 to 0.500 inches, but usually in the range of 0.030 to 0.400 inches, but can extend to smaller and larger sizes as technology and procedures require or even larger. The dilatation mechanism will usually have two diameters, a smaller/undeployed diameter which would be in the range of 0.010 to 0.100 inches or even larger. The larger/deployed state of the mechanism may extend from 0.050 to 2.00″ inches or even larger depending upon the vessel being dilated.
- Physical Configuration
- The device of the present invention may have conventional lubricious coatings to enhance introduction into the target body lumen, e.g. hyaluronic or other equivalent coatings. Further, the technician may apply a lubricious coating just prior to surgery. As an advantage of the present invention, the device will be less difficult to feed it to the desired location in the body due to its decreased size. Another advantage of the present invention would be the ease with which obstructions can be snared for removal or obliteration. This decreased difficulty will decrease cost due to time in the Operating Room (Operating Rooms costs are estimated in excess of $90 dollars per minute in the U.S.) Additionally, there will be realized a decrease in difficulty for perfusion during treatment that will aid in patient care/recovery and the potential in deleterious effects due to the total occlusion during conventional treatment.
- An exemplary device having dilating mechanism(s) located on its distal tip is illustrated in FIGS.1-4. The mechanism(s) may be at the tip or somewhere else in the distal portion of the device or even in the middle of the device. Additionally, this mechanism(s) may be any of a number of mechanisms that will help aid in dilating the tissue. In all FIGS. 1-3, the dilation mechanism/system is illustrated in its un-deployed condition. In FIG. 4-B, it is in its deployed condition.
- As previously mentioned, emboli can become loosened during many of these therapies and these emboli can have deleterious affects ‘downstream’. This occurrence would appear to be increased with a LIS approach due to the fact that in an open procedure, the site of revision is in direct view so that this particulate should be more easily detected and removed. Conversely, in a LIS procedure the physician is dependent upon image intensification and his or her actual skill to not allow emboli from being dislodged and causing ‘downstream’, distal problems. The instant invention may likely be used with a distal protection system as described.
- It is an object of the invention to provide a catheter/device for deploying an endoprosthesis/stent/stent-graft.
- It is yet a further object of the invention to provide an endoprosthesis deployment device or guide wire with the added ability to dilate the narrowed passageway using the same device.
- It is still a further object of the invention to provide a system for dilating a narrowed passageway.
- It is another object of the present invention to allow the dilating mechanism to have an irregular surface for disturbing the matrix of the narrowed intima of the tissue to aid in the therapy.
- It is another object of the present invention to allow perfusion through the dilating mechanism.
- It is another object of the present invention to allow delivery of drugs, energy, mechanisms, etc. through or into the walls of the dilating mechanism to aid with such therapies.
- It is still a further object of the invention to provide a system for allowing the delivery of a drug or other therapeutic agent to the dilatation site at the time of dilatation and this iteration is described below. The preferred version of this embodiment relies on a passive system of drug delivery, in concert with the objectives to keep the device simple, inexpensive, and easy to operate.
- The passive system for delivery of the drug or other agent will rely primarily on diffusion of the concentrated drug into the vessel wall. An active system may use a process referred to as iontophoresis, which because of a differential in electric charges essentially pumps the drug into the vessel wall and perivascular soft tissues. One embodiment employs a novel method of iontophoresis, which uses the normal negative resting potential of the heart and the normal depolarization/repolarization cycle to draw the drug into the vessel wall and perivascular tissues.
- The device is simply soaked in a container of fluid which contains a drug or other material, absorbing a quantity of the fluid determined by the size and composition of the braid and, to a lesser extent, the type of fluid. The fluid may contain any drug or other material approved for use within the body by the Food and Drug Administration. The device, including the angioplasty balloon, is inserted into the blood vessel, the angioplasty balloon positioned appropriately, and the balloon inflated in a standard manner. The distention of the angioplasty balloon stretches and compresses the braid so that the braid releases the fluid containing the drug or other material adjacent to the arterial wall, where it is absorbed into the arterial wall by passive diffusion.
- Alternatively, an active transport mechanism may be provided to better facilitate the transfer of the drug or material into the vessel wall. One active transport system is Iontophoresis, which uses a differential in electrical charges to either pull the drug or material into the vessel wall or to pump it from the inner surface of the vessel into the vessel wall. The configuration of the electrodes within the device, the catheter, or the body may take any one of several forms. There may be an external electrode on the patient's body and an internal electrode within the braid device or the angioplasty catheter. There may be two internal electrodes, one within the braid device and one within the angioplasty catheter. The electrodes may be placed elsewhere, i.e., on the guiding catheter or on the guide wire. In the case of a stent, the stent may act as an electrode and the second electrode may be incorporated into any one of the locations described. One configuration involves a single electrode in the braid device or any of the other locations, and uses the normal negative resting potential of the heart to draw the drug or material into the vessel wall. In fact, there may be any combination of the above configurations.
- It is likely that, in the case of intracoronary iontophoretically enhanced drug delivery; the device will be synchronized with the electrocardiogram to deliver tiny pulses of electrical charge. These pulses may be delivered in the depolarization phase, the repolarization phase, the resting phase, or the refractory phase or period. A separate programmable device would control the delivery time, amplitude, voltage, current, etc., and the synchronization with the electrocardiogram.
- The operator would initiate the iontophoretic components at the onset of balloon inflation, typically, although initiation after or during balloon inflation is also possible. If the braid device remains expanded after the initial balloon dilatation, the iontophoretic components may be activated continuously even after the angioplasty balloon is deflated. This will allow the process to continue while allowing for blood flow through the site of the lesion because of the porous nature of the braid device. In the case of the passive diffusion configuration, the braid device will maintain contact with the vessel wall continuously, allowing more material to diffuse into the vessel wall.
- The braid device will also act as scaffolding to prevent elastic recoil during the balloon deflations. This is secondary to the radial forces caused by the braid device being shortened during the balloon inflation. Therefore, the braid device would diminish elastic recoil by acting as scaffolding and because of the micro-fractures caused in the plaque matrix. These micro-fractures would disrupt the structure of the plaque it would not tend to reassume its pre-dilated shape.
- Moreover, the present invention may be utilized with a stent to provide pharmacological and mechanical means of combating re-stenosis. A self-expandable or balloon expandable stent may be used, and the stent may or may not be designed and packaged for use with the device. Additionally, the device may have the properties of a scaffold or stent and actually act as means to mechanically counteract the forces of elastic recoil without the presence of a separate stent.
- While the discussion centers on braid design, it is the express intent that this patent should cover any material whether braided, woven, molded, pressed, sliced, compressed, expanded, or any other material which has the capacity to absorb a drug or other substance containing a physiologically active ingredient, and release that drug or material when compressed. For example, the device may be constructed of a sponge material or foam material, which would absorb the drug or other substance, and then release that drug or material when compressed by the expanding balloon. In fact, some other force other than compression may accomplish the release of the absorbed drug or material.
- As mentioned above, the texture of the braid over the angioplasty balloon will create tiny micro-fractures within the plaque matrix which will reduce damage to the vessel wall, diminish the incidence of dissections, diminish the elastic recoil of the wall, and allow for more uniform compressibility of the plaque. All of these factors have been implicated in the re-stenosis process. This action, even without the drug delivery features, may diminish re-stenosis. However, by creating the tiny micro-fractures within the plaque, the drug is able to be delivered in a better proximity to the vessel wall than without this property. The braid will likely become slightly and temporarily imbedded within the micro-fractures of the plaque, creating a desirable situation which enhances delivery of the drug or material into the plaque and vessel wall because of proximity, and, concomitantly, decreases the amount of drug or material which is washed away by the flowing blood.
- The operator would inflate the angioplasty balloon a single or multiple times, while simultaneously delivering the drugs, fracturing the plaque, and preserving the distention of the lesion with the braid device. As one can see from the foregoing description of the preferred embodiment, the drug delivery and other actions are accomplished essentially during the angioplasty procedure and there is no need for a second catheter insertion to deliver the drug or other material or to effect the other actions of the device with the embodiment described. Obviating the need to reinsert another catheter to accomplish this action saves a significant amount of time, expense, and potential risk to the patient. However, in another embodiment, the drug delivery and other actions could be performed with a device separate from the angioplasty catheter or on another balloon on or separate from the initial angioplasty catheter. In still another embodiment, the actions could be performed in concert with a stent deployment. The operation of these other embodiments will not be described, but are similar to the operation of the preferred embodiment.
- The un-deployment or contraction of the braid device from the vessel wall deserves special attention since the braid device will not contract to its original state when the balloon is deflated, at least in the preferred embodiment in which it acts as a scaffold while the balloon is deflated. The braid device may be returned to its original low profile shape over the deflated angioplasty balloon by one of several means, which by mention, are incorporated into the present invention.
- The distal end of the braid device may be constructed so that it engages a guide wire, so that by advancing the guide wire, withdrawing the catheter, or a combination of these motions, the braid device elongates and returns to its original undeployed shape and state. The guide wire may contain an expanded portion that will engage the braid device or there may be a portion of the guide wire, which expands because of traction on an inner core of the guide wire. This expandable portion of the guide wire may be constructed of a flexible braid or other material.
- The braid device may be collapsed or contracted by holding the catheter in place and pulling on a wire or thread attached to the proximal portion of the braid device. Alternatively, if the braid device were affixed to the catheter shaft proximal to the balloon, simply withdrawing the catheter would cause the braid device to disengage the vessel wall and elongate.
- Still another means of collapsing the braid device after use may be to use a shaped memory alloy within the braid. The shaped memory alloy would be formed so that it would cause the braid to seek a collapsed, elongated, tubular shape after expansion when the distending balloon is deflated. This alloy may be used as a filament within the braid, but also may be disposed as longitudinal lay-ins between the braided filaments. Horizontal lay-ins may also be utilized to aid in returning the braid device to its original undeployed state. A combination of any of the collapsing means may be used, as well.
- Further, it is yet another object of the instant invention to provide a novel prosthesis/tissue interface that prevents, treats or inhibits disease during implantation such as long term indwelling catheters which may be used to inhibit or treat re-stenosis or disease. This is a device to be used on any long term indwelling catheter in the lumens or cavities of the body at the site the catheter exits the patients skin. There is a need to stabilize the catheter and prevent its withdrawal and to promote healing of the skin around the exit site to prevent infection, irritation, need for daily care, weeping, inability to shower, etc. The exit site device of the instant invention addresses and solves these problems with a unique expandable braid of collagen yarns which can be attached to the synthetic material of the catheter and will allow the ingrowth of skin into the device. In other words, the skin will not grow into or attach itself to the foreign catheter material directly. This new exit site device in constructed so it can be affixed to the catheter and the skin will then grow into the device creating a seal between the skin and the catheter. This exit site device is usually constructed of a braid, similar to the drug delivery device above, and is meant to be placed over or on the catheter just beneath the skin. The purpose of this device is to encourage the skin to heal over the catheter and produce a tight seal preventing the ingress of bacteria, fungus, and contaminants into the catheter tract. The indwelling catheter creates a crevice in the tissues and the epidermis tends to grow down this tract, frequently carrying bacteria with them. This results in infection in the catheter tract. This device would create a bond between the skin and the catheter utilizing braided crosslinked collagen attached to the outer portion of the catheter in a tubular matter. The collagen lattice will provide an optimal framework for the ingrowth of normal tissues, which would be affixed to a membrane, such as silicone, which in turn, would be affixed to the catheter. If the device were constructed from a braid, foreshortening the braid would cause diametric expansion of portions of the braided device, causing it to initially assume a football like shape and subsequently a plate like shape, depending on the forces applied. This would cause an anchor like effect within the tissues and prevent movement of the catheter. Alternatively, the device may be constructed of material other than collagen and may not necessarily be of braided construction. A spiral or helical configuration is possible and this patent is to cover any expansile configuration, i.e., the device maintains a low profile shape upon insertion but is changed to a diametrically expanded shape after insertion for anchoring purposes. The preferred embodiment, being a braided collagen device, may have only one end of its tubular configuration attached to the catheter. Forcing the non-attached end of the tubular braid toward the attached end will cause the braid to deform into the shapes above. Alternatively, the device may be in a football or plate-like shape initially, and tension may be required to cause it to assume a tubular shape for insertion, for example.
- The features of the invention believed to be novel are set forth within the description of this disclosure. However, the invention themselves, both as to organization and method of operation, together with further objects and advantages thereof may best be understood by reference to the following description taken in conjunction with the accompanying drawings.
- The Tubular Braid or Braided Sleeve Element
- The braided sleeve or tubular braid apparatus described herein include an expandable tubular braid. In the case of the dilating apparatus, an inner mandril or wire may be used o contact the tubular braid. The elongate mandril extends from the proximal end of the device to the distal end of the tubular braid. The distal end of the tubular braid is bonded/attached to the distal end of the inner elongate mandril. The mandril may extend beyond the tubular braid. The proximal end of the tubular braid is bonded to the distal end of an elongate tube. In the case of the drug delivery element, the tubular braid may or may not be attached to the substrate catheter. In this case, the tubular braid will be used as a means to deliver the drug or other agent to the lesion or to break up the matrix of plaque in the lesion.
- The braid may be open, but may be laminated or covered with a coating of elastic, generally inelastic, plastic or plastically deformable material, such as silicone rubber, latex, polyethylene, thermoplastic elastomers (such as C-Flex, commercially available from Consolidated Polymer Technology), polyurethane and the like. Further, the inventors of the instant invention have disclosed a method of coating the interstitial pores of the tubular braid without adding to the overall wall thickness of the tubular braid. This manufacturing invention is disclosed in pending provisional submission Ser. No. 60/121,640. The assembly of tube, mandril and braid is introduced percutaneously in its radially compressed state. In this state, the outside diameter of the braid is close to the outside diameter of the elongate tube. This diameter is in the range of 10 to 50 mils, and usually 25 to 40 mils (i.e. thousandth of an inch). After insertion, moving the mandril proximally with respect to the tube expands the tubular braid.
- The tubular braid is preferably formed as a mesh of individual non-elastic filaments (called “yarns” in the braiding industry). Nevertheless, it can have some elastic filaments interwoven to create certain characteristics. The non-elastic yarns can be materials such as polyester, PET, polypropylene, polyamide fiber (Kevlar, DuPont), composite filament wound polymer, extruded polymer tubing (such as Nylon II or Ultem, commercially available from General Electric), stainless steel, Nickel Titanium (Nitinol), or the like so that axial shortening causes radial expansion of the braid. These materials have sufficient strength so that the engaging element will retain its expanded condition in the lumen of the body while removing the obstruction therefrom. In the case where the tubular braid is used as an absorbent material for drug or other agent delivery, the individual filaments may be absorbent in nature or as stated earlier, the drug or other agent may be merely trapped in between the tubular braid and the underlying dilating member.
- The braid may be of conventional construction, comprising round filaments, flat or ribbon filaments, square filaments, or the like. Non-round filaments may be advantageous to decrease the axial force required for expansion to create a preferred surface area configuration or to decrease the wall thickness of the tubular braid. The filament width or diameter will typically be from about 0.5 to 25 mils, usually being from about 5 to 10 mils. Suitable braids are commercially available from a variety of commercial suppliers.
- The tubular braids are typically formed by a “Maypole” dance of yarn carriers. The braid consists of two systems of yarns alternately passing over and under each other causing a zigzag pattern on the surface. One system of yarns moves helically clockwise with respect to the fabric axis while the other moves helically counter-clockwise. The resulting fabric is a tubular braid. Common applications of tubular braids are lacings, electrical cable covers (i.e. insulation and shielding), “Chinese hand-cuffs” and reinforcements for composites. To form a balanced, torque-free fabric (tubular braid), the structure must contain the same number of yarns in each helical direction. The tubular braid may also be pressed flat so as to form a double thickness fabric strip. The braid weave used in the tubular braid of the present invention will preferably be of the construction known as “two dimensional, tubular, diamond braid” that has a 1/1 intersection pattern of the yarns which is referred to as the “intersection repeat”. Alternatively, a Regular braid with a 2/2 intersection repeat and a Hercules braid with an intersection repeat of 3/3 may be used. In all instances, the helix angle (that being the angle between the axis of the tubular braid and the yarn) will increase as the braid is expanded. Even further, Longitudinal Lay-Ins can be added within the braid yarns and parallel to the axis to aid with stability, improve tensile and compressive properties and modulus of the fabric. When these longitudinal “Lay-In” yarns are elastic in nature, the tubular braid is known as an elastic braid. When the longitudinal yarns are stiff, the fabric is called a rigid braid. Biaxially braided fabrics such as those of the present invention are not dimensionally stable. This is why the braid can be placed into an expanded state from a relaxed state (in the case of putting it into the compressive mode). Alternatively this could be a decreased/reduced (braid diameter decreases) state when put into tension from the relaxed state. When put into tension (or compression for that matter) the braid eventually reaches a state wherein the diameter will decrease no more. This is called the “Jammed State”. On a stress strain curve, this corresponds to increase modulus. Much of the engineering analysis concerning braids is calculated using the “Jammed State” of the structure/braid. These calculations help one skilled in the art to design a braid with particular desired characteristics. Further, material characteristics are tensile strength, stiffness and Young's modulus. In most instances, varying the material characteristics will vary the force with which the expanded condition of the tubular can exert radially. Even further, the friction between the individual yarns has an effect on the force required to compress and un-compress the tubular braid. For the present invention, friction should be relatively low for a chosen yarn so that the user will have little trouble deploying the engaging element. This is particularly important when the engaging element is located a significant distance from the user. Such is the case when the percutaneous entry is the groin (Femoral Artery for vascular interventions) and the point of engaging the engaging element is some distance away (i.e. the Carotid Artery in the neck). Similarly, this is true for long distances that are not vascular or percutaneous applications.
