LIGATION CLIP

A surgical ligation clip and method of operation are described and include a top jaw member and bottom jaw member joined at a hinge section for movement about the hinge section. The hinge section can be offset or space laterally from one or both of the jaw members. Teeth arrangements and distributions are also described, as well as closing and jaw ends engagement configurations, for example for more easily engaging/piercing connective or other tissue. 1. A surgical clip comprising:first and second jaw members having proximal portions and distal portions, the first and second jaw members extending generally longitudinally and movably coupled to each other by a hinge portion at the proximal portions;a tip member on the distal portion of the first jaw member; anda hook member on the distal portion of the second jaw member, the hook member being configured to deflect around the tip member to secure the surgical clip in a closed configuration,wherein the first jaw member includes an inner convex segment extending between the tip member and the hinge portion, the second jaw member includes an inner concave segment extending between the hook member and the hinge portion, the inner concave segment is configured to receive the inner convex segment in the closed configuration, and the first jaw member includes an outer convex surface.2. The surgical clip of claim 1 , wherein the outer convex surface extends at least a quarter of a length of the first jaw member.3. The surgical clip of claim 2 , wherein the outer convex surface extends at least half of the length of the first jaw member.4. The surgical clip of claim 1 , wherein the first jaw member further includes an outer concave surface.5. The surgical clip of claim 1 , wherein the second jaw member includes an outer convex surface.6. The surgical clip of claim 1 , further comprising at least one tooth positioned on the inner convex segment.7. The surgical clip of claim 6 , wherein the at least one tooth includes a ...

Laparoscopic fascial closure system

A tissue closure device to assist in retrieving a suture during a suturing procedure, the device including an elongated body having a proximal end, a distal end, and a lumen extending axially through the elongated body. The device further including an actuator rod at least partially extending through the lumen of the elongated body to actuate a plurality of wings and a plurality of shields attached to a distal end of the elongated body. The elongated body including at least one needle guide lumen with an opening an exit, the at least one needle guide lumen traversing the elongated body at an angle with respect to a central axis of the elongated body to guide a suture grasper to an enclosed suture retrieval cavity.

Apparatus and methods for facilitating access through a puncture including sealing compound therein

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

Modified fixed flat wire bifurcated catheter and its application in lower extremity interventions

A bifurcated catheter and methods of use are disclosed herein. The bifurcated catheter can include a fixed flat wire that is configurable as a stabilization wire. The bifurcated catheter can be configured to improve the initial access and directability by application of a pull force to the stabilization wire, in addition to a push force from the proximal end of the bifurcated catheter. The stabilization wire is anchored once the bifurcated catheter is positioned. The anchored, bifurcated catheter provides stability and pushability to assist the procedural catheter in traversing the tortuous peripheral vasculature.

Apparatus and methods for tissue closure

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Implant deployment apparatus

A delivery system including a restraining member maintains a collapsed implant in its collapsed state for delivery through a small passageway to a desired site in a mammalian body. Once the implant is positioned at the desired site, the restraining member is released so that the stent may expand or be expanded to its expanded state. In a preferred embodiment, the restraining member comprises a sheet of material that surrounds at least a portion of the collapsed stent. Portions of the restraining member are releasably coupled to one another with a low profile thread-like member or suture.

Auto-injector apparatus and methods for sealing a vascular puncture

Apparatus for sealing a puncture communicating with a blood vessel includes a pair of syringe barrels having sealing components therein, and a plunger assembly biased to slide within the barrels from proximal to distal positions for injecting the components through outlets of the barrels. An auto-injector assembly is coupled to the plunger apparatus, and includes a spring mechanism locked in an inactive condition and an actuator activatable to release the spring mechanism, whereupon the spring mechanism automatically advances the plunger assembly towards the distal position to inject the components from the barrels. A valve coupled to the outlets and movable from a first position for mixing and/or reconstituting the sealing components from vials, a second position where the outlets communicate with a delivery line for delivering the sealing components into a puncture, and a third position for closing the outlets.