- Therefore, in summary, the use of the device is relatively simple and adds little time to the procedure and potentially a significant benefit to the patient. The drug or other material is delivered at the same time and with the same catheter as the angioplasty and the device is removed with the angioplasty balloon, in the preferred embodiment. In addition, other actions occur at this time (scaffolding and micro-fractures) which also contributes significantly to inhibit the re-stenosis process.
- While preferred embodiments of the present invention have been described in detail, it is apparent that modifications or adaptations of the embodiments will occur to those skilled in the art. It is to be expressly understood, however, that such modifications and adaptations are within the scope of the present invention.
Claims (25)
Priority Applications (8)
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US10/051,848 US20020161392A1 (en) | 1998-04-27 | 2002-01-17 | Particle-removing medical device and method |
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---|---|---|---|---|
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US20060190071A1 (en) * | 2002-07-22 | 2006-08-24 | Armstrong Joseph R | Endoluminal expansion system |
US20060200168A1 (en) * | 2005-03-03 | 2006-09-07 | Azam Anwar | System and method for providing access in divergent directions in a vascular environment |
US20070055338A1 (en) * | 2003-05-09 | 2007-03-08 | Jurgen Dorn | Strain management in stent delivery system |
US20080065192A1 (en) * | 2006-09-13 | 2008-03-13 | Medtronic Vascular, Inc. | Compliance Graded Stent |
US7717892B2 (en) | 2006-07-10 | 2010-05-18 | Mcneil-Ppc, Inc. | Method of treating urinary incontinence |
US20100168612A1 (en) * | 2008-12-30 | 2010-07-01 | Ducharme Richard W | Balloon-tipped endoscopic system |
US20100179581A1 (en) * | 2003-12-03 | 2010-07-15 | Jim Beckham | Non-Compliant Medical Balloon Having a Longitudinal Fiber Layer |
US20100274347A1 (en) * | 2000-11-17 | 2010-10-28 | Advanced Bio Prosthetic Surfaces, Ltd.,a wholly owned subsidiary of Palmaz Scientific, Inc. | Endoluminal device for in vivo delivery of bioactive agents |
US20100318178A1 (en) * | 2009-06-15 | 2010-12-16 | Perflow Medical Ltd. | Method and apparatus for allowing blood flow through an occluded vessel |
US20110106135A1 (en) * | 2009-10-29 | 2011-05-05 | Medtronic Vascular, Inc. | Indwelling Temporary IVC Filter System With Drug Delivery and Aspiration |
US20110251555A1 (en) * | 2009-10-19 | 2011-10-13 | Wilson-Cook Medical Inc. | Balloon-tipped endoscopic system with inverted sleeve |
US8252016B2 (en) | 2005-01-13 | 2012-08-28 | Azam Anwar | System and method for providing embolic protection |
US8449905B2 (en) | 2001-10-22 | 2013-05-28 | Covidien Lp | Liquid and low melting coatings for stents |
US20130165958A1 (en) * | 2008-03-21 | 2013-06-27 | Innovasc Llc | Intravascular device |
US20130297003A1 (en) * | 2011-01-13 | 2013-11-07 | Innovia Llc | Endoluminal Drug Applicator and Method of Treating Diseased Vessels of the Body |
US8608639B2 (en) | 2006-07-10 | 2013-12-17 | Mcneil-Ppc, Inc. | Resilient device |
WO2013148779A3 (en) * | 2012-03-28 | 2014-01-09 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising structure to produce a resilient load |
US8753258B2 (en) | 2006-07-10 | 2014-06-17 | Mcneil-Ppc, Inc. | Resilient device |
US9480826B2 (en) | 2008-03-21 | 2016-11-01 | Cagent Vascular, Llc | Intravascular device |
US9931495B2 (en) | 2010-02-23 | 2018-04-03 | Covidien Lp | Devices and methods for vascular recanalization |
US10004584B2 (en) | 2006-07-10 | 2018-06-26 | First Quality Hygienic, Inc. | Resilient intravaginal device |
US20180193540A1 (en) * | 2017-01-12 | 2018-07-12 | Tyrx, Inc. | Devices and treatments for implantable devices |
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US10219884B2 (en) | 2006-07-10 | 2019-03-05 | First Quality Hygienic, Inc. | Resilient device |
US20190104929A1 (en) * | 2013-03-13 | 2019-04-11 | Spiway Llc | Surgical tissue protection sheath |
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US20200316340A1 (en) * | 2008-12-12 | 2020-10-08 | Corindus, Inc. | Remote catheter procedure system |
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US11219750B2 (en) | 2008-03-21 | 2022-01-11 | Cagent Vascular, Inc. | System and method for plaque serration |
US11369779B2 (en) | 2018-07-25 | 2022-06-28 | Cagent Vascular, Inc. | Medical balloon catheters with enhanced pushability |
US11738181B2 (en) | 2014-06-04 | 2023-08-29 | Cagent Vascular, Inc. | Cage for medical balloon |
Families Citing this family (984)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6006134A (en) | 1998-04-30 | 1999-12-21 | Medtronic, Inc. | Method and device for electronically controlling the beating of a heart using venous electrical stimulation of nerve fibers |
US7491216B2 (en) | 1997-11-07 | 2009-02-17 | Salviac Limited | Filter element with retractable guidewire tip |
US6336934B1 (en) | 1997-11-07 | 2002-01-08 | Salviac Limited | Embolic protection device |
US20040199202A1 (en) * | 1997-11-12 | 2004-10-07 | Genesis Technologies Llc | Biological passageway occlusion removal |
US20100030256A1 (en) | 1997-11-12 | 2010-02-04 | Genesis Technologies Llc | Medical Devices and Methods |
US20040260333A1 (en) * | 1997-11-12 | 2004-12-23 | Dubrul William R. | Medical device and method |
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US9498604B2 (en) | 1997-11-12 | 2016-11-22 | Genesis Technologies Llc | Medical device and method |
US6450989B2 (en) * | 1998-04-27 | 2002-09-17 | Artemis Medical, Inc. | Dilating and support apparatus with disease inhibitors and methods for use |
WO1999055285A2 (en) * | 1998-04-27 | 1999-11-04 | Dubrul William R | Dilating and support apparatus with disease inhibitors and methods for use |
US20100036481A1 (en) * | 1998-04-27 | 2010-02-11 | Artemis Medical, Inc. | Cardiovascular Devices and Methods |
US8177743B2 (en) | 1998-05-18 | 2012-05-15 | Boston Scientific Scimed, Inc. | Localized delivery of drug agents |
US7637886B2 (en) * | 1999-01-25 | 2009-12-29 | Atrium Medical Corporation | Expandable fluoropolymer device and method of making |
US6964672B2 (en) | 1999-05-07 | 2005-11-15 | Salviac Limited | Support frame for an embolic protection device |
US6918921B2 (en) | 1999-05-07 | 2005-07-19 | Salviac Limited | Support frame for an embolic protection device |
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US6692462B2 (en) | 1999-05-19 | 2004-02-17 | Mackenzie Andrew J. | System and method for establishing vascular access |
US8529430B2 (en) | 2002-08-01 | 2013-09-10 | Cardiokinetix, Inc. | Therapeutic methods and devices following myocardial infarction |
US8257428B2 (en) * | 1999-08-09 | 2012-09-04 | Cardiokinetix, Inc. | System for improving cardiac function |
US8388672B2 (en) | 1999-08-09 | 2013-03-05 | Cardiokinetix, Inc. | System for improving cardiac function by sealing a partitioning membrane within a ventricle |
US9694121B2 (en) | 1999-08-09 | 2017-07-04 | Cardiokinetix, Inc. | Systems and methods for improving cardiac function |
US8500795B2 (en) | 1999-08-09 | 2013-08-06 | Cardiokinetix, Inc. | Retrievable devices for improving cardiac function |
US7674222B2 (en) | 1999-08-09 | 2010-03-09 | Cardiokinetix, Inc. | Cardiac device and methods of use thereof |
US10307147B2 (en) | 1999-08-09 | 2019-06-04 | Edwards Lifesciences Corporation | System for improving cardiac function by sealing a partitioning membrane within a ventricle |
US8579966B2 (en) | 1999-11-17 | 2013-11-12 | Medtronic Corevalve Llc | Prosthetic valve for transluminal delivery |
US8016877B2 (en) | 1999-11-17 | 2011-09-13 | Medtronic Corevalve Llc | Prosthetic valve for transluminal delivery |
US7018406B2 (en) | 1999-11-17 | 2006-03-28 | Corevalve Sa | Prosthetic valve for transluminal delivery |
US6660021B1 (en) | 1999-12-23 | 2003-12-09 | Advanced Cardiovascular Systems, Inc. | Intravascular device and system |
US6402771B1 (en) | 1999-12-23 | 2002-06-11 | Guidant Endovascular Solutions | Snare |
US6575997B1 (en) | 1999-12-23 | 2003-06-10 | Endovascular Technologies, Inc. | Embolic basket |
US6695813B1 (en) | 1999-12-30 | 2004-02-24 | Advanced Cardiovascular Systems, Inc. | Embolic protection devices |
US7918820B2 (en) | 1999-12-30 | 2011-04-05 | Advanced Cardiovascular Systems, Inc. | Device for, and method of, blocking emboli in vessels such as blood arteries |
US8241274B2 (en) | 2000-01-19 | 2012-08-14 | Medtronic, Inc. | Method for guiding a medical device |
US6692513B2 (en) | 2000-06-30 | 2004-02-17 | Viacor, Inc. | Intravascular filter with debris entrapment mechanism |
US7749245B2 (en) | 2000-01-27 | 2010-07-06 | Medtronic, Inc. | Cardiac valve procedure methods and devices |
US8088060B2 (en) | 2000-03-15 | 2012-01-03 | Orbusneich Medical, Inc. | Progenitor endothelial cell capturing with a drug eluting implantable medical device |
US9522217B2 (en) | 2000-03-15 | 2016-12-20 | Orbusneich Medical, Inc. | Medical device with coating for capturing genetically-altered cells and methods for using same |
US6632241B1 (en) | 2000-03-22 | 2003-10-14 | Endovascular Technologies, Inc. | Self-expanding, pseudo-braided intravascular device |
US6569150B2 (en) * | 2000-04-11 | 2003-05-27 | Scimed Life Systems, Inc. | Reinforced retention structures |
GB2369575A (en) | 2000-04-20 | 2002-06-05 | Salviac Ltd | An embolic protection system |
US6964670B1 (en) | 2000-07-13 | 2005-11-15 | Advanced Cardiovascular Systems, Inc. | Embolic protection guide wire |
US8398537B2 (en) | 2005-06-10 | 2013-03-19 | Cardiokinetix, Inc. | Peripheral seal for a ventricular partitioning device |
US9332993B2 (en) | 2004-08-05 | 2016-05-10 | Cardiokinetix, Inc. | Devices and methods for delivering an endocardial device |
US10064696B2 (en) | 2000-08-09 | 2018-09-04 | Edwards Lifesciences Corporation | Devices and methods for delivering an endocardial device |
US9332992B2 (en) | 2004-08-05 | 2016-05-10 | Cardiokinetix, Inc. | Method for making a laminar ventricular partitioning device |
US7762943B2 (en) | 2004-03-03 | 2010-07-27 | Cardiokinetix, Inc. | Inflatable ventricular partitioning device |
US9078660B2 (en) | 2000-08-09 | 2015-07-14 | Cardiokinetix, Inc. | Devices and methods for delivering an endocardial device |
CN1447669A (en) | 2000-08-18 | 2003-10-08 | 阿特里泰克公司 | Expandable implant devices for filtering blood flow from atrial appendages |
US6652574B1 (en) * | 2000-09-28 | 2003-11-25 | Vascular Concepts Holdings Limited | Product and process for manufacturing a wire stent coated with a biocompatible fluoropolymer |
US6506203B1 (en) | 2000-12-19 | 2003-01-14 | Advanced Cardiovascular Systems, Inc. | Low profile sheathless embolic protection system |
DE10105592A1 (en) | 2001-02-06 | 2002-08-08 | Achim Goepferich | Placeholder for drug release in the frontal sinus |
US7422579B2 (en) | 2001-05-01 | 2008-09-09 | St. Jude Medical Cardiology Divison, Inc. | Emboli protection devices and related methods of use |
US6599307B1 (en) | 2001-06-29 | 2003-07-29 | Advanced Cardiovascular Systems, Inc. | Filter device for embolic protection systems |
US8771302B2 (en) | 2001-06-29 | 2014-07-08 | Medtronic, Inc. | Method and apparatus for resecting and replacing an aortic valve |
US7338510B2 (en) | 2001-06-29 | 2008-03-04 | Advanced Cardiovascular Systems, Inc. | Variable thickness embolic filtering devices and method of manufacturing the same |
US7544206B2 (en) | 2001-06-29 | 2009-06-09 | Medtronic, Inc. | Method and apparatus for resecting and replacing an aortic valve |
US8623077B2 (en) | 2001-06-29 | 2014-01-07 | Medtronic, Inc. | Apparatus for replacing a cardiac valve |
FR2826863B1 (en) | 2001-07-04 | 2003-09-26 | Jacques Seguin | ASSEMBLY FOR PLACING A PROSTHETIC VALVE IN A BODY CONDUIT |
FR2828091B1 (en) | 2001-07-31 | 2003-11-21 | Seguin Jacques | ASSEMBLY ALLOWING THE PLACEMENT OF A PROTHETIC VALVE IN A BODY DUCT |
US7071898B2 (en) * | 2002-07-18 | 2006-07-04 | Information Decision Technologies, Llc | Method for using a wireless motorized camera mount for tracking in augmented reality |
US6638294B1 (en) | 2001-08-30 | 2003-10-28 | Advanced Cardiovascular Systems, Inc. | Self furling umbrella frame for carotid filter |
US6592606B2 (en) | 2001-08-31 | 2003-07-15 | Advanced Cardiovascular Systems, Inc. | Hinged short cage for an embolic protection device |
US7097659B2 (en) | 2001-09-07 | 2006-08-29 | Medtronic, Inc. | Fixation band for affixing a prosthetic heart valve to tissue |
US8262689B2 (en) | 2001-09-28 | 2012-09-11 | Advanced Cardiovascular Systems, Inc. | Embolic filtering devices |
WO2003041760A2 (en) | 2001-11-09 | 2003-05-22 | Novoste Corporation | Baloon catheter with non-deployable stent |
US20040111108A1 (en) | 2001-11-09 | 2004-06-10 | Farnan Robert C. | Balloon catheter with non-deployable stent |
US7488313B2 (en) * | 2001-11-29 | 2009-02-10 | Boston Scientific Scimed, Inc. | Mechanical apparatus and method for dilating and delivering a therapeutic agent to a site of treatment |
US7241304B2 (en) | 2001-12-21 | 2007-07-10 | Advanced Cardiovascular Systems, Inc. | Flexible and conformable embolic filtering devices |
EP1455681B1 (en) | 2001-12-21 | 2014-09-17 | Salviac Limited | A support frame for an embolic protection device |
CN100393323C (en) * | 2002-02-13 | 2008-06-11 | 贝思·伊斯雷尔·迪科尼斯医药中心 | Methods of treating vascular disease |
WO2003071926A2 (en) * | 2002-02-21 | 2003-09-04 | Persidsky Maxim D | Apparatus and method for making a percutaneous access for port of variable size |
US20030187495A1 (en) | 2002-04-01 | 2003-10-02 | Cully Edward H. | Endoluminal devices, embolic filters, methods of manufacture and use |
AU2003226366A1 (en) | 2002-04-15 | 2003-11-03 | Beth Israel Deaconess Medical Center | Use of heme oxygenase-1 and products of heme degradation |
US7648515B2 (en) * | 2002-04-16 | 2010-01-19 | Tyco Healthcare Group Lp | Method and apparatus for anastomosis including an expandable anchor |
US8721713B2 (en) | 2002-04-23 | 2014-05-13 | Medtronic, Inc. | System for implanting a replacement valve |
US7519418B2 (en) * | 2002-04-30 | 2009-04-14 | Boston Scientific Scimed, Inc. | Mechanical apparatus and method for dilating and delivering a therapeutic agent to a site of treatment |
PL375161A1 (en) * | 2002-06-21 | 2005-11-28 | University Of Pittsburgh Of The Commonwealth System Of Higher Education | Pharmaceutical use of nitric oxide, heme oxygenase-1 and products of heme degradation |
US6793678B2 (en) | 2002-06-27 | 2004-09-21 | Depuy Acromed, Inc. | Prosthetic intervertebral motion disc having dampening |
DE10233085B4 (en) * | 2002-07-19 | 2014-02-20 | Dendron Gmbh | Stent with guide wire |
US8425549B2 (en) | 2002-07-23 | 2013-04-23 | Reverse Medical Corporation | Systems and methods for removing obstructive matter from body lumens and treating vascular defects |
US7303575B2 (en) * | 2002-08-01 | 2007-12-04 | Lumen Biomedical, Inc. | Embolism protection devices |
CA2714875C (en) | 2002-08-28 | 2014-01-07 | Heart Leaflet Technologies, Inc. | Method and device for treating diseased valve |
US20060015136A1 (en) * | 2002-09-19 | 2006-01-19 | Memory Metal Holland Bv | Vascular filter with improved strength and flexibility |
US7331973B2 (en) | 2002-09-30 | 2008-02-19 | Avdanced Cardiovascular Systems, Inc. | Guide wire with embolic filtering attachment |
US8317816B2 (en) | 2002-09-30 | 2012-11-27 | Acclarent, Inc. | Balloon catheters and methods for treating paranasal sinuses |
US7252675B2 (en) | 2002-09-30 | 2007-08-07 | Advanced Cardiovascular, Inc. | Embolic filtering devices |
US20040093012A1 (en) | 2002-10-17 | 2004-05-13 | Cully Edward H. | Embolic filter frame having looped support strut elements |
US20040088000A1 (en) | 2002-10-31 | 2004-05-06 | Muller Paul F. | Single-wire expandable cages for embolic filtering devices |
US7122058B2 (en) | 2002-12-02 | 2006-10-17 | Gi Dynamics, Inc. | Anti-obesity devices |
US7025791B2 (en) | 2002-12-02 | 2006-04-11 | Gi Dynamics, Inc. | Bariatric sleeve |