CROP RESIDUE AND SOIL CONDITIONING AGRICULTURAL IMPLEMENT

A disc harrow composed of one or more disc gangs has a subframe coupled to the disc gangs to move the disc gangs in response to variations in farmland terrain to limit the impact of obstructions when encountered during the harrowing process. When the obstruction is cleared, the subframe automatically returns the disc gangs to their pre-obstruction position. In addition to reducing the potentially-damaging impact of obstructions, the subframe also maintains a more consistent reel depth during undulations or changes in the farmland terrain, such as during harrowing of slopes or unleveled fields such as valleys, near waterways, and along fence rows.

Modified fixed flat wire bifurcated catheter and its application in lower extremity interventions

A bifurcated catheter and methods of use are disclosed herein. The bifurcated catheter can include a fixed flat wire that is configurable as a stabilization wire. The bifurcated catheter can be configured to improve the initial access and directability by application of a pull force to the stabilization wire, in addition to a push force from the proximal end of the bifurcated catheter. The stabilization wire is anchored once the bifurcated catheter is positioned. The anchored, bifurcated catheter provides stability and pushability to assist the procedural catheter in traversing the tortuous peripheral vasculature.

NOISE MITIGATION HOOD

Systems and apparatuses include a hood for a machine including a noise inhibitor housing inhibiting transmission of noise in a horizontal plane from the machine, and a noise diffusive panel supported by the noise inhibitor housing and structured to release noise upward.

LIGATION CLIP

A surgical ligation clip and method of operation are described and include a top jaw member and bottom jaw member joined at a hinge section for movement about the hinge section. The hinge section can be offset or space laterally from one or both of the jaw members. Teeth arrangements and distributions are also described, as well as closing and jaw ends engagement configurations, for example for more easily engaging/piercing connective or other tissue. 1. A ligation clip comprising:first and second jaws having proximal portions extending generally longitudinally and movably coupled to each other by a flexible portion at the proximal portions; andwherein the flexible portion includes a first angularly-extending element having first and second end points on different sides of an intermediate point and extending angularly from the first jaw and wherein the flexible portion is flexible between endpoints of the angularly-extending element and configured to allow the first and second jaws to move relative to each other as a result of flexibility at the intermediate point.2. The clip of wherein at least one of the jaws includes a tooth extending at an angle to a surface on which the tooth is supported.3. The clip of wherein the at least one of the jaws includes teeth extending at angles to their respective support surfaces different relative to each other.4. The clip of wherein at least one of the jaws includes a plurality of teeth claim 1 , wherein a first density of teeth on one portion of the jaw is greater than or equal to zero and a second density of teeth on another portion of the jaw is greater than the first density of teeth.5. The clip of wherein the first and second jaws include teeth claim 1 , and wherein the first jaw has a density of teeth different than a density of teeth on the second jaw.6. The clip of wherein one of the first and second jaws is an upper jaw and wherein the upper jaw includes a proximal portion and a distal portion and wherein the proximal ...

OCCLUSION MEMBER AND TENSIONER APPARATUS AND METHODS OF THEIR USE FOR SEALING A VASCULAR PUNCTURE

Apparatus for sealing a puncture includes an elongate occlusion member having a balloon attached to distal ends of telescoping inner and outer members. A housing on the proximal end of the outer member includes a piston coupled to the inner member and slidable within a chamber communicating with a fluid reservoir. A switch on the housing is actuated to direct fluid from the reservoir through the outer member into the balloon to expand the balloon and into the chamber to move the piston and pull the inner member, shortening the balloon as it expands. During use, the distal end of the occlusion member is introduced into a puncture communicating with a vessel until the collapsed balloon is disposed within the vessel. The balloon is expanded, and a tensioner is connected to the housing to apply a proximal force holding the balloon against the vessel wall to seal the puncture.

Ligation clip

A surgical ligation clip and method of operation are described and include a top jaw member and bottom jaw member joined at a hinge section for movement about the hinge section. The hinge section can be offset or space laterally from one or both of the jaw members. Teeth arrangements and distributions are also described, as well as closing and jaw ends engagement configurations, for example for more easily engaging/piercing connective or other tissue.