US7608114B2 (en) | 2002-12-02 | 2009-10-27 | Gi Dynamics, Inc. | Bariatric sleeve |
US7695446B2 (en) | 2002-12-02 | 2010-04-13 | Gi Dynamics, Inc. | Methods of treatment using a bariatric sleeve |
US7678068B2 (en) | 2002-12-02 | 2010-03-16 | Gi Dynamics, Inc. | Atraumatic delivery devices |
US7229454B2 (en) * | 2003-01-07 | 2007-06-12 | Boston Scientific Scimed, Inc. | Occlusive cinching devices and methods of use |
US6929626B2 (en) * | 2003-01-15 | 2005-08-16 | Scimed Life Systems, Inc. | Intraluminally placeable textile catheter, drain and stent |
US20050021070A1 (en) * | 2003-01-21 | 2005-01-27 | Angioscore, Inc. | Methods and apparatus for manipulating vascular prostheses |
US7686824B2 (en) * | 2003-01-21 | 2010-03-30 | Angioscore, Inc. | Apparatus and methods for treating hardened vascular lesions |
US8080026B2 (en) | 2003-01-21 | 2011-12-20 | Angioscore, Inc. | Apparatus and methods for treating hardened vascular lesions |
US20070185522A1 (en) * | 2003-01-21 | 2007-08-09 | Gareth Davies | Dilator |
US7323001B2 (en) | 2003-01-30 | 2008-01-29 | Ev3 Inc. | Embolic filters with controlled pore size |
US7220271B2 (en) | 2003-01-30 | 2007-05-22 | Ev3 Inc. | Embolic filters having multiple layers and controlled pore size |
EP1594672A1 (en) * | 2003-01-31 | 2005-11-16 | Preton Limited | A process for producing a performance enhanced single-layer blow-moulded container |
US7115127B2 (en) | 2003-02-04 | 2006-10-03 | Cardiodex, Ltd. | Methods and apparatus for hemostasis following arterial catheterization |
US7223266B2 (en) * | 2003-02-04 | 2007-05-29 | Cardiodex Ltd. | Methods and apparatus for hemostasis following arterial catheterization |
US8591540B2 (en) | 2003-02-27 | 2013-11-26 | Abbott Cardiovascular Systems Inc. | Embolic filtering devices |
AU2003232010A1 (en) * | 2003-04-29 | 2004-11-26 | Not Given | Mechanical apparatus and method for dilating and delivering a therapeutic agent |
US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
US8048042B2 (en) * | 2003-07-22 | 2011-11-01 | Medtronic Vascular, Inc. | Medical articles incorporating surface capillary fiber |
US7879062B2 (en) * | 2003-07-22 | 2011-02-01 | Lumen Biomedical, Inc. | Fiber based embolism protection device |
US20050209674A1 (en) * | 2003-09-05 | 2005-09-22 | Kutscher Tuvia D | Balloon assembly (V) |
US20050055077A1 (en) * | 2003-09-05 | 2005-03-10 | Doron Marco | Very low profile medical device system having an adjustable balloon |
US7208008B2 (en) * | 2003-10-02 | 2007-04-24 | Medtronic Vascular, Inc. | Balloonless direct stenting device |
US9579194B2 (en) | 2003-10-06 | 2017-02-28 | Medtronic ATS Medical, Inc. | Anchoring structure with concave landing zone |
US7892251B1 (en) | 2003-11-12 | 2011-02-22 | Advanced Cardiovascular Systems, Inc. | Component for delivering and locking a medical device to a guide wire |
AU2004305450B2 (en) | 2003-12-09 | 2009-01-08 | Gi Dynamics, Inc. | Intestinal sleeve |
US8057420B2 (en) | 2003-12-09 | 2011-11-15 | Gi Dynamics, Inc. | Gastrointestinal implant with drawstring |
US7354445B2 (en) * | 2003-12-15 | 2008-04-08 | Medtronic Vascular Inc. | Embolic containment system with asymmetric frictional control |
US9005273B2 (en) | 2003-12-23 | 2015-04-14 | Sadra Medical, Inc. | Assessing the location and performance of replacement heart valves |
US8840663B2 (en) | 2003-12-23 | 2014-09-23 | Sadra Medical, Inc. | Repositionable heart valve method |
US8052749B2 (en) | 2003-12-23 | 2011-11-08 | Sadra Medical, Inc. | Methods and apparatus for endovascular heart valve replacement comprising tissue grasping elements |
US7959666B2 (en) | 2003-12-23 | 2011-06-14 | Sadra Medical, Inc. | Methods and apparatus for endovascularly replacing a heart valve |
US8343213B2 (en) | 2003-12-23 | 2013-01-01 | Sadra Medical, Inc. | Leaflet engagement elements and methods for use thereof |
US20050137694A1 (en) | 2003-12-23 | 2005-06-23 | Haug Ulrich R. | Methods and apparatus for endovascularly replacing a patient's heart valve |
US7824442B2 (en) | 2003-12-23 | 2010-11-02 | Sadra Medical, Inc. | Methods and apparatus for endovascularly replacing a heart valve |
US7748389B2 (en) | 2003-12-23 | 2010-07-06 | Sadra Medical, Inc. | Leaflet engagement elements and methods for use thereof |
US20050137687A1 (en) | 2003-12-23 | 2005-06-23 | Sadra Medical | Heart valve anchor and method |
US7824443B2 (en) | 2003-12-23 | 2010-11-02 | Sadra Medical, Inc. | Medical implant delivery and deployment tool |
US7780725B2 (en) | 2004-06-16 | 2010-08-24 | Sadra Medical, Inc. | Everting heart valve |
US7445631B2 (en) | 2003-12-23 | 2008-11-04 | Sadra Medical, Inc. | Methods and apparatus for endovascularly replacing a patient's heart valve |
US7329279B2 (en) | 2003-12-23 | 2008-02-12 | Sadra Medical, Inc. | Methods and apparatus for endovascularly replacing a patient's heart valve |
CN100589779C (en) | 2003-12-23 | 2010-02-17 | 萨德拉医学公司 | Repositionable heart valve |
US8182528B2 (en) | 2003-12-23 | 2012-05-22 | Sadra Medical, Inc. | Locking heart valve anchor |
US9526609B2 (en) | 2003-12-23 | 2016-12-27 | Boston Scientific Scimed, Inc. | Methods and apparatus for endovascularly replacing a patient's heart valve |
US8603160B2 (en) | 2003-12-23 | 2013-12-10 | Sadra Medical, Inc. | Method of using a retrievable heart valve anchor with a sheath |
US20120041550A1 (en) | 2003-12-23 | 2012-02-16 | Sadra Medical, Inc. | Methods and Apparatus for Endovascular Heart Valve Replacement Comprising Tissue Grasping Elements |
US8287584B2 (en) | 2005-11-14 | 2012-10-16 | Sadra Medical, Inc. | Medical implant deployment tool |
US8579962B2 (en) | 2003-12-23 | 2013-11-12 | Sadra Medical, Inc. | Methods and apparatus for performing valvuloplasty |
US11278398B2 (en) | 2003-12-23 | 2022-03-22 | Boston Scientific Scimed, Inc. | Methods and apparatus for endovascular heart valve replacement comprising tissue grasping elements |
US7381219B2 (en) | 2003-12-23 | 2008-06-03 | Sadra Medical, Inc. | Low profile heart valve and delivery system |
ITTO20040135A1 (en) | 2004-03-03 | 2004-06-03 | Sorin Biomedica Cardio Spa | CARDIAC VALVE PROSTHESIS |
US9039724B2 (en) * | 2004-03-19 | 2015-05-26 | Aga Medical Corporation | Device for occluding vascular defects |
US8313505B2 (en) * | 2004-03-19 | 2012-11-20 | Aga Medical Corporation | Device for occluding vascular defects |
US7678129B1 (en) | 2004-03-19 | 2010-03-16 | Advanced Cardiovascular Systems, Inc. | Locking component for an embolic filter assembly |
US8747453B2 (en) | 2008-02-18 | 2014-06-10 | Aga Medical Corporation | Stent/stent graft for reinforcement of vascular abnormalities and associated method |
US8398670B2 (en) | 2004-03-19 | 2013-03-19 | Aga Medical Corporation | Multi-layer braided structures for occluding vascular defects and for occluding fluid flow through portions of the vasculature of the body |
US8777974B2 (en) * | 2004-03-19 | 2014-07-15 | Aga Medical Corporation | Multi-layer braided structures for occluding vascular defects |
US20050215959A1 (en) * | 2004-03-24 | 2005-09-29 | Children's Memorial Hospital. | Delivery devices and methods of delivering liquids and nutrition to patients |
US7686825B2 (en) | 2004-03-25 | 2010-03-30 | Hauser David L | Vascular filter device |
US10188413B1 (en) | 2004-04-21 | 2019-01-29 | Acclarent, Inc. | Deflectable guide catheters and related methods |
US7803150B2 (en) | 2004-04-21 | 2010-09-28 | Acclarent, Inc. | Devices, systems and methods useable for treating sinusitis |
US20190314620A1 (en) | 2004-04-21 | 2019-10-17 | Acclarent, Inc. | Apparatus and methods for dilating and modifying ostia of paranasal sinuses and other intranasal or paranasal structures |
US7410480B2 (en) | 2004-04-21 | 2008-08-12 | Acclarent, Inc. | Devices and methods for delivering therapeutic substances for the treatment of sinusitis and other disorders |
US9101384B2 (en) | 2004-04-21 | 2015-08-11 | Acclarent, Inc. | Devices, systems and methods for diagnosing and treating sinusitis and other disorders of the ears, Nose and/or throat |
US9399121B2 (en) | 2004-04-21 | 2016-07-26 | Acclarent, Inc. | Systems and methods for transnasal dilation of passageways in the ear, nose or throat |
US7361168B2 (en) | 2004-04-21 | 2008-04-22 | Acclarent, Inc. | Implantable device and methods for delivering drugs and other substances to treat sinusitis and other disorders |
US8932276B1 (en) | 2004-04-21 | 2015-01-13 | Acclarent, Inc. | Shapeable guide catheters and related methods |
US7462175B2 (en) | 2004-04-21 | 2008-12-09 | Acclarent, Inc. | Devices, systems and methods for treating disorders of the ear, nose and throat |
US7720521B2 (en) * | 2004-04-21 | 2010-05-18 | Acclarent, Inc. | Methods and devices for performing procedures within the ear, nose, throat and paranasal sinuses |
US20070208252A1 (en) | 2004-04-21 | 2007-09-06 | Acclarent, Inc. | Systems and methods for performing image guided procedures within the ear, nose, throat and paranasal sinuses |
US8702626B1 (en) | 2004-04-21 | 2014-04-22 | Acclarent, Inc. | Guidewires for performing image guided procedures |
US7654997B2 (en) * | 2004-04-21 | 2010-02-02 | Acclarent, Inc. | Devices, systems and methods for diagnosing and treating sinusitus and other disorders of the ears, nose and/or throat |
US7419497B2 (en) | 2004-04-21 | 2008-09-02 | Acclarent, Inc. | Methods for treating ethmoid disease |
US9089258B2 (en) | 2004-04-21 | 2015-07-28 | Acclarent, Inc. | Endoscopic methods and devices for transnasal procedures |
US9554691B2 (en) | 2004-04-21 | 2017-01-31 | Acclarent, Inc. | Endoscopic methods and devices for transnasal procedures |
US8146400B2 (en) | 2004-04-21 | 2012-04-03 | Acclarent, Inc. | Endoscopic methods and devices for transnasal procedures |
US8764729B2 (en) | 2004-04-21 | 2014-07-01 | Acclarent, Inc. | Frontal sinus spacer |
US8894614B2 (en) | 2004-04-21 | 2014-11-25 | Acclarent, Inc. | Devices, systems and methods useable for treating frontal sinusitis |
US20060063973A1 (en) | 2004-04-21 | 2006-03-23 | Acclarent, Inc. | Methods and apparatus for treating disorders of the ear, nose and throat |
US8747389B2 (en) | 2004-04-21 | 2014-06-10 | Acclarent, Inc. | Systems for treating disorders of the ear, nose and throat |
US9351750B2 (en) | 2004-04-21 | 2016-05-31 | Acclarent, Inc. | Devices and methods for treating maxillary sinus disease |
US20070167682A1 (en) * | 2004-04-21 | 2007-07-19 | Acclarent, Inc. | Endoscopic methods and devices for transnasal procedures |
US7559925B2 (en) | 2006-09-15 | 2009-07-14 | Acclarent Inc. | Methods and devices for facilitating visualization in a surgical environment |
US20060004323A1 (en) | 2004-04-21 | 2006-01-05 | Exploramed Nc1, Inc. | Apparatus and methods for dilating and modifying ostia of paranasal sinuses and other intranasal or paranasal structures |
BRPI0510107A (en) | 2004-04-23 | 2007-09-25 | 3F Therapeutics Inc | implantable protein valve |
BE1016067A3 (en) * | 2004-06-03 | 2006-02-07 | Frid Noureddine | Luminal endoprosthesis FOR OBSTRUCTION OF ANEURYSM AND METHOD OF MANUFACTURING SUCH STENT. |
JP4856067B2 (en) | 2004-07-09 | 2012-01-18 | ジーアイ・ダイナミックス・インコーポレーテッド | Method and apparatus for positioning a gastrointestinal sleeve |
US20060020269A1 (en) * | 2004-07-20 | 2006-01-26 | Eric Cheng | Device to aid in stone removal and laser lithotripsy |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
US11896225B2 (en) | 2004-07-28 | 2024-02-13 | Cilag Gmbh International | Staple cartridge comprising a pan |
US20060025848A1 (en) * | 2004-07-29 | 2006-02-02 | Jan Weber | Medical device having a coating layer with structural elements therein and method of making the same |
US9387313B2 (en) | 2004-08-03 | 2016-07-12 | Interventional Spine, Inc. | Telescopic percutaneous tissue dilation systems and related methods |
US20060052867A1 (en) | 2004-09-07 | 2006-03-09 | Medtronic, Inc | Replacement prosthetic heart valve, system and method of implant |
ATE520369T1 (en) * | 2004-09-17 | 2011-09-15 | Nitinol Dev Corp | SHAPE MEMORY THIN FILM EMBOLIC PROTECTION DEVICE |
CA2580222C (en) * | 2004-09-17 | 2013-08-27 | Nitinol Development Corporation | Shape memory thin film embolic protection device |
WO2006034062A1 (en) | 2004-09-17 | 2006-03-30 | Gi Dynamics, Inc. | Gastrointestinal anchor |
US8795315B2 (en) | 2004-10-06 | 2014-08-05 | Cook Medical Technologies Llc | Emboli capturing device having a coil and method for capturing emboli |
US20060100658A1 (en) * | 2004-11-09 | 2006-05-11 | Hiroyuki Obana | Interventional guiding sheath system and method of use |
US8562672B2 (en) | 2004-11-19 | 2013-10-22 | Medtronic, Inc. | Apparatus for treatment of cardiac valves and method of its manufacture |
WO2006054170A1 (en) | 2004-11-22 | 2006-05-26 | Cardiodex Ltd. | Techniques for heat-treating varicose veins |
DE102005003632A1 (en) | 2005-01-20 | 2006-08-17 | Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. | Catheter for the transvascular implantation of heart valve prostheses |
ITTO20050074A1 (en) | 2005-02-10 | 2006-08-11 | Sorin Biomedica Cardio Srl | CARDIAC VALVE PROSTHESIS |
US20060184105A1 (en) * | 2005-02-15 | 2006-08-17 | Townsend Gregory L | Thin wall catheter and method of placing same |
US7955351B2 (en) | 2005-02-18 | 2011-06-07 | Tyco Healthcare Group Lp | Rapid exchange catheters and embolic protection devices |
US7476232B2 (en) * | 2005-03-04 | 2009-01-13 | Boston Scientific Scimed, Inc. | Access catheter having dilation capability and related methods |
US8945169B2 (en) | 2005-03-15 | 2015-02-03 | Cook Medical Technologies Llc | Embolic protection device |
US8221446B2 (en) | 2005-03-15 | 2012-07-17 | Cook Medical Technologies | Embolic protection device |
US9259305B2 (en) | 2005-03-31 | 2016-02-16 | Abbott Cardiovascular Systems Inc. | Guide wire locking mechanism for rapid exchange and other catheter systems |
US7962208B2 (en) | 2005-04-25 | 2011-06-14 | Cardiac Pacemakers, Inc. | Method and apparatus for pacing during revascularization |
US10076641B2 (en) | 2005-05-11 | 2018-09-18 | The Spectranetics Corporation | Methods and systems for delivering substances into luminal walls |
US7914569B2 (en) | 2005-05-13 | 2011-03-29 | Medtronics Corevalve Llc | Heart valve prosthesis and methods of manufacture and use |
US9034025B2 (en) | 2005-05-23 | 2015-05-19 | Ostial Corporation | Balloon catheters and methods for use |
US8672990B2 (en) * | 2005-05-27 | 2014-03-18 | Boston Scientific Scimed, Inc. | Fiber mesh controlled expansion balloon catheter |
US7976488B2 (en) | 2005-06-08 | 2011-07-12 | Gi Dynamics, Inc. | Gastrointestinal anchor compliance |
US8951225B2 (en) | 2005-06-10 | 2015-02-10 | Acclarent, Inc. | Catheters with non-removable guide members useable for treatment of sinusitis |
US7850708B2 (en) | 2005-06-20 | 2010-12-14 | Cook Incorporated | Embolic protection device having a reticulated body with staggered struts |
US8109962B2 (en) | 2005-06-20 | 2012-02-07 | Cook Medical Technologies Llc | Retrievable device having a reticulation portion with staggered struts |
US7771452B2 (en) | 2005-07-12 | 2010-08-10 | Cook Incorporated | Embolic protection device with a filter bag that disengages from a basket |
US7766934B2 (en) | 2005-07-12 | 2010-08-03 | Cook Incorporated | Embolic protection device with an integral basket and bag |
US8187298B2 (en) | 2005-08-04 | 2012-05-29 | Cook Medical Technologies Llc | Embolic protection device having inflatable frame |
US20070055358A1 (en) * | 2005-08-22 | 2007-03-08 | Krolik Jeffrey A | Axially compressible flared stents and apparatus and methods for delivering them |
US7905841B2 (en) * | 2005-08-31 | 2011-03-15 | Boston Scientific Scimed, Inc. | Cytology device and related methods of use |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
US20070194079A1 (en) | 2005-08-31 | 2007-08-23 | Hueil Joseph C | Surgical stapling device with staple drivers of different height |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
US7712606B2 (en) | 2005-09-13 | 2010-05-11 | Sadra Medical, Inc. | Two-part package for medical implant |
US8377092B2 (en) | 2005-09-16 | 2013-02-19 | Cook Medical Technologies Llc | Embolic protection device |
US8114113B2 (en) | 2005-09-23 | 2012-02-14 | Acclarent, Inc. | Multi-conduit balloon catheter |
WO2007038540A1 (en) | 2005-09-26 | 2007-04-05 | Medtronic, Inc. | Prosthetic cardiac and venous valves |
US8632562B2 (en) | 2005-10-03 | 2014-01-21 | Cook Medical Technologies Llc | Embolic protection device |
US8182508B2 (en) | 2005-10-04 | 2012-05-22 | Cook Medical Technologies Llc | Embolic protection device |
US8252017B2 (en) | 2005-10-18 | 2012-08-28 | Cook Medical Technologies Llc | Invertible filter for embolic protection |
US8216269B2 (en) | 2005-11-02 | 2012-07-10 | Cook Medical Technologies Llc | Embolic protection device having reduced profile |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
US8152831B2 (en) | 2005-11-17 | 2012-04-10 | Cook Medical Technologies Llc | Foam embolic protection device |
US20070123926A1 (en) * | 2005-11-28 | 2007-05-31 | Medtronic Vascular, Inc. | Pre-curved guiding catheter with mechanically actuated occluder for embolic protection |
US7892186B2 (en) | 2005-12-09 | 2011-02-22 | Heraeus Materials S.A. | Handle and articulator system and method |
US20070198047A1 (en) * | 2005-12-20 | 2007-08-23 | Medical Components, Inc. | Cutting balloon catheter assembly |
US20070213813A1 (en) | 2005-12-22 | 2007-09-13 | Symetis Sa | Stent-valves for valve replacement and associated methods and systems for surgery |
US9078781B2 (en) | 2006-01-11 | 2015-07-14 | Medtronic, Inc. | Sterile cover for compressible stents used in percutaneous device delivery systems |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US20110295295A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument having recording capabilities |
US8708213B2 (en) | 2006-01-31 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a feedback system |
US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US7753904B2 (en) | 2006-01-31 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Endoscopic surgical instrument with a handle that can articulate with respect to the shaft |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
AU2007211269B2 (en) | 2006-02-01 | 2013-10-03 | The Cleveland Clinic Foundation | A method and apparatus for increasing blood flow through an obstructed blood vessel |
EP1988851A2 (en) | 2006-02-14 | 2008-11-12 | Sadra Medical, Inc. | Systems and methods for delivering a medical implant |
US8157837B2 (en) | 2006-03-13 | 2012-04-17 | Pneumrx, Inc. | Minimally invasive lung volume reduction device and method |
US9402633B2 (en) | 2006-03-13 | 2016-08-02 | Pneumrx, Inc. | Torque alleviating intra-airway lung volume reduction compressive implant structures |
US8888800B2 (en) | 2006-03-13 | 2014-11-18 | Pneumrx, Inc. | Lung volume reduction devices, methods, and systems |
US8992422B2 (en) | 2006-03-23 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Robotically-controlled endoscopic accessory channel |
US20070225562A1 (en) | 2006-03-23 | 2007-09-27 | Ethicon Endo-Surgery, Inc. | Articulating endoscopic accessory channel |
EP2004095B1 (en) | 2006-03-28 | 2019-06-12 | Medtronic, Inc. | Prosthetic cardiac valve formed from pericardium material and methods of making same |
US7846175B2 (en) * | 2006-04-03 | 2010-12-07 | Medrad, Inc. | Guidewire and collapsable filter system |
US7740655B2 (en) | 2006-04-06 | 2010-06-22 | Medtronic Vascular, Inc. | Reinforced surgical conduit for implantation of a stented valve therein |
US8190389B2 (en) | 2006-05-17 | 2012-05-29 | Acclarent, Inc. | Adapter for attaching electromagnetic image guidance components to a medical device |
US20080234722A1 (en) * | 2006-06-14 | 2008-09-25 | Possis Medical, Inc. | Inferior vena cava filter on guidewire |
US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
US9820688B2 (en) * | 2006-09-15 | 2017-11-21 | Acclarent, Inc. | Sinus illumination lightwire device |
US8834564B2 (en) | 2006-09-19 | 2014-09-16 | Medtronic, Inc. | Sinus-engaging valve fixation member |
US11304800B2 (en) | 2006-09-19 | 2022-04-19 | Medtronic Ventor Technologies Ltd. | Sinus-engaging valve fixation member |
US8052750B2 (en) | 2006-09-19 | 2011-11-08 | Medtronic Ventor Technologies Ltd | Valve prosthesis fixation techniques using sandwiching |
US20080071307A1 (en) | 2006-09-19 | 2008-03-20 | Cook Incorporated | Apparatus and methods for in situ embolic protection |
US20080097401A1 (en) | 2006-09-22 | 2008-04-24 | Trapp Benjamin M | Cerebral vasculature device |
US8005429B2 (en) * | 2006-09-27 | 2011-08-23 | Hewlett-Packard Development Company, L.P. | Wireless communication noise suppression system |
WO2008040014A2 (en) * | 2006-09-28 | 2008-04-03 | Heart Leaflet Technologies, Inc. | Delivery tool for percutaneous delivery of a prosthesis |
US7665647B2 (en) | 2006-09-29 | 2010-02-23 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling device with closure apparatus for limiting maximum tissue compression force |
US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
US11666377B2 (en) | 2006-09-29 | 2023-06-06 | Boston Scientific Medical Device Limited | Electrosurgical device |
US10568652B2 (en) | 2006-09-29 | 2020-02-25 | Ethicon Llc | Surgical staples having attached drivers of different heights and stapling instruments for deploying the same |
US20210121227A1 (en) | 2006-09-29 | 2021-04-29 | Baylis Medical Company Inc. | Connector system for electrosurgical device |
US9149609B2 (en) * | 2006-10-16 | 2015-10-06 | Embolitech, Llc | Catheter for removal of an organized embolic thrombus |
US8784478B2 (en) | 2006-10-16 | 2014-07-22 | Medtronic Corevalve, Inc. | Transapical delivery system with ventruculo-arterial overlfow bypass |
US20080269774A1 (en) * | 2006-10-26 | 2008-10-30 | Chestnut Medical Technologies, Inc. | Intracorporeal Grasping Device |
US8747459B2 (en) | 2006-12-06 | 2014-06-10 | Medtronic Corevalve Llc | System and method for transapical delivery of an annulus anchored self-expanding valve |
WO2008070863A2 (en) | 2006-12-07 | 2008-06-12 | Interventional Spine, Inc. | Intervertebral implant |
US8439687B1 (en) | 2006-12-29 | 2013-05-14 | Acclarent, Inc. | Apparatus and method for simulated insertion and positioning of guidewares and other interventional devices |
US8652120B2 (en) | 2007-01-10 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
US8684253B2 (en) | 2007-01-10 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor |
US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
US8540128B2 (en) | 2007-01-11 | 2013-09-24 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with a curved end effector |
US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
US9707379B2 (en) | 2007-01-16 | 2017-07-18 | Radiadyne Llc | Rectal balloon with locking stopper |
US8500771B2 (en) | 2007-01-16 | 2013-08-06 | Radiadyne, Llc | Rectal balloon apparatus with pressure relieving lumen and sensors |
US20080172080A1 (en) * | 2007-01-16 | 2008-07-17 | Isham John | Minimally invasive rectal balloon apparatus |
US9381334B2 (en) | 2007-01-16 | 2016-07-05 | Radiadyne Llc | Endorectal balloon with gas release lumen |
CA2677648C (en) | 2007-02-16 | 2015-10-27 | Medtronic, Inc. | Replacement prosthetic heart valves and methods of implantation |
US8801647B2 (en) | 2007-02-22 | 2014-08-12 | Gi Dynamics, Inc. | Use of a gastrointestinal sleeve to treat bariatric surgery fistulas and leaks |
US9901434B2 (en) | 2007-02-27 | 2018-02-27 | Cook Medical Technologies Llc | Embolic protection device including a Z-stent waist band |
US7735703B2 (en) | 2007-03-15 | 2010-06-15 | Ethicon Endo-Surgery, Inc. | Re-loadable surgical stapling instrument |
US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
WO2008124787A2 (en) | 2007-04-09 | 2008-10-16 | Acclarent, Inc. | Ethmoidotomy system and implantable spacer devices having therapeutic substance delivery capability for treatment of paranasal sinusitis |
US7896915B2 (en) | 2007-04-13 | 2011-03-01 | Jenavalve Technology, Inc. | Medical device for treating a heart valve insufficiency |
FR2915087B1 (en) | 2007-04-20 | 2021-11-26 | Corevalve Inc | IMPLANT FOR TREATMENT OF A HEART VALVE, IN PARTICULAR OF A MITRAL VALVE, EQUIPMENT INCLUDING THIS IMPLANT AND MATERIAL FOR PLACING THIS IMPLANT. |
US8118757B2 (en) | 2007-04-30 | 2012-02-21 | Acclarent, Inc. | Methods and devices for ostium measurement |
US8485199B2 (en) | 2007-05-08 | 2013-07-16 | Acclarent, Inc. | Methods and devices for protecting nasal turbinate during surgery |
US9144509B2 (en) | 2007-05-31 | 2015-09-29 | Abbott Cardiovascular Systems Inc. | Method and apparatus for delivering an agent to a kidney |
US8216209B2 (en) | 2007-05-31 | 2012-07-10 | Abbott Cardiovascular Systems Inc. | Method and apparatus for delivering an agent to a kidney |
US9364586B2 (en) | 2007-05-31 | 2016-06-14 | Abbott Cardiovascular Systems Inc. | Method and apparatus for improving delivery of an agent to a kidney |
US9149610B2 (en) | 2007-05-31 | 2015-10-06 | Abbott Cardiovascular Systems Inc. | Method and apparatus for improving delivery of an agent to a kidney |
US20110022149A1 (en) | 2007-06-04 | 2011-01-27 | Cox Brian J | Methods and devices for treatment of vascular defects |
US11857181B2 (en) | 2007-06-04 | 2024-01-02 | Cilag Gmbh International | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US8408439B2 (en) | 2007-06-22 | 2013-04-02 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
US8900307B2 (en) | 2007-06-26 | 2014-12-02 | DePuy Synthes Products, LLC | Highly lordosed fusion cage |
US7867273B2 (en) | 2007-06-27 | 2011-01-11 | Abbott Laboratories | Endoprostheses for peripheral arteries and other body vessels |
US11849941B2 (en) | 2007-06-29 | 2023-12-26 | Cilag Gmbh International | Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis |
EP2182875A4 (en) | 2007-08-15 | 2011-08-24 | Cardiodex Ltd | Systems and methods for puncture closure |
US8747458B2 (en) | 2007-08-20 | 2014-06-10 | Medtronic Ventor Technologies Ltd. | Stent loading tool and method for use thereof |
US8252018B2 (en) | 2007-09-14 | 2012-08-28 | Cook Medical Technologies Llc | Helical embolic protection device |
US8419748B2 (en) | 2007-09-14 | 2013-04-16 | Cook Medical Technologies Llc | Helical thrombus removal device |
US9138307B2 (en) | 2007-09-14 | 2015-09-22 | Cook Medical Technologies Llc | Expandable device for treatment of a stricture in a body vessel |
US8795326B2 (en) | 2007-10-05 | 2014-08-05 | Covidien Lp | Expanding seal anchor for single incision surgery |
US10856970B2 (en) | 2007-10-10 | 2020-12-08 | Medtronic Ventor Technologies Ltd. | Prosthetic heart valve for transfemoral delivery |
US9848981B2 (en) | 2007-10-12 | 2017-12-26 | Mayo Foundation For Medical Education And Research | Expandable valve prosthesis with sealing mechanism |
US8088140B2 (en) | 2008-05-19 | 2012-01-03 | Mindframe, Inc. | Blood flow restorative and embolus removal methods |
US11337714B2 (en) | 2007-10-17 | 2022-05-24 | Covidien Lp | Restoring blood flow and clot removal during acute ischemic stroke |
EP2211972B1 (en) | 2007-10-26 | 2015-12-23 | Embolitech, LLC | Intravascular guidewire filter system for pulmonary embolism protection and embolism removal or maceration |
US10206821B2 (en) | 2007-12-20 | 2019-02-19 | Acclarent, Inc. | Eustachian tube dilation balloon with ventilation path |
US20100318175A1 (en) * | 2007-12-31 | 2010-12-16 | C.R. Bard, Inc. | Vascular graft prosthesis with selective flow reduction |
US8070720B2 (en) * | 2008-01-11 | 2011-12-06 | Medtronic Vascular, Inc | Methods for incorporating a drug into an elastomeric medical device |
KR101552476B1 (en) | 2008-01-17 | 2015-09-11 | 신세스 게엠바하 | An expandable intervertebral implant and associated method of manufacturing the same |
US8628566B2 (en) | 2008-01-24 | 2014-01-14 | Medtronic, Inc. | Stents for prosthetic heart valves |
US9149358B2 (en) | 2008-01-24 | 2015-10-06 | Medtronic, Inc. | Delivery systems for prosthetic heart valves |
EP3744291B1 (en) | 2008-01-24 | 2022-11-23 | Medtronic, Inc. | Stents for prosthetic heart valves |
EP2254512B1 (en) | 2008-01-24 | 2016-01-06 | Medtronic, Inc. | Markers for prosthetic heart valves |
US9393115B2 (en) | 2008-01-24 | 2016-07-19 | Medtronic, Inc. | Delivery systems and methods of implantation for prosthetic heart valves |
US8157852B2 (en) | 2008-01-24 | 2012-04-17 | Medtronic, Inc. | Delivery systems and methods of implantation for prosthetic heart valves |
US7905381B2 (en) | 2008-09-19 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with cutting member arrangement |
US8561870B2 (en) | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
RU2493788C2 (en) | 2008-02-14 | 2013-09-27 | Этикон Эндо-Серджери, Инк. | Surgical cutting and fixing instrument, which has radio-frequency electrodes |
US8657174B2 (en) | 2008-02-14 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument having handle based power source |
US20130153641A1 (en) | 2008-02-15 | 2013-06-20 | Ethicon Endo-Surgery, Inc. | Releasable layer of material and surgical end effector having the same |
US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
ES2737991T3 (en) | 2008-02-22 | 2020-01-17 | Covidien Lp | Device for flow restoration |
BR112012021347A2 (en) | 2008-02-26 | 2019-09-24 | Jenavalve Tecnology Inc | stent for positioning and anchoring a valve prosthesis at an implantation site in a patient's heart |
US9044318B2 (en) | 2008-02-26 | 2015-06-02 | Jenavalve Technology Gmbh | Stent for the positioning and anchoring of a valvular prosthesis |
EP3915525A1 (en) | 2008-02-28 | 2021-12-01 | Medtronic, Inc. | Prosthetic heart valve systems |
CA2716985A1 (en) * | 2008-03-06 | 2009-09-11 | Boston Scientific Scimed, Inc. | Balloon catheter devices with sheath covering |
US8182432B2 (en) | 2008-03-10 | 2012-05-22 | Acclarent, Inc. | Corewire design and construction for medical devices |
US8313525B2 (en) | 2008-03-18 | 2012-11-20 | Medtronic Ventor Technologies, Ltd. | Valve suturing and implantation procedures |
US20100004623A1 (en) * | 2008-03-27 | 2010-01-07 | Angiodynamics, Inc. | Method for Treatment of Complications Associated with Arteriovenous Grafts and Fistulas Using Electroporation |
EP2262449B1 (en) | 2008-04-05 | 2020-03-11 | Synthes GmbH | Expandable intervertebral implant |
US8430927B2 (en) | 2008-04-08 | 2013-04-30 | Medtronic, Inc. | Multiple orifice implantable heart valve and methods of implantation |
US8696743B2 (en) | 2008-04-23 | 2014-04-15 | Medtronic, Inc. | Tissue attachment devices and methods for prosthetic heart valves |
US8312825B2 (en) | 2008-04-23 | 2012-11-20 | Medtronic, Inc. | Methods and apparatuses for assembly of a pericardial prosthetic heart valve |
US8241316B2 (en) | 2008-04-25 | 2012-08-14 | Paul Oberle | Inflatable nasopharyngeal stent |
CA2722672C (en) | 2008-05-02 | 2019-10-22 | Sequent Medical Inc. | Filamentary devices for treatment of vascular defects |
US8840661B2 (en) | 2008-05-16 | 2014-09-23 | Sorin Group Italia S.R.L. | Atraumatic prosthetic heart valve prosthesis |
US20090299261A1 (en) * | 2008-06-03 | 2009-12-03 | Istvan Bognar | Expandable Catheters and Methods Relating Thereto |
WO2010011843A1 (en) | 2008-07-25 | 2010-01-28 | Cook Incorporated | Balloon catheter and method for making the same |
EP2306886B1 (en) | 2008-07-30 | 2018-10-31 | Acclarent, Inc. | Paranasal ostium finder devices |
US20100057000A1 (en) * | 2008-08-27 | 2010-03-04 | Cook Incorporated | Malecot with textile cover |
US8632605B2 (en) * | 2008-09-12 | 2014-01-21 | Pneumrx, Inc. | Elongated lung volume reduction devices, methods, and systems |
US8998981B2 (en) | 2008-09-15 | 2015-04-07 | Medtronic, Inc. | Prosthetic heart valve having identifiers for aiding in radiographic positioning |
US8721714B2 (en) | 2008-09-17 | 2014-05-13 | Medtronic Corevalve Llc | Delivery system for deployment of medical devices |
WO2010033629A1 (en) | 2008-09-18 | 2010-03-25 | Acclarent, Inc. | Methods and apparatus for treating disorders of the ear nose and throat |