Apparatus and methods for delivering sealing materials during a percutaneous procedure to facilitate hemostasis

An apparatus for sealing a puncture extending through tissue to a blood vessel includes a guidewire including an expandable tamp, a retaining sheath for covering the tamp, and a delivery sheath including a primary lumen for receiving the guidewire therethrough and a secondary lumen for delivering sealing compound into the puncture. The guidewire is advanced into the puncture with the tamp in a contracted condition, the tamp is expanded within the vessel after retracting the retaining sheath, and the guidewire is retracted to seal the puncture from the vessel. The delivery sheath is advanced over the guidewire, and sealing compound is introduced into the puncture through the delivery sheath. After introducing the sealing compound, the delivery sheath is removed, and an introducer sheath is advanced over the guidewire to provide access to perform a medical procedure via the vessel after removing the guidewire.

Methods and apparatus for treating vascular occlusions

An intravascular catheter system for the treatment of occluded blood vessels that includes tissue displacement or hinged expansion members that are movable from a closed to an open position. An actuating assembly may be provided for moving the tissue expansion members between an open and closed position to exert a substantially lateral distal end force upon the region surrounding an occluded blood vessel. The tissue expansion members may stretch apart, tear or otherwise disrupt a vascular occlusion sufficiently to create a pathway that may support the passage or placement of a guidewire or an interventional vascular device across the occlusion or obstruction. Methods of crossing or displacing a vascular occlusion are further provided that include the positioning of a vascular catheter having at least one hinged spreading member positioned at the distal region of the catheter that is responsive to directed force along the longitudinal axis of the catheter. A directed force is applied to ...

Apparatus and methods for sealing a puncture in tissue

An occlusion device for sealing a puncture through tissue includes a tubular wire member having a proximal end, a distal end sized for insertion into the puncture, a lumen extending between the proximal and distal ends, a port adjacent the proximal end communicating with the lumen, and a balloon on the distal end. A source of fluid is connectable to the wire member for delivering fluid via the port into the lumen for expanding the balloon. A piston is movable axially within the wire member to allow fluid to be delivered into the lumen, to isolate the lumen, and to deliver fluid within the lumen into the balloon to expand the balloon.

Method and apparatus for role-based security policy management

A method and corresponding tool are described for security policy management in a network comprising a plurality of hosts and at least one configurable policy enforcement point. The method, comprises creating one or more policy templates representing classes of usage control models within the network that are enforceable by configuration of the policy enforcement points; creating one or more policy instances, each based on one of the templates and instantiating the template for identified sets of hosts within the network to which the usage control model is to be applied, deploying the policy instances by generating and providing one or more configuration files for provisioning corresponding policy enforcement points within the network. Access to the templates and policy instances is controlled so that the policy templates are only modifiable by a first predeterminable user group, the policy instances are only modifiable by the first or a second predeterminable user group and the policy ...

Systems for heart treatment

Devices and methods for treating degenerative, congestive heart disease and related dysfunction are described. Passive and active cardiac support structures mitigate changes in ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. Cardiac efficiency is improved by providing reinforcement that restores or maintains an elliptical ventricular shape and mimics the position and positive inotropic effects of helical wound myofibrils to provide active contraction of the ventricle in synchrony with the metabolically required cardiac pace or output. In addition, the cardiac support structures compensate or provide therapeutic treatment for congestive heart failure and/or reverse the remodeling that produces an enlarged heart. The structures may be implanted in target heart regions using less invasive surgical techniques, such as those involving ...

Systems for heart treatment

Described are devices and methods for treating degenerative, congestive heart disease and related valvular dysfunction. Percutaneous and minimally invasive surgical tensioning structures offer devices that mitigate changes in the ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These tensioning structures can be implanted within various major coronary blood-carrying conduit structures (arteries, veins and branching vessels), into or through myocardium, or into engagement with other anatomic structures that impact cardiac output to provide tensile support to the heart muscle wall which resists diastolic filling pressure while simultaneously providing a compressive force to the muscle wall to limit, compensate or provide therapeutic treatment for congestive heart failure and/or to reverse the remodeling that produces an enlarged heart ...