PL3476312T3 (en) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Surgical stapler with apparatus for adjusting staple height |
US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US9386983B2 (en) | 2008-09-23 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Robotically-controlled motorized surgical instrument |
US9005230B2 (en) | 2008-09-23 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US8500687B2 (en) | 2008-09-25 | 2013-08-06 | Abbott Cardiovascular Systems Inc. | Stent delivery system having a fibrous matrix covering with improved stent retention |
US8226603B2 (en) * | 2008-09-25 | 2012-07-24 | Abbott Cardiovascular Systems Inc. | Expandable member having a covering formed of a fibrous matrix for intraluminal drug delivery |
US8076529B2 (en) * | 2008-09-26 | 2011-12-13 | Abbott Cardiovascular Systems, Inc. | Expandable member formed of a fibrous matrix for intraluminal drug delivery |
US8049061B2 (en) * | 2008-09-25 | 2011-11-01 | Abbott Cardiovascular Systems, Inc. | Expandable member formed of a fibrous matrix having hydrogel polymer for intraluminal drug delivery |
ES2409693T3 (en) | 2008-10-10 | 2013-06-27 | Sadra Medical, Inc. | Medical devices and supply systems to supply medical devices |
US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
US8137398B2 (en) | 2008-10-13 | 2012-03-20 | Medtronic Ventor Technologies Ltd | Prosthetic valve having tapered tip when compressed for delivery |
US8986361B2 (en) | 2008-10-17 | 2015-03-24 | Medtronic Corevalve, Inc. | Delivery system for deployment of medical devices |
DE102008053635A1 (en) * | 2008-10-29 | 2010-05-12 | Acandis Gmbh & Co. Kg | Medical device for recanalization of thrombi |
ES2551694T3 (en) | 2008-12-23 | 2015-11-23 | Sorin Group Italia S.R.L. | Expandable prosthetic valve with anchoring appendages |
US8388644B2 (en) | 2008-12-29 | 2013-03-05 | Cook Medical Technologies Llc | Embolic protection device and method of use |
AU2010205881B2 (en) * | 2009-01-18 | 2015-08-13 | Avent, Inc. | Stabilization device |
US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
RU2525225C2 (en) | 2009-02-06 | 2014-08-10 | Этикон Эндо-Серджери, Инк. | Improvement of drive surgical suturing instrument |
US8453907B2 (en) | 2009-02-06 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Motor driven surgical fastener device with cutting member reversing mechanism |
US8444036B2 (en) | 2009-02-06 | 2013-05-21 | Ethicon Endo-Surgery, Inc. | Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector |
US7988669B2 (en) * | 2009-02-17 | 2011-08-02 | Tyco Healthcare Group Lp | Port fixation with filament actuating member |
US8277477B2 (en) * | 2009-02-20 | 2012-10-02 | Paul Oberle | Mechanically deployable upper airway stent |
US20100241155A1 (en) | 2009-03-20 | 2010-09-23 | Acclarent, Inc. | Guide system with suction |
IL197800A0 (en) | 2009-03-25 | 2009-12-24 | Shmuel Ben Muvhar | Internal filtering device |
US9526620B2 (en) | 2009-03-30 | 2016-12-27 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
US7978742B1 (en) | 2010-03-24 | 2011-07-12 | Corning Incorporated | Methods for operating diode lasers |
US8435290B2 (en) | 2009-03-31 | 2013-05-07 | Acclarent, Inc. | System and method for treatment of non-ventilating middle ear by providing a gas pathway through the nasopharynx |
EP2628465A1 (en) | 2009-04-27 | 2013-08-21 | Sorin Group Italia S.r.l. | Prosthetic vascular conduit |
CN104622599B (en) * | 2009-05-18 | 2017-04-12 | 纽姆克斯股份有限公司 | Cross-sectional modification during deployment of an elongate lung volume reduction device |
WO2010138919A2 (en) | 2009-05-28 | 2010-12-02 | Angiodynamics, Inc. | System and method for synchronizing energy delivery to the cardiac rhythm |
US20100318171A1 (en) * | 2009-06-15 | 2010-12-16 | Boston Scientific Scimed, Inc. | Multiple Stent Delivery System |
US9895189B2 (en) | 2009-06-19 | 2018-02-20 | Angiodynamics, Inc. | Methods of sterilization and treating infection using irreversible electroporation |
US8740961B2 (en) * | 2009-08-13 | 2014-06-03 | Richard Eustis Fulton, III | Method for treating a target site in a vascular body channel |
EP2470232B1 (en) * | 2009-08-27 | 2016-03-30 | Boston Scientific Scimed, Inc. | Balloon catheter devices with drug-coated sheath |
US8808369B2 (en) | 2009-10-05 | 2014-08-19 | Mayo Foundation For Medical Education And Research | Minimally invasive aortic valve replacement |
AU2010315535A1 (en) * | 2009-10-26 | 2012-05-03 | Cardiokinetix, Inc. | Ventricular volume reduction |
US9393129B2 (en) | 2009-12-10 | 2016-07-19 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
US8771289B2 (en) * | 2009-12-21 | 2014-07-08 | Acist Medical Systems, Inc. | Thrombus removal device and system |
US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
CN102821704A (en) * | 2010-02-05 | 2012-12-12 | 斯瑞克运营有限公司 | Multimode occlusion and stenosis treatment apparatus and method of use |
US20110196478A1 (en) * | 2010-02-10 | 2011-08-11 | Beoptima Inc. | Devices and methods for lumen treatment |
US9226826B2 (en) | 2010-02-24 | 2016-01-05 | Medtronic, Inc. | Transcatheter valve structure and methods for valve delivery |
CN103037929B (en) | 2010-03-06 | 2015-08-26 | 新融合血管系统有限公司 | Reclaim catheter kit |
US8652204B2 (en) | 2010-04-01 | 2014-02-18 | Medtronic, Inc. | Transcatheter valve with torsion spring fixation and related systems and methods |
EP2380604A1 (en) | 2010-04-19 | 2011-10-26 | InnoRa Gmbh | Improved coating formulations for scoring or cutting balloon catheters |
IT1400327B1 (en) | 2010-05-21 | 2013-05-24 | Sorin Biomedica Cardio Srl | SUPPORT DEVICE FOR VALVULAR PROSTHESIS AND CORRESPONDING CORRESPONDENT. |
AU2011257298B2 (en) | 2010-05-25 | 2014-07-31 | Jenavalve Technology Inc. | Prosthetic heart valve and transcatheter delivered endoprosthesis comprising a prosthetic heart valve and a stent |
US10010439B2 (en) | 2010-06-13 | 2018-07-03 | Synerz Medical, Inc. | Intragastric device for treating obesity |
US9526648B2 (en) | 2010-06-13 | 2016-12-27 | Synerz Medical, Inc. | Intragastric device for treating obesity |
US10420665B2 (en) | 2010-06-13 | 2019-09-24 | W. L. Gore & Associates, Inc. | Intragastric device for treating obesity |
US8628554B2 (en) | 2010-06-13 | 2014-01-14 | Virender K. Sharma | Intragastric device for treating obesity |
US9592063B2 (en) | 2010-06-24 | 2017-03-14 | DePuy Synthes Products, Inc. | Universal trial for lateral cages |
US8979860B2 (en) | 2010-06-24 | 2015-03-17 | DePuy Synthes Products. LLC | Enhanced cage insertion device |
JP5850930B2 (en) | 2010-06-29 | 2016-02-03 | ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング | Isolated intervertebral implant |
US8927000B2 (en) | 2010-06-30 | 2015-01-06 | Surmodics, Inc. | Lipid coating for medical devices delivering bioactive agent |
JP6017420B2 (en) | 2010-06-30 | 2016-11-02 | サーモディクス,インコーポレイティド | Catheter assembly |
US9561094B2 (en) | 2010-07-23 | 2017-02-07 | Nfinium Vascular Technologies, Llc | Devices and methods for treating venous diseases |
US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
CN103118629A (en) | 2010-09-01 | 2013-05-22 | 美敦力瓦斯科尔勒戈尔韦有限公司 | Prosthetic valve support structure |
RU139021U1 (en) | 2010-09-10 | 2014-04-10 | Симетис Са | VALVE REPLACEMENT DEVICES, SYSTEMS CONTAINING A VALVE REPLACEMENT DEVICE, HEART VALVE REPLACEMENT DEVICES AND A DELIVERY SYSTEM FOR DELIVERY OF A VALVE REPLACEMENT DEVICE |
US8632559B2 (en) | 2010-09-21 | 2014-01-21 | Angioscore, Inc. | Method and system for treating valve stenosis |
US9155492B2 (en) | 2010-09-24 | 2015-10-13 | Acclarent, Inc. | Sinus illumination lightwire device |
US9320523B2 (en) | 2012-03-28 | 2016-04-26 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising tissue ingrowth features |
US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
AU2011308701B2 (en) | 2010-09-30 | 2013-11-14 | Ethicon Endo-Surgery, Inc. | Fastener system comprising a retention matrix and an alignment matrix |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US11849952B2 (en) | 2010-09-30 | 2023-12-26 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US9232941B2 (en) | 2010-09-30 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising a reservoir |
US20120080498A1 (en) | 2010-09-30 | 2012-04-05 | Ethicon Endo-Surgery, Inc. | Curved end effector for a stapling instrument |
US9301753B2 (en) | 2010-09-30 | 2016-04-05 | Ethicon Endo-Surgery, Llc | Expandable tissue thickness compensator |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
US9168038B2 (en) | 2010-09-30 | 2015-10-27 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising a tissue thickness compensator |
US9241714B2 (en) | 2011-04-29 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator and method for making the same |
US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
US9861361B2 (en) | 2010-09-30 | 2018-01-09 | Ethicon Llc | Releasable tissue thickness compensator and fastener cartridge having the same |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
US9301752B2 (en) | 2010-09-30 | 2016-04-05 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising a plurality of capsules |
US9039749B2 (en) | 2010-10-01 | 2015-05-26 | Covidien Lp | Methods and apparatuses for flow restoration and implanting members in the human body |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
US9402732B2 (en) | 2010-10-11 | 2016-08-02 | DePuy Synthes Products, Inc. | Expandable interspinous process spacer implant |
WO2012051433A2 (en) | 2010-10-13 | 2012-04-19 | Angiodynamics, Inc. | System and method for electrically ablating tissue of a patient |
US8801736B2 (en) | 2010-11-19 | 2014-08-12 | Gil Vardi | Percutaneous thrombus extraction device and method |
EP2486894B1 (en) | 2011-02-14 | 2021-06-09 | Sorin Group Italia S.r.l. | Sutureless anchoring device for cardiac valve prostheses |
ES2641902T3 (en) | 2011-02-14 | 2017-11-14 | Sorin Group Italia S.R.L. | Sutureless anchoring device for cardiac valve prostheses |
US9415193B2 (en) | 2011-03-04 | 2016-08-16 | W. L. Gore & Associates, Inc. | Eluting medical devices |
US9707374B2 (en) | 2011-03-14 | 2017-07-18 | Cook Medical Technologies Llc | Infusion system having filtration device and method |
US10625069B2 (en) | 2011-03-14 | 2020-04-21 | Cook Medical Technologies, LLC | Infusion system having filtration device and method |
EP4119095A1 (en) | 2011-03-21 | 2023-01-18 | Cephea Valve Technologies, Inc. | Disk-based valve apparatus |
BR112013027794B1 (en) | 2011-04-29 | 2020-12-15 | Ethicon Endo-Surgery, Inc | CLAMP CARTRIDGE SET |
EP2704672B1 (en) | 2011-05-05 | 2016-02-10 | Relief Therapies, Inc. | Device for protecting hemorrhoids |
EP2520251A1 (en) | 2011-05-05 | 2012-11-07 | Symetis SA | Method and Apparatus for Compressing Stent-Valves |
US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
JP2014527425A (en) | 2011-07-12 | 2014-10-16 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Linkage system for medical devices |
US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
US9078665B2 (en) | 2011-09-28 | 2015-07-14 | Angiodynamics, Inc. | Multiple treatment zone ablation probe |
US9131926B2 (en) | 2011-11-10 | 2015-09-15 | Boston Scientific Scimed, Inc. | Direct connect flush system |
US8940014B2 (en) | 2011-11-15 | 2015-01-27 | Boston Scientific Scimed, Inc. | Bond between components of a medical device |
US8951243B2 (en) | 2011-12-03 | 2015-02-10 | Boston Scientific Scimed, Inc. | Medical device handle |
US9510945B2 (en) | 2011-12-20 | 2016-12-06 | Boston Scientific Scimed Inc. | Medical device handle |
US9277993B2 (en) | 2011-12-20 | 2016-03-08 | Boston Scientific Scimed, Inc. | Medical device delivery systems |
EP2842517A1 (en) | 2011-12-29 | 2015-03-04 | Sorin Group Italia S.r.l. | A kit for implanting prosthetic vascular conduits |
US10172708B2 (en) | 2012-01-25 | 2019-01-08 | Boston Scientific Scimed, Inc. | Valve assembly with a bioabsorbable gasket and a replaceable valve implant |
US9044230B2 (en) | 2012-02-13 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status |
RU2639857C2 (en) | 2012-03-28 | 2017-12-22 | Этикон Эндо-Серджери, Инк. | Tissue thickness compensator containing capsule for medium with low pressure |
US9198662B2 (en) | 2012-03-28 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator having improved visibility |
BR112014024194B1 (en) | 2012-03-28 | 2022-03-03 | Ethicon Endo-Surgery, Inc | STAPLER CARTRIDGE SET FOR A SURGICAL STAPLER |
RU2014143258A (en) | 2012-03-28 | 2016-05-20 | Этикон Эндо-Серджери, Инк. | FABRIC THICKNESS COMPENSATOR CONTAINING MANY LAYERS |
US9848881B2 (en) | 2012-05-09 | 2017-12-26 | Fusion Medical, Inc. | Clot removal device for deep vein thrombosis |
US10448969B2 (en) | 2012-05-09 | 2019-10-22 | Fusion Medical, Inc. | Clot removal device for blood vessels |
US9108029B2 (en) | 2012-05-21 | 2015-08-18 | Nfusion Vascular Systems, Llc | Recovery catheter assembly and method |
BR112014030643A8 (en) | 2012-05-31 | 2018-05-15 | Baylis Medical Co Inc | radiofrequency drilling rig. |
US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
US9883941B2 (en) | 2012-06-19 | 2018-02-06 | Boston Scientific Scimed, Inc. | Replacement heart valve |
US11278284B2 (en) | 2012-06-28 | 2022-03-22 | Cilag Gmbh International | Rotary drive arrangements for surgical instruments |
US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
US9125662B2 (en) | 2012-06-28 | 2015-09-08 | Ethicon Endo-Surgery, Inc. | Multi-axis articulating and rotating surgical tools |
BR112014032776B1 (en) | 2012-06-28 | 2021-09-08 | Ethicon Endo-Surgery, Inc | SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM |
US9561038B2 (en) | 2012-06-28 | 2017-02-07 | Ethicon Endo-Surgery, Llc | Interchangeable clip applier |
BR112014032740A2 (en) | 2012-06-28 | 2020-02-27 | Ethicon Endo Surgery Inc | empty clip cartridge lock |
US20140005718A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Multi-functional powered surgical device with external dissection features |
US20140001234A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Coupling arrangements for attaching surgical end effectors to drive systems therefor |
US9101385B2 (en) | 2012-06-28 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Electrode connections for rotary driven surgical tools |
US9119657B2 (en) | 2012-06-28 | 2015-09-01 | Ethicon Endo-Surgery, Inc. | Rotary actuatable closure arrangement for surgical end effector |
US9028494B2 (en) | 2012-06-28 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Interchangeable end effector coupling arrangement |
US9072536B2 (en) | 2012-06-28 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Differential locking arrangements for rotary powered surgical instruments |
US9649111B2 (en) | 2012-06-28 | 2017-05-16 | Ethicon Endo-Surgery, Llc | Replaceable clip cartridge for a clip applier |
US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
US8940052B2 (en) | 2012-07-26 | 2015-01-27 | DePuy Synthes Products, LLC | Expandable implant |
US9308007B2 (en) | 2012-08-14 | 2016-04-12 | W. L. Gore & Associates, Inc. | Devices and systems for thrombus treatment |
US20140067069A1 (en) | 2012-08-30 | 2014-03-06 | Interventional Spine, Inc. | Artificial disc |
US10173038B2 (en) * | 2012-09-05 | 2019-01-08 | W. L. Gore & Associates, Inc. | Retractable sheath devices, systems, and methods |
DK2897536T3 (en) | 2012-09-24 | 2020-11-23 | Inari Medical Inc | APPARATUS FOR THE TREATMENT OF VASCULAR OCCLUSIONS |
JP6353458B2 (en) | 2012-11-15 | 2018-07-04 | エンフィニアム バスキュラー テクノロジーズ, エルエルシー | Temporary vascular scaffolding and scoring device |
US8784434B2 (en) | 2012-11-20 | 2014-07-22 | Inceptus Medical, Inc. | Methods and apparatus for treating embolism |
US10219924B2 (en) | 2012-12-26 | 2019-03-05 | Stryker Corporation | Multilayer stent |
US10413703B2 (en) * | 2012-12-31 | 2019-09-17 | Clearstream Technologies Limited | Catheter with markings to facilitate alignment |
US9888956B2 (en) | 2013-01-22 | 2018-02-13 | Angiodynamics, Inc. | Integrated pump and generator device and method of use |
US9386984B2 (en) | 2013-02-08 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Staple cartridge comprising a releasable cover |
BR112015021098B1 (en) | 2013-03-01 | 2022-02-15 | Ethicon Endo-Surgery, Inc | COVERAGE FOR A JOINT JOINT AND SURGICAL INSTRUMENT |
US9358003B2 (en) | 2013-03-01 | 2016-06-07 | Ethicon Endo-Surgery, Llc | Electromechanical surgical device with signal relay arrangement |
RU2669463C2 (en) | 2013-03-01 | 2018-10-11 | Этикон Эндо-Серджери, Инк. | Surgical instrument with soft stop |
US9522070B2 (en) | 2013-03-07 | 2016-12-20 | Interventional Spine, Inc. | Intervertebral implant |
US11937873B2 (en) | 2013-03-12 | 2024-03-26 | Boston Scientific Medical Device Limited | Electrosurgical device having a lumen |
US20140263552A1 (en) | 2013-03-13 | 2014-09-18 | Ethicon Endo-Surgery, Inc. | Staple cartridge tissue thickness sensor system |
US9629629B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgey, LLC | Control systems for surgical instruments |
US9883860B2 (en) | 2013-03-14 | 2018-02-06 | Ethicon Llc | Interchangeable shaft assemblies for use with a surgical instrument |
US9433437B2 (en) | 2013-03-15 | 2016-09-06 | Acclarent, Inc. | Apparatus and method for treatment of ethmoid sinusitis |
US9629684B2 (en) | 2013-03-15 | 2017-04-25 | Acclarent, Inc. | Apparatus and method for treatment of ethmoid sinusitis |
US9572577B2 (en) | 2013-03-27 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a tissue thickness compensator including openings therein |
US9795384B2 (en) | 2013-03-27 | 2017-10-24 | Ethicon Llc | Fastener cartridge comprising a tissue thickness compensator and a gap setting element |
US9332984B2 (en) | 2013-03-27 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Fastener cartridge assemblies |
EP2789354A1 (en) * | 2013-04-13 | 2014-10-15 | IPPyramids GmbH | Catheter balloon with micro boreholes and a metal mesh |
US9844368B2 (en) | 2013-04-16 | 2017-12-19 | Ethicon Llc | Surgical system comprising first and second drive systems |
BR112015026109B1 (en) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | surgical instrument |
JP6561044B2 (en) | 2013-05-03 | 2019-08-14 | メドトロニック,インコーポレイテッド | Valve transfer tool |
US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
US9561103B2 (en) | 2013-07-17 | 2017-02-07 | Cephea Valve Technologies, Inc. | System and method for cardiac valve repair and replacement |
US9078658B2 (en) | 2013-08-16 | 2015-07-14 | Sequent Medical, Inc. | Filamentary devices for treatment of vascular defects |
US9955976B2 (en) | 2013-08-16 | 2018-05-01 | Sequent Medical, Inc. | Filamentary devices for treatment of vascular defects |
MX369362B (en) | 2013-08-23 | 2019-11-06 | Ethicon Endo Surgery Llc | Firing member retraction devices for powered surgical instruments. |
US9283054B2 (en) | 2013-08-23 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Interactive displays |
EP4098226A1 (en) | 2013-08-30 | 2022-12-07 | JenaValve Technology, Inc. | Endoprosthesis comprising a radially collapsible frame and a prosthetic valve |
US10076399B2 (en) | 2013-09-13 | 2018-09-18 | Covidien Lp | Endovascular device engagement |
US10117668B2 (en) | 2013-10-08 | 2018-11-06 | The Spectranetics Corporation | Balloon catheter with non-deployable stent having improved stability |
WO2015061365A1 (en) | 2013-10-21 | 2015-04-30 | Inceptus Medical, Llc | Methods and apparatus for treating embolism |
WO2015061790A2 (en) | 2013-10-25 | 2015-04-30 | Pneumrx, Inc. | Genetically-associated chronic obstructive pulmonary disease treatment |
WO2015076864A1 (en) * | 2013-11-22 | 2015-05-28 | The General Hospital Corporation | Methods and devices for treating and preventing conditions of tubular body structures |
US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
US9549735B2 (en) | 2013-12-23 | 2017-01-24 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a firing member including fastener transfer surfaces |
US20150173756A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling methods |
US9724092B2 (en) | 2013-12-23 | 2017-08-08 | Ethicon Llc | Modular surgical instruments |
RU2766737C2 (en) * | 2013-12-31 | 2022-03-15 | Клирстрим Текнолоджис Лимитэд | Catheter with positioning markers |
US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
BR112016019387B1 (en) | 2014-02-24 | 2022-11-29 | Ethicon Endo-Surgery, Llc | SURGICAL INSTRUMENT SYSTEM AND FASTENER CARTRIDGE FOR USE WITH A SURGICAL FIXING INSTRUMENT |
US9775608B2 (en) | 2014-02-24 | 2017-10-03 | Ethicon Llc | Fastening system comprising a firing member lockout |
US9750499B2 (en) | 2014-03-26 | 2017-09-05 | Ethicon Llc | Surgical stapling instrument system |
US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
US20150272557A1 (en) | 2014-03-26 | 2015-10-01 | Ethicon Endo-Surgery, Inc. | Modular surgical instrument system |
BR112016021943B1 (en) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE |
US10013049B2 (en) | 2014-03-26 | 2018-07-03 | Ethicon Llc | Power management through sleep options of segmented circuit and wake up control |
NZ724237A (en) | 2014-03-31 | 2020-07-31 | Clearstream Tech Ltd | Catheter structures for reducing fluoroscopy usage during endovascular procedures |
US9629635B2 (en) | 2014-04-14 | 2017-04-25 | Sequent Medical, Inc. | Devices for therapeutic vascular procedures |
JP6612256B2 (en) | 2014-04-16 | 2019-11-27 | エシコン エルエルシー | Fastener cartridge with non-uniform fastener |
US10542988B2 (en) | 2014-04-16 | 2020-01-28 | Ethicon Llc | End effector comprising an anvil including projections extending therefrom |
US20150297225A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
BR112016023698B1 (en) | 2014-04-16 | 2022-07-26 | Ethicon Endo-Surgery, Llc | FASTENER CARTRIDGE FOR USE WITH A SURGICAL INSTRUMENT |
CN106456159B (en) | 2014-04-16 | 2019-03-08 | 伊西康内外科有限责任公司 | Fastener cartridge assembly and nail retainer lid arragement construction |
US9801627B2 (en) | 2014-09-26 | 2017-10-31 | Ethicon Llc | Fastener cartridge for creating a flexible staple line |
US20150342610A1 (en) * | 2014-05-29 | 2015-12-03 | Pulmonx Corporation | Medical devices and methods for lung volume reduction |
US9901722B2 (en) | 2014-06-01 | 2018-02-27 | White Swell Medical Ltd | System and method for treatment of pulmonary edema |
EP3151904A4 (en) | 2014-06-04 | 2018-02-14 | Nfinium Vascular Technologies, LLC | Low radial force vascular device and method of occlusion |
EP3094363A4 (en) | 2014-06-09 | 2017-10-04 | Inceptus Medical, LLC | Retraction and aspiration device for treating embolism and associated systems and methods |
US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
US10390838B1 (en) | 2014-08-20 | 2019-08-27 | Pneumrx, Inc. | Tuned strength chronic obstructive pulmonary disease treatment |
US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
US10111679B2 (en) | 2014-09-05 | 2018-10-30 | Ethicon Llc | Circuitry and sensors for powered medical device |
BR112017004361B1 (en) | 2014-09-05 | 2023-04-11 | Ethicon Llc | ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT |
US10105142B2 (en) | 2014-09-18 | 2018-10-23 | Ethicon Llc | Surgical stapler with plurality of cutting elements |
BR112017005981B1 (en) | 2014-09-26 | 2022-09-06 | Ethicon, Llc | ANCHOR MATERIAL FOR USE WITH A SURGICAL STAPLE CARTRIDGE AND SURGICAL STAPLE CARTRIDGE FOR USE WITH A SURGICAL INSTRUMENT |
US11523821B2 (en) | 2014-09-26 | 2022-12-13 | Cilag Gmbh International | Method for creating a flexible staple line |
CN106852115A (en) | 2014-09-28 | 2017-06-13 | 卡迪欧凯尼迪克斯公司 | device for treating cardiac insufficiency |
US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
US9924944B2 (en) | 2014-10-16 | 2018-03-27 | Ethicon Llc | Staple cartridge comprising an adjunct material |
WO2016067286A1 (en) | 2014-10-27 | 2016-05-06 | Lithiblock Ltd. | Gallbladder implant and systems and methods for the delivery thereof |
US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
US9901445B2 (en) | 2014-11-21 | 2018-02-27 | Boston Scientific Scimed, Inc. | Valve locking mechanism |
US9439757B2 (en) | 2014-12-09 | 2016-09-13 | Cephea Valve Technologies, Inc. | Replacement cardiac valves and methods of use and manufacture |
US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
US10085748B2 (en) | 2014-12-18 | 2018-10-02 | Ethicon Llc | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
US9844374B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member |
US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
US10117649B2 (en) | 2014-12-18 | 2018-11-06 | Ethicon Llc | Surgical instrument assembly comprising a lockable articulation system |
US10188385B2 (en) | 2014-12-18 | 2019-01-29 | Ethicon Llc | Surgical instrument system comprising lockable systems |
US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
MX2017008108A (en) | 2014-12-18 | 2018-03-06 | Ethicon Llc | Surgical instrument with an anvil that is selectively movable about a discrete non-movable axis relative to a staple cartridge. |
US10004501B2 (en) | 2014-12-18 | 2018-06-26 | Ethicon Llc | Surgical instruments with improved closure arrangements |
US10182834B2 (en) | 2015-01-08 | 2019-01-22 | Cook Medical Technologies Llc | Delivery of thrombolytic agent through actuation member of thrombus retrieval device |
WO2016115375A1 (en) | 2015-01-16 | 2016-07-21 | Boston Scientific Scimed, Inc. | Displacement based lock and release mechanism |
US9861477B2 (en) | 2015-01-26 | 2018-01-09 | Boston Scientific Scimed Inc. | Prosthetic heart valve square leaflet-leaflet stitch |
US9788942B2 (en) | 2015-02-03 | 2017-10-17 | Boston Scientific Scimed Inc. | Prosthetic heart valve having tubular seal |
US10201417B2 (en) | 2015-02-03 | 2019-02-12 | Boston Scientific Scimed Inc. | Prosthetic heart valve having tubular seal |
US10180463B2 (en) | 2015-02-27 | 2019-01-15 | Ethicon Llc | Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band |
US9931118B2 (en) | 2015-02-27 | 2018-04-03 | Ethicon Endo-Surgery, Llc | Reinforced battery for a surgical instrument |
US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
US10285809B2 (en) | 2015-03-06 | 2019-05-14 | Boston Scientific Scimed Inc. | TAVI anchoring assist device |
JP2020121162A (en) | 2015-03-06 | 2020-08-13 | エシコン エルエルシーEthicon LLC | Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement |
US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
US10426617B2 (en) | 2015-03-06 | 2019-10-01 | Boston Scientific Scimed, Inc. | Low profile valve locking mechanism and commissure assembly |
US10052044B2 (en) | 2015-03-06 | 2018-08-21 | Ethicon Llc | Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
US10045776B2 (en) | 2015-03-06 | 2018-08-14 | Ethicon Llc | Control techniques and sub-processor contained within modular shaft with select control processing from handle |
US9895148B2 (en) | 2015-03-06 | 2018-02-20 | Ethicon Endo-Surgery, Llc | Monitoring speed control and precision incrementing of motor for powered surgical instruments |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
US11426290B2 (en) | 2015-03-06 | 2022-08-30 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
US10080652B2 (en) | 2015-03-13 | 2018-09-25 | Boston Scientific Scimed, Inc. | Prosthetic heart valve having an improved tubular seal |
US10433844B2 (en) | 2015-03-31 | 2019-10-08 | Ethicon Llc | Surgical instrument with selectively disengageable threaded drive systems |
FI3288493T3 (en) * | 2015-04-29 | 2023-01-31 | Stent delivery system | |
EP3288495B1 (en) | 2015-05-01 | 2019-09-25 | JenaValve Technology, Inc. | Device with reduced pacemaker rate in heart valve replacement |
IL294513A (en) | 2015-05-11 | 2022-09-01 | White Swell Medical Ltd | Systems and methods for reducing pressure at an outflow of a duct |
WO2016183523A1 (en) | 2015-05-14 | 2016-11-17 | Cephea Valve Technologies, Inc. | Cardiac valve delivery devices and systems |
AU2016262564B2 (en) | 2015-05-14 | 2020-11-05 | Cephea Valve Technologies, Inc. | Replacement mitral valves |
US10178992B2 (en) | 2015-06-18 | 2019-01-15 | Ethicon Llc | Push/pull articulation drive systems for articulatable surgical instruments |
US10195392B2 (en) | 2015-07-02 | 2019-02-05 | Boston Scientific Scimed, Inc. | Clip-on catheter |
US10335277B2 (en) | 2015-07-02 | 2019-07-02 | Boston Scientific Scimed Inc. | Adjustable nosecone |
US9913727B2 (en) | 2015-07-02 | 2018-03-13 | Medos International Sarl | Expandable implant |
EP4272660A3 (en) | 2015-07-24 | 2024-01-03 | Ichor Vascular Inc. | Embolectomy system |
US9999493B2 (en) | 2015-08-06 | 2018-06-19 | Kp Medcure, Inc. | Axial lengthening thrombus capture system |
US9744024B2 (en) | 2015-08-06 | 2017-08-29 | Kp Medcure, Inc. | Axial lengthening thrombus capture system |
CN113116459A (en) | 2015-08-06 | 2021-07-16 | Kp万科公司 | Axially elongated thrombus capture system |
US10179041B2 (en) | 2015-08-12 | 2019-01-15 | Boston Scientific Scimed Icn. | Pinless release mechanism |
US10136991B2 (en) | 2015-08-12 | 2018-11-27 | Boston Scientific Scimed Inc. | Replacement heart valve implant |
US10835249B2 (en) | 2015-08-17 | 2020-11-17 | Ethicon Llc | Implantable layers for a surgical instrument |
US10390829B2 (en) | 2015-08-26 | 2019-08-27 | Ethicon Llc | Staples comprising a cover |
JP6828018B2 (en) | 2015-08-26 | 2021-02-10 | エシコン エルエルシーEthicon LLC | Surgical staple strips that allow you to change the characteristics of staples and facilitate filling into cartridges |
MX2022006189A (en) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples. |
US10314587B2 (en) | 2015-09-02 | 2019-06-11 | Ethicon Llc | Surgical staple cartridge with improved staple driver configurations |
US10779940B2 (en) | 2015-09-03 | 2020-09-22 | Boston Scientific Scimed, Inc. | Medical device handle |
EP3865082A1 (en) | 2015-09-09 | 2021-08-18 | Baylis Medical Company Inc. | A needle for epicardial access |
US10363036B2 (en) | 2015-09-23 | 2019-07-30 | Ethicon Llc | Surgical stapler having force-based motor control |
US10085751B2 (en) | 2015-09-23 | 2018-10-02 | Ethicon Llc | Surgical stapler having temperature-based motor control |
US10238386B2 (en) | 2015-09-23 | 2019-03-26 | Ethicon Llc | Surgical stapler having motor control based on an electrical parameter related to a motor current |
US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
US10076326B2 (en) | 2015-09-23 | 2018-09-18 | Ethicon Llc | Surgical stapler having current mirror-based motor control |
US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
US20170086829A1 (en) | 2015-09-30 | 2017-03-30 | Ethicon Endo-Surgery, Llc | Compressible adjunct with intermediate supporting structures |
US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
US11690623B2 (en) | 2015-09-30 | 2023-07-04 | Cilag Gmbh International | Method for applying an implantable layer to a fastener cartridge |
EP4233744A3 (en) | 2015-10-23 | 2023-11-01 | Inari Medical, Inc. | Device for intravascular treatment of vascular occlusion |
US10342571B2 (en) | 2015-10-23 | 2019-07-09 | Inari Medical, Inc. | Intravascular treatment of vascular occlusion and associated devices, systems, and methods |
US9700332B2 (en) | 2015-10-23 | 2017-07-11 | Inari Medical, Inc. | Intravascular treatment of vascular occlusion and associated devices, systems, and methods |
US10183159B2 (en) | 2015-12-15 | 2019-01-22 | Heartstitch, Inc. | Constriction valve |
US11433218B2 (en) | 2015-12-18 | 2022-09-06 | Inari Medical, Inc. | Catheter shaft and associated devices, systems, and methods |
US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
US10342660B2 (en) | 2016-02-02 | 2019-07-09 | Boston Scientific Inc. | Tensioned sheathing aids |
US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
US10245030B2 (en) | 2016-02-09 | 2019-04-02 | Ethicon Llc | Surgical instruments with tensioning arrangements for cable driven articulation systems |
JP6911054B2 (en) | 2016-02-09 | 2021-07-28 | エシコン エルエルシーEthicon LLC | Surgical instruments with asymmetric joint composition |
US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10258331B2 (en) | 2016-02-12 | 2019-04-16 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