Apparatus and methods for tissue closure

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Blunt micro-dissection catheter

An intravascular catheter system for the treatment of occluded blood vessels that includes tissue displacement or hinged expansion members that are movable from a closed to an open position. An actuating assembly may be provided for moving the tissue expansion members between an open and closed position to exert a substantially lateral distal end force upon the region surrounding an occluded blood vessel. The tissue expansion members may stretch apart, tear or otherwise disrupt a vascular occlusion sufficiently to create a pathway that may support the passage or placement of a guidewire or an interventional vascular device across the occlusion or obstruction. Methods of crossing or displacing a vascular occlusion are further provided that include the positioning of a vascular catheter having at least one hinged spreading member positioned at the distal region of the catheter that is responsive to directed force along the longitudinal axis of the catheter. A directed force is applied to ...

Auto-retraction apparatus and methods for sealing a vascular puncture

Apparatus for sealing a puncture communicating with a blood vessel includes an introducer sheath, an occlusion member with a balloon thereon, a retraction assembly, and a syringe assembly including sealing material therein. During use, the introducer sheath is introduced into the puncture. With the balloon in a collapsed state, the occlusion member is introduced through the introducer sheath until the balloon is disposed within the vessel. The introducer sheath is coupled to the retraction assembly, the balloon is expanded, and the occlusion member is partially withdrawn to seal the puncture. A sealing compound is delivered from the syringe assembly through the introducer sheath into the puncture, the syringe assembly triggering the retraction assembly, whereupon the introducer sheath is automatically withdrawn at least partially from the puncture, delivering the sealing compound along the puncture.

Occlusion member and tensioner apparatus and methods of their use for sealing a vascular puncture

Apparatus for sealing a puncture includes an elongate occlusion member having a balloon attached to distal ends of telescoping inner and outer members. A housing on the proximal end of the outer member includes a piston coupled to the inner member and slidable within a chamber communicating with a fluid reservoir. A switch on the housing is actuated to direct fluid from the reservoir through the outer member into the balloon to expand the balloon and into the chamber to move the piston and pull the inner member, shortening the balloon as it expands. During use, the distal end of the occlusion member is introduced into a puncture communicating with a vessel until the collapsed balloon is disposed within the vessel. The balloon is expanded, and a tensioner is connected to the housing to apply a proximal force holding the balloon against the vessel wall to seal the puncture.

Systems for heart treatment

Described are devices and methods for treating degenerative, congestive heart disease and related valvular dysfunction. Percutaneous and minimally invasive surgical tensioning structures offer devices that mitigate changes in the ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These tensioning structures can be implanted within various major coronary blood-carrying conduit structures (arteries, veins and branching vessels), into or through myocardium, or into engagement with other anatomic structures that impact cardiac output to provide tensile support to the heart muscle wall which resists diastolic filling pressure while simultaneously providing a compressive force to the muscle wall to limit, compensate or provide therapeutic treatment for congestive heart failure and/or to reverse the remodeling that produces an enlarged heart ...

Apparatus and Methods for Inflating and Deflating Balloon Catheters

Among the various embodiments, objects and features of the present invention may generally be noted an inflation/deflation syringe that enables one-handed operation to inflate a medical device to a given pressure or volume and one-handed operation to deflate said medical device.

Laparoscopic fascial closure system

A tissue closure device to assist in retrieving a suture during a suturing procedure, the device including an elongated body having a proximal end, a distal end, and a lumen extending axially through the elongated body. The device further including an actuator rod at least partially extending through the lumen of the elongated body to actuate a plurality of wings and a plurality of shields attached to a distal end of the elongated body. The elongated body including at least one needle guide lumen with an opening an exit, the at least one needle guide lumen traversing the elongated body at an angle with respect to a central axis of the elongated body to guide a suture grasper to an enclosed suture retrieval cavity.