US10376263B2 (en) | 2016-04-01 | 2019-08-13 | Ethicon Llc | Anvil modification members for surgical staplers |
US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10828028B2 (en) | 2016-04-15 | 2020-11-10 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
US11179150B2 (en) | 2016-04-15 | 2021-11-23 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
US10363037B2 (en) | 2016-04-18 | 2019-07-30 | Ethicon Llc | Surgical instrument system comprising a magnetic lockout |
US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
US10779980B2 (en) | 2016-04-27 | 2020-09-22 | Synerz Medical, Inc. | Intragastric device for treating obesity |
US10245136B2 (en) | 2016-05-13 | 2019-04-02 | Boston Scientific Scimed Inc. | Containment vessel with implant sheathing guide |
US10583005B2 (en) | 2016-05-13 | 2020-03-10 | Boston Scientific Scimed, Inc. | Medical device handle |
EP3454795B1 (en) | 2016-05-13 | 2023-01-11 | JenaValve Technology, Inc. | Heart valve prosthesis delivery system for delivery of heart valve prosthesis with introducer sheath and loading system |
US10201416B2 (en) | 2016-05-16 | 2019-02-12 | Boston Scientific Scimed, Inc. | Replacement heart valve implant with invertible leaflets |
US11331187B2 (en) | 2016-06-17 | 2022-05-17 | Cephea Valve Technologies, Inc. | Cardiac valve delivery devices and systems |
CN109310431B (en) | 2016-06-24 | 2022-03-04 | 伊西康有限责任公司 | Staple cartridge comprising wire staples and punch staples |
US11000278B2 (en) | 2016-06-24 | 2021-05-11 | Ethicon Llc | Staple cartridge comprising wire staples and stamped staples |
USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
US11510788B2 (en) | 2016-06-28 | 2022-11-29 | Eit Emerging Implant Technologies Gmbh | Expandable, angularly adjustable intervertebral cages |
CN109640889B (en) | 2016-06-28 | 2021-07-30 | Eit 新兴移植技术股份有限公司 | Expandable angularly adjustable intervertebral cage for joint motion |
JP6771970B2 (en) * | 2016-07-04 | 2020-10-21 | 株式会社カネカ | Balloon catheter |
WO2018080590A1 (en) | 2016-10-24 | 2018-05-03 | Inari Medical | Devices and methods for treating vascular occlusion |
US10537436B2 (en) | 2016-11-01 | 2020-01-21 | DePuy Synthes Products, Inc. | Curved expandable cage |
IL295266A (en) | 2016-11-01 | 2022-10-01 | White Swell Medical Ltd | Systems and methods for treatment of fluid overload |
US10905492B2 (en) | 2016-11-17 | 2021-02-02 | Angiodynamics, Inc. | Techniques for irreversible electroporation using a single-pole tine-style internal device communicating with an external surface electrode |
US10888433B2 (en) | 2016-12-14 | 2021-01-12 | DePuy Synthes Products, Inc. | Intervertebral implant inserter and related methods |
US20180168625A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments with smart staple cartridges |
US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
US11419606B2 (en) | 2016-12-21 | 2022-08-23 | Cilag Gmbh International | Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems |
US10537324B2 (en) | 2016-12-21 | 2020-01-21 | Ethicon Llc | Stepped staple cartridge with asymmetrical staples |
US20180168615A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument |
US10524789B2 (en) | 2016-12-21 | 2020-01-07 | Ethicon Llc | Laterally actuatable articulation lock arrangements for locking an end effector of a surgical instrument in an articulated configuration |
JP6983893B2 (en) | 2016-12-21 | 2021-12-17 | エシコン エルエルシーEthicon LLC | Lockout configuration for surgical end effectors and replaceable tool assemblies |
US10588630B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical tool assemblies with closure stroke reduction features |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
US10682138B2 (en) | 2016-12-21 | 2020-06-16 | Ethicon Llc | Bilaterally asymmetric staple forming pocket pairs |
US10448950B2 (en) | 2016-12-21 | 2019-10-22 | Ethicon Llc | Surgical staplers with independently actuatable closing and firing systems |
JP7010956B2 (en) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | How to staple tissue |
US10588632B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical end effectors and firing members thereof |
US10835245B2 (en) | 2016-12-21 | 2020-11-17 | Ethicon Llc | Method for attaching a shaft assembly to a surgical instrument and, alternatively, to a surgical robot |
US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
US10856868B2 (en) | 2016-12-21 | 2020-12-08 | Ethicon Llc | Firing member pin configurations |
JP2020501779A (en) | 2016-12-21 | 2020-01-23 | エシコン エルエルシーEthicon LLC | Surgical stapling system |
US10695055B2 (en) | 2016-12-21 | 2020-06-30 | Ethicon Llc | Firing assembly comprising a lockout |
US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
US10675026B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Methods of stapling tissue |
US10881401B2 (en) | 2016-12-21 | 2021-01-05 | Ethicon Llc | Staple firing member comprising a missing cartridge and/or spent cartridge lockout |
US10893864B2 (en) | 2016-12-21 | 2021-01-19 | Ethicon | Staple cartridges and arrangements of staples and staple cavities therein |
EP4209196A1 (en) | 2017-01-23 | 2023-07-12 | Cephea Valve Technologies, Inc. | Replacement mitral valves |
JP7046078B2 (en) | 2017-01-23 | 2022-04-01 | セフィア・バルブ・テクノロジーズ,インコーポレイテッド | Replacement mitral valve |
WO2018138658A1 (en) | 2017-01-27 | 2018-08-02 | Jenavalve Technology, Inc. | Heart valve mimicry |
EP3589217B1 (en) | 2017-03-02 | 2023-06-28 | White Swell Medical Ltd | Systems and methods for reducing pressure at outflow of a duct |
EP3600178A4 (en) | 2017-03-19 | 2020-12-02 | White Swell Medical Ltd | Methods and devices for reducing pressure |
US10898330B2 (en) | 2017-03-28 | 2021-01-26 | Edwards Lifesciences Corporation | Positioning, deploying, and retrieving implantable devices |
US10398563B2 (en) | 2017-05-08 | 2019-09-03 | Medos International Sarl | Expandable cage |
EP3634311A1 (en) | 2017-06-08 | 2020-04-15 | Boston Scientific Scimed, Inc. | Heart valve implant commissure support structure |
US11344424B2 (en) | 2017-06-14 | 2022-05-31 | Medos International Sarl | Expandable intervertebral implant and related methods |
US10307170B2 (en) | 2017-06-20 | 2019-06-04 | Ethicon Llc | Method for closed loop control of motor velocity of a surgical stapling and cutting instrument |
US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
US10390841B2 (en) | 2017-06-20 | 2019-08-27 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
US10327767B2 (en) | 2017-06-20 | 2019-06-25 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
US10779820B2 (en) | 2017-06-20 | 2020-09-22 | Ethicon Llc | Systems and methods for controlling motor speed according to user input for a surgical instrument |
US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
US11517325B2 (en) | 2017-06-20 | 2022-12-06 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval |
US10813639B2 (en) | 2017-06-20 | 2020-10-27 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions |
US11071554B2 (en) | 2017-06-20 | 2021-07-27 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
US11090046B2 (en) | 2017-06-20 | 2021-08-17 | Cilag Gmbh International | Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument |
US10888321B2 (en) | 2017-06-20 | 2021-01-12 | Ethicon Llc | Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument |
US10980537B2 (en) | 2017-06-20 | 2021-04-20 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
US11382638B2 (en) | 2017-06-20 | 2022-07-12 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
US10631859B2 (en) | 2017-06-27 | 2020-04-28 | Ethicon Llc | Articulation systems for surgical instruments |
US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
US11259805B2 (en) | 2017-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical instrument comprising firing member supports |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
USD869655S1 (en) | 2017-06-28 | 2019-12-10 | Ethicon Llc | Surgical fastener cartridge |
US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
US10786253B2 (en) | 2017-06-28 | 2020-09-29 | Ethicon Llc | Surgical end effectors with improved jaw aperture arrangements |
US11000279B2 (en) | 2017-06-28 | 2021-05-11 | Ethicon Llc | Surgical instrument comprising an articulation system ratio |
EP4070740A1 (en) | 2017-06-28 | 2022-10-12 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
US10398434B2 (en) | 2017-06-29 | 2019-09-03 | Ethicon Llc | Closed loop velocity control of closure member for robotic surgical instrument |
US10258418B2 (en) | 2017-06-29 | 2019-04-16 | Ethicon Llc | System for controlling articulation forces |
US10898183B2 (en) | 2017-06-29 | 2021-01-26 | Ethicon Llc | Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing |
US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
US10940016B2 (en) | 2017-07-05 | 2021-03-09 | Medos International Sarl | Expandable intervertebral fusion cage |
CN111163729B (en) | 2017-08-01 | 2022-03-29 | 波士顿科学国际有限公司 | Medical implant locking mechanism |
US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
US11944300B2 (en) | 2017-08-03 | 2024-04-02 | Cilag Gmbh International | Method for operating a surgical system bailout |
US10939996B2 (en) | 2017-08-16 | 2021-03-09 | Boston Scientific Scimed, Inc. | Replacement heart valve commissure assembly |
WO2019050765A1 (en) | 2017-09-06 | 2019-03-14 | Inari Medical, Inc. | Hemostasis valves and methods of use |
US10796471B2 (en) | 2017-09-29 | 2020-10-06 | Ethicon Llc | Systems and methods of displaying a knife position for a surgical instrument |
US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US10765429B2 (en) | 2017-09-29 | 2020-09-08 | Ethicon Llc | Systems and methods for providing alerts according to the operational state of a surgical instrument |
US10172634B1 (en) | 2017-10-16 | 2019-01-08 | Michael Bruce Horowitz | Catheter based retrieval device with proximal body having axial freedom of movement |
AU2021362245A1 (en) | 2017-10-16 | 2023-05-25 | Retriever Medical, Inc. | Clot removal methods and devices with multiple independently controllable elements |
US20220104839A1 (en) | 2017-10-16 | 2022-04-07 | Retriever Medical, Inc. | Clot Removal Methods and Devices with Multiple Independently Controllable Elements |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
EP3716907B1 (en) | 2017-12-01 | 2023-06-07 | C. R. Bard, Inc. | Adjustable vascular graft for custom inner diameter reduction and related methods |
WO2019113043A1 (en) | 2017-12-05 | 2019-06-13 | Pedersen Wesley Robert | Transseptal guide wire puncture system |
US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
US10828033B2 (en) | 2017-12-15 | 2020-11-10 | Ethicon Llc | Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
US11006955B2 (en) | 2017-12-15 | 2021-05-18 | Ethicon Llc | End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments |
US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
US11197670B2 (en) | 2017-12-15 | 2021-12-14 | Cilag Gmbh International | Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed |
US10966718B2 (en) | 2017-12-15 | 2021-04-06 | Ethicon Llc | Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments |
US10779825B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
US10835330B2 (en) | 2017-12-19 | 2020-11-17 | Ethicon Llc | Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly |
US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
US11076853B2 (en) | 2017-12-21 | 2021-08-03 | Cilag Gmbh International | Systems and methods of displaying a knife position during transection for a surgical instrument |
US10682134B2 (en) | 2017-12-21 | 2020-06-16 | Ethicon Llc | Continuous use self-propelled stapling instrument |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
JP7047106B2 (en) | 2018-01-19 | 2022-04-04 | ボストン サイエンティフィック サイムド,インコーポレイテッド | Medical device delivery system with feedback loop |
EP3740160A2 (en) | 2018-01-19 | 2020-11-25 | Boston Scientific Scimed Inc. | Inductance mode deployment sensors for transcatheter valve system |
US11154314B2 (en) | 2018-01-26 | 2021-10-26 | Inari Medical, Inc. | Single insertion delivery system for treating embolism and associated systems and methods |
EP3749252A1 (en) | 2018-02-07 | 2020-12-16 | Boston Scientific Scimed, Inc. | Medical device delivery system with alignment feature |
US11439732B2 (en) | 2018-02-26 | 2022-09-13 | Boston Scientific Scimed, Inc. | Embedded radiopaque marker in adaptive seal |
CN112399836A (en) | 2018-05-15 | 2021-02-23 | 波士顿科学国际有限公司 | Replacement heart valve commissure assemblies |
CN112437649A (en) | 2018-05-23 | 2021-03-02 | 索林集团意大利有限责任公司 | Heart valve prosthesis |
CN112638317A (en) | 2018-05-30 | 2021-04-09 | 艾露姆技术股份有限公司 | Integrated thrombectomy and filtration device and method of use |
WO2019241477A1 (en) | 2018-06-13 | 2019-12-19 | Boston Scientific Scimed, Inc. | Replacement heart valve delivery device |
WO2020018319A1 (en) | 2018-07-20 | 2020-01-23 | eLum Technologies, Inc. | Neurovascular distal access support catheters, aspiration catheters, or device shafts |
EP3836855A4 (en) | 2018-08-13 | 2022-08-10 | Inari Medical, Inc. | System for treating embolism and associated devices and methods |
US11083458B2 (en) | 2018-08-20 | 2021-08-10 | Cilag Gmbh International | Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions |
USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
US10842492B2 (en) | 2018-08-20 | 2020-11-24 | Ethicon Llc | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
US11446156B2 (en) | 2018-10-25 | 2022-09-20 | Medos International Sarl | Expandable intervertebral implant, inserter instrument, and related methods |
US11241312B2 (en) | 2018-12-10 | 2022-02-08 | Boston Scientific Scimed, Inc. | Medical device delivery system including a resistance member |
US11793996B2 (en) | 2019-02-26 | 2023-10-24 | White Swell Medical Ltd | Devices and methods for treating edema |
US11660426B2 (en) | 2019-02-26 | 2023-05-30 | White Swell Medical Ltd | Devices and methods for treating edema |
US11724095B2 (en) | 2019-02-26 | 2023-08-15 | White Swell Medical Ltd | Devices and methods for treating edema |
US11717652B2 (en) | 2019-02-26 | 2023-08-08 | White Swell Medical Ltd | Devices and methods for treating edema |
US11931560B2 (en) | 2019-02-26 | 2024-03-19 | White Swell Medical Ltd | Devices and methods for treating edema |
US11317921B2 (en) | 2019-03-15 | 2022-05-03 | Sequent Medical, Inc. | Filamentary devices for treatment of vascular defects |
EP3908209A4 (en) | 2019-03-15 | 2022-10-19 | Sequent Medical, Inc. | Filamentary devices for treatment of vascular defects |
US11291453B2 (en) | 2019-03-15 | 2022-04-05 | Sequent Medical, Inc. | Filamentary devices having a flexible joint for treatment of vascular defects |
US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11147551B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11172929B2 (en) | 2019-03-25 | 2021-11-16 | Cilag Gmbh International | Articulation drive arrangements for surgical systems |
US11432816B2 (en) | 2019-04-30 | 2022-09-06 | Cilag Gmbh International | Articulation pin for a surgical instrument |
US11452528B2 (en) | 2019-04-30 | 2022-09-27 | Cilag Gmbh International | Articulation actuators for a surgical instrument |
US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
US11426251B2 (en) | 2019-04-30 | 2022-08-30 | Cilag Gmbh International | Articulation directional lights on a surgical instrument |
US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
US11439504B2 (en) | 2019-05-10 | 2022-09-13 | Boston Scientific Scimed, Inc. | Replacement heart valve with improved cusp washout and reduced loading |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
US11229437B2 (en) | 2019-06-28 | 2022-01-25 | Cilag Gmbh International | Method for authenticating the compatibility of a staple cartridge with a surgical instrument |
US11864779B2 (en) | 2019-10-16 | 2024-01-09 | Inari Medical, Inc. | Systems, devices, and methods for treating vascular occlusions |
US11759190B2 (en) | 2019-10-18 | 2023-09-19 | Boston Scientific Medical Device Limited | Lock for medical devices, and related systems and methods |
CN115175638A (en) | 2019-11-05 | 2022-10-11 | 瓦斯科尔勒治疗股份有限公司 | Axially elongated thrombus capture system, tensioning system, and expandable funnel catheter |
US11801087B2 (en) | 2019-11-13 | 2023-10-31 | Boston Scientific Medical Device Limited | Apparatus and methods for puncturing tissue |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11724070B2 (en) | 2019-12-19 | 2023-08-15 | Boston Scientific Medical Device Limited | Methods for determining a position of a first medical device with respect to a second medical device, and related systems and medical devices |
US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
US11576672B2 (en) | 2019-12-19 | 2023-02-14 | Cilag Gmbh International | Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw |
US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
US11931098B2 (en) | 2020-02-19 | 2024-03-19 | Boston Scientific Medical Device Limited | System and method for carrying out a medical procedure |
US11426286B2 (en) | 2020-03-06 | 2022-08-30 | Eit Emerging Implant Technologies Gmbh | Expandable intervertebral implant |
US11819243B2 (en) | 2020-03-19 | 2023-11-21 | Boston Scientific Medical Device Limited | Medical sheath and related systems and methods |
US11826075B2 (en) | 2020-04-07 | 2023-11-28 | Boston Scientific Medical Device Limited | Elongated medical assembly |
USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
JP2023534895A (en) * | 2020-06-05 | 2023-08-15 | イナリ メディカル, インコーポレイテッド | Recapturable funnel catheter and related systems and methods |
CA3173427C (en) | 2020-06-17 | 2024-01-02 | Boston Scientific Medical Device Limited | Electroanatomical mapping system |
US11938285B2 (en) | 2020-06-17 | 2024-03-26 | Boston Scientific Medical Device Limited | Stop-movement device for elongated medical assembly |
US11937796B2 (en) | 2020-06-18 | 2024-03-26 | Boston Scientific Medical Device Limited | Tissue-spreader assembly |
US11864756B2 (en) | 2020-07-28 | 2024-01-09 | Cilag Gmbh International | Surgical instruments with flexible ball chain drive arrangements |
US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
US11617577B2 (en) | 2020-10-29 | 2023-04-04 | Cilag Gmbh International | Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable |
US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
US11653915B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Surgical instruments with sled location detection and adjustment features |
US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
US11944296B2 (en) | 2020-12-02 | 2024-04-02 | Cilag Gmbh International | Powered surgical instruments with external connectors |
US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
US11737751B2 (en) | 2020-12-02 | 2023-08-29 | Cilag Gmbh International | Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings |
US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11950779B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Method of powering and communicating with a staple cartridge |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
US11950777B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Staple cartridge comprising an information access control system |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11944336B2 (en) | 2021-03-24 | 2024-04-02 | Cilag Gmbh International | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11850160B2 (en) | 2021-03-26 | 2023-12-26 | Medos International Sarl | Expandable lordotic intervertebral fusion cage |
US11752009B2 (en) | 2021-04-06 | 2023-09-12 | Medos International Sarl | Expandable intervertebral fusion cage |
US20220378424A1 (en) | 2021-05-28 | 2022-12-01 | Cilag Gmbh International | Stapling instrument comprising a firing lockout |
US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
WO2023150752A1 (en) * | 2022-02-04 | 2023-08-10 | The General Hospital Corporation | Percutaneous device |
WO2023183476A1 (en) * | 2022-03-23 | 2023-09-28 | Silk Road Medical, Inc. | Aspiration system including preformed non-linear dilator for aspiration of emboli |
WO2024018460A1 (en) * | 2022-07-19 | 2024-01-25 | EndoWays LTD. | Guidewire and microcatheter |
Family Cites Families (77)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3996938A (en) | 1975-07-10 | 1976-12-14 | Clark Iii William T | Expanding mesh catheter |
DE2821048C2 (en) | 1978-05-13 | 1980-07-17 | Willy Ruesch Gmbh & Co Kg, 7053 Kernen | Medical instrument |
US4425908A (en) | 1981-10-22 | 1984-01-17 | Beth Israel Hospital | Blood clot filter |
DE3235974A1 (en) * | 1981-11-24 | 1983-06-01 | Volkmar Dipl.-Ing. Merkel (FH), 8520 Erlangen | DEVICE FOR REMOVAL OR FOR THE EXPANSION OF CONSTRAINTS IN BODY LIQUID LEADING VESSELS |
US4445892A (en) * | 1982-05-06 | 1984-05-01 | Laserscope, Inc. | Dual balloon catheter device |
US5197977A (en) * | 1984-01-30 | 1993-03-30 | Meadox Medicals, Inc. | Drug delivery collagen-impregnated synthetic vascular graft |
US4611594A (en) | 1984-04-11 | 1986-09-16 | Northwestern University | Medical instrument for containment and removal of calculi |
US4650466A (en) | 1985-11-01 | 1987-03-17 | Angiobrade Partners | Angioplasty device |
US4794928A (en) | 1987-06-10 | 1989-01-03 | Kletschka Harold D | Angioplasty device and method of using the same |
US4921478A (en) | 1988-02-23 | 1990-05-01 | C. R. Bard, Inc. | Cerebral balloon angioplasty system |
US5328471A (en) * | 1990-02-26 | 1994-07-12 | Endoluminal Therapeutics, Inc. | Method and apparatus for treatment of focal disease in hollow tubular organs and other tissue lumens |
US5011488A (en) | 1988-12-07 | 1991-04-30 | Robert Ginsburg | Thrombus extraction system |
DE3913935A1 (en) | 1989-04-27 | 1990-10-31 | Wiedeck Joerg Guenter Dr Med | Catheter for removing stones from the ureter - consists of plastics tube with retractable mandrel |
DE8910603U1 (en) | 1989-09-06 | 1989-12-07 | Guenther, Rolf W., Prof. Dr. | |
US5100425A (en) * | 1989-09-14 | 1992-03-31 | Medintec R&D Limited Partnership | Expandable transluminal atherectomy catheter system and method for the treatment of arterial stenoses |
US5888335A (en) * | 1989-10-26 | 1999-03-30 | Minnesota Mining And Manufacturing Company | Multiple releasable contact responsive fasteners |
US5030201A (en) | 1989-11-24 | 1991-07-09 | Aubrey Palestrant | Expandable atherectomy catheter device |
US5059166A (en) | 1989-12-11 | 1991-10-22 | Medical Innovative Technologies R & D Limited Partnership | Intra-arterial stent with the capability to inhibit intimal hyperplasia |
US5545208A (en) * | 1990-02-28 | 1996-08-13 | Medtronic, Inc. | Intralumenal drug eluting prosthesis |
US5135484A (en) * | 1990-05-09 | 1992-08-04 | Pioneering Technologies, Inc. | Method of removing plaque from vessels |
JPH05509008A (en) | 1990-05-18 | 1993-12-16 | スタック、リチャード・エス | bioabsorbable stent |
US5222971A (en) * | 1990-10-09 | 1993-06-29 | Scimed Life Systems, Inc. | Temporary stent and methods for use and manufacture |
JP2751617B2 (en) * | 1990-10-24 | 1998-05-18 | ヤマハ株式会社 | Music synthesizer |
US5183464A (en) | 1991-05-17 | 1993-02-02 | Interventional Thermodynamics, Inc. | Radially expandable dilator |
US5318531A (en) * | 1991-06-11 | 1994-06-07 | Cordis Corporation | Infusion balloon catheter |
US5192297A (en) * | 1991-12-31 | 1993-03-09 | Medtronic, Inc. | Apparatus and method for placement and implantation of a stent |
US5599352A (en) * | 1992-03-19 | 1997-02-04 | Medtronic, Inc. | Method of making a drug eluting stent |
US5380273A (en) * | 1992-05-19 | 1995-01-10 | Dubrul; Will R. | Vibrating catheter |
US5250060A (en) * | 1992-06-26 | 1993-10-05 | Carbo Paul L | Angioplasty apparatus |
CA2137566A1 (en) | 1992-06-26 | 1994-01-06 | Joseph E. Laptewicz | Catheter with expandable wire mesh tip |
US5507724A (en) * | 1992-07-01 | 1996-04-16 | Genetronics, Inc. | Electroporation and iontophoresis apparatus and method for insertion of drugs and genes into cells |
EP0611311A1 (en) | 1992-08-28 | 1994-08-24 | Cortrak Medical, Inc. | Polymer matrix drug delivery apparatus and method |
US5562725A (en) | 1992-09-14 | 1996-10-08 | Meadox Medicals Inc. | Radially self-expanding implantable intraluminal device |
US5382259A (en) | 1992-10-26 | 1995-01-17 | Target Therapeutics, Inc. | Vasoocclusion coil with attached tubular woven or braided fibrous covering |
US5807306A (en) * | 1992-11-09 | 1998-09-15 | Cortrak Medical, Inc. | Polymer matrix drug delivery apparatus |
US5792157A (en) | 1992-11-13 | 1998-08-11 | Scimed Life Systems, Inc. | Expandable intravascular occlusion material removal devices and methods of use |
US5431676A (en) * | 1993-03-05 | 1995-07-11 | Innerdyne Medical, Inc. | Trocar system having expandable port |
US5897567A (en) | 1993-04-29 | 1999-04-27 | Scimed Life Systems, Inc. | Expandable intravascular occlusion material removal devices and methods of use |
US5342306A (en) * | 1993-05-26 | 1994-08-30 | Don Michael T Anthony | Adjustable catheter device |
US5419774A (en) * | 1993-07-13 | 1995-05-30 | Scimed Life Systems, Inc. | Thrombus extraction device |
US5380284A (en) * | 1993-08-13 | 1995-01-10 | Don Michael; T. Anthony | Obstruction dissolution catheter with variably expanding blocking balloons and method of use |
US5370660A (en) | 1993-11-01 | 1994-12-06 | Cordis Corporation | Apparatus and method for delivering a vessel plug into the body of a patient |
US5454790A (en) | 1994-05-09 | 1995-10-03 | Innerdyne, Inc. | Method and apparatus for catheterization access |
US5810767A (en) * | 1994-05-11 | 1998-09-22 | Localmed, Inc. | Method and apparatus for pressurized intraluminal drug delivery |
ES2340142T3 (en) | 1994-07-08 | 2010-05-31 | Ev3 Inc. | SYSTEM TO CARRY OUT AN INTRAVASCULAR PROCEDURE. |
US5643282A (en) | 1994-08-22 | 1997-07-01 | Kieturakis; Maciej J. | Surgical instrument and method for removing tissue from an endoscopic workspace |
US5891108A (en) * | 1994-09-12 | 1999-04-06 | Cordis Corporation | Drug delivery stent |
US5709704A (en) * | 1994-11-30 | 1998-01-20 | Boston Scientific Corporation | Blood clot filtering |
US5833650A (en) * | 1995-06-05 | 1998-11-10 | Percusurge, Inc. | Catheter apparatus and method for treating occluded vessels |
US5591199A (en) * | 1995-06-07 | 1997-01-07 | Porter; Christopher H. | Curable fiber composite stent and delivery system |
US5766203A (en) | 1995-07-20 | 1998-06-16 | Intelliwire, Inc. | Sheath with expandable distal extremity and balloon catheters and stents for use therewith and method |
US5749883A (en) | 1995-08-30 | 1998-05-12 | Halpern; David Marcos | Medical instrument |
US5653689A (en) * | 1995-09-30 | 1997-08-05 | Abacus Design & Development, Inc. | Infusion catheter |
US5843022A (en) * | 1995-10-25 | 1998-12-01 | Scimied Life Systems, Inc. | Intravascular device utilizing fluid to extract occlusive material |
US5769871A (en) | 1995-11-17 | 1998-06-23 | Louisville Laboratories, Inc. | Embolectomy catheter |
FR2743402B1 (en) | 1996-01-10 | 1998-01-30 | Gremco Sa | BRAIDED SHEATH SLEEVE FOR THREADING ON AT LEAST ONE ELONGATE MEMBER TO BE PROTECTED, AND METHOD FOR MANUFACTURING SUCH A SLEEVE |
US5791157A (en) * | 1996-01-16 | 1998-08-11 | Ebara Corporation | Heat pump device and desiccant assisted air conditioning system |
WO1997042879A1 (en) | 1996-05-14 | 1997-11-20 | Embol-X, Inc. | Aortic occluder with associated filter and methods of use during cardiac surgery |
US5749890A (en) * | 1996-12-03 | 1998-05-12 | Shaknovich; Alexander | Method and system for stent placement in ostial lesions |
US5882329A (en) * | 1997-02-12 | 1999-03-16 | Prolifix Medical, Inc. | Apparatus and method for removing stenotic material from stents |
US5814064A (en) | 1997-03-06 | 1998-09-29 | Scimed Life Systems, Inc. | Distal protection device |
US5827324A (en) | 1997-03-06 | 1998-10-27 | Scimed Life Systems, Inc. | Distal protection device |
US5851210A (en) * | 1997-03-21 | 1998-12-22 | Torossian; Richard | Stent delivery system and method |
US6258115B1 (en) * | 1997-04-23 | 2001-07-10 | Artemis Medical, Inc. | Bifurcated stent and distal protection system |
US5868708A (en) | 1997-05-07 | 1999-02-09 | Applied Medical Resources Corporation | Balloon catheter apparatus and method |
US5911734A (en) | 1997-05-08 | 1999-06-15 | Embol-X, Inc. | Percutaneous catheter and guidewire having filter and medical device deployment capabilities |
US5928260A (en) | 1997-07-10 | 1999-07-27 | Scimed Life Systems, Inc. | Removable occlusion system for aneurysm neck |
US6361545B1 (en) | 1997-09-26 | 2002-03-26 | Cardeon Corporation | Perfusion filter catheter |
EP0917886B1 (en) * | 1997-10-23 | 2003-10-01 | Schneider (Europe) GmbH | Seal for catheter assembly with dilation and occlusion balloon |
US6461370B1 (en) | 1998-11-03 | 2002-10-08 | C. R. Bard, Inc. | Temporary vascular filter guide wire |
EP1030603B1 (en) | 1997-11-12 | 2008-08-13 | Genesis Technologies LLC. | Biological passageway occlusion removal |
US6635068B1 (en) | 1998-02-10 | 2003-10-21 | Artemis Medical, Inc. | Occlusion, anchoring, tensioning and flow direction apparatus and methods for use |
US5925060A (en) * | 1998-03-13 | 1999-07-20 | B. Braun Celsa | Covered self-expanding vascular occlusion device |
US6219577B1 (en) * | 1998-04-14 | 2001-04-17 | Global Vascular Concepts, Inc. | Iontophoresis, electroporation and combination catheters for local drug delivery to arteries and other body tissues |
US6450989B2 (en) * | 1998-04-27 | 2002-09-17 | Artemis Medical, Inc. | Dilating and support apparatus with disease inhibitors and methods for use |
US6635065B2 (en) * | 2000-11-16 | 2003-10-21 | Vascular Control Systems, Inc. | Doppler directed suture ligation device and method |
US7771443B2 (en) * | 2005-05-20 | 2010-08-10 | Ams Research Corporation | Anastomosis device approximating structure configurations |
-
1999
- 1999-04-23 US US09/298,279 patent/US6450989B2/en not_active Expired - Lifetime
-
2001
- 2001-02-12 US US09/781,721 patent/US7011654B2/en not_active Expired - Lifetime
-
2002
- 2002-01-17 US US10/051,848 patent/US20020161392A1/en not_active Abandoned
-
2004
- 2004-06-14 US US10/866,980 patent/US7524319B2/en not_active Expired - Lifetime
-
2005
- 2005-01-14 US US11/035,581 patent/US7232432B2/en not_active Expired - Fee Related
-
2007
- 2007-07-11 US US11/776,257 patent/US20080015628A1/en not_active Abandoned
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US8177832B2 (en) | 2002-07-22 | 2012-05-15 | W. L. Gore & Associates, Inc. | Endoluminal expansion system |
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US8790385B2 (en) * | 2003-05-09 | 2014-07-29 | C. R. Bard, Inc. | Strain management in stent delivery system |
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US8323242B2 (en) * | 2003-12-03 | 2012-12-04 | C.R. Bard, Inc. | Non-compliant medical balloon having a longitudinal fiber layer |
US8252016B2 (en) | 2005-01-13 | 2012-08-28 | Azam Anwar | System and method for providing embolic protection |
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US8177706B2 (en) | 2006-07-10 | 2012-05-15 | Mcneil-Ppc, Inc. | Method of treating urinary incontinence |
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US8047980B2 (en) | 2006-07-10 | 2011-11-01 | Mcneil-Ppc, Inc. | Method of treating urinary incontinence |
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US8753258B2 (en) | 2006-07-10 | 2014-06-17 | Mcneil-Ppc, Inc. | Resilient device |
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Also Published As
Publication number | Publication date |
---|---|
US20020161392A1 (en) | 2002-10-31 |
US20080015628A1 (en) | 2008-01-17 |
US20010027307A1 (en) | 2001-10-04 |
US20050124931A1 (en) | 2005-06-09 |
US7524319B2 (en) | 2009-04-28 |
US7011654B2 (en) | 2006-03-14 |
US6450989B2 (en) | 2002-09-17 |
US7232432B2 (en) | 2007-06-19 |
US20040236369A1 (en) | 2004-11-25 |
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