APPARATUS AND METHODS FOR SEALING A VASCULAR PUNCTURE

An apparatus for sealing a puncture through tissue to a vessel includes an elongate occlusion member including an expandable member, a cartridge carried on the occlusion member, and a sealant carried within the cartridge. The cartridge includes an outer member and a pusher member within the outer member. The sealant is disposed within the outer member adjacent the expandable member distal to the pusher member. During use, the occlusion member is introduced into a puncture until the expandable member and the sealant extend from the puncture into the vessel. The expandable member is expanded, and withdrawn until the expanded expandable member contacts the vessel wall, thereby withdrawing the sealant back into the puncture. The outer member is withdrawn to expose the sealant within the puncture, while the pusher member prevents removal of the sealant, and then the cartridge, occlusion member, and pusher member are successively removed.

Apparatus and Methods for Sealing a Vascular Puncture

Apparatus for sealing a puncture communicating with a blood vessel includes a porous carrier formed from lyophilized hydrogel or other material. The plug may include at least first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture.

Intravascular Tissue Disruption

Disrupting tissue and devices and systems for disrupting tissue. The disclosure describes ways to deliver moieties to a target tissue, where the target tissue in general is not at the point of introduction, in such a way that minimal damage is produced in the tissue at the point of introduction. In some embodiments this is accomplished by jetting fluid at high velocity into the target tissue. The disclosure further describes novel agents deliverable in such systems for use in remodeling tissues. Some of these agents comprise a liquid while others do not. Additionally, although not specifically described in detail much of the disclosure may additionally be used in the delivery of therapeutic drugs.

Vascular access devices and methods for lower limb interventions

A guide sheath device with an integrated stabilization wire is provided. The guide sheath device includes an elongate member having a proximal and distal end and a lumen there between and a stabilization wire integrated to the elongate member. The guide sheath is configured to access the lower vasculature via a contralateral percutaneous access. The stabilization wire is configured to exit the vasculature at an ipsilateral percutaneous access and be locked in place at the exit. The proximal end of the guide sheath and the distal end of the stabilization wire being accessible outside the vasculature enable stabilization of the stabilization wire and the guide sheath. The stabilization enables stabilization of procedural catheters and instruments as they access the site of a procedure within the lower vasculature.

APPARATUS AND METHODS FOR TISSUE CLOSURE

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Apparatus and methods for tissue closure

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Intravascular tissue disruption

Disrupting tissue and devices and systems for disrupting tissue. The disclosure describes ways to deliver moieties to a target tissue, where the target tissue in general is not at the point of introduction, in such a way that minimal damage is produced in the tissue at the point of introduction. In some embodiments this is accomplished by jetting fluid at high velocity into the target tissue. The disclosure further describes novel agents deliverable in such systems for use in remodeling tissues. Some of these agents comprise a liquid while others do not. Additionally, although not specifically described in detail much of the disclosure may additionally be used in the delivery of therapeutic drugs.

Method and apparatus for role-based security policy management

A method and corresponding tool are described for security policy management in a network comprising a plurality of hosts and at least one configurable policy enforcement point. The method, comprises creating one or more policy templates representing classes of usage control models within the network that are enforceable by configuration of the policy enforcement points; creating one or more policy instances, each based on one of the templates and instantiating the template for identified sets of hosts within the network to which the usage control model is to be applied, deploying the policy instances by generating and providing one or more configuration files for provisioning corresponding policy enforcement points within the network. Access to the templates and policy instances is controlled so that the policy templates are only modifiable by a first predeterminable user group, the policy instances are only modifiable by the first or a second predeterminable user group and the policy ...

Apparatus and methods for tissue closure

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. The resiliently flexible target material may be included as part of a removable mating component for use with a movable wing. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Apparatus and methods for sealing a vascular puncture

Apparatus for sealing a puncture communicating with a blood vessel includes a porous carrier formed from lyophilized hydrogel or other material. The plug may include at least first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture.

APPARATUS AND METHODS FOR SEALING A VASCULAR PUNCTURE

Apparatus for sealing a puncture communicating with a blood vessel includes a porous carrier formed from lyophilized hydrogel or other material. The plug may include at least first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture.

Ligation clip

A surgical ligation clip and method of operation are described and include a top jaw member and bottom jaw member joined at a hinge section for movement about the hinge section. The hinge section can be offset or space laterally from one or both of the jaw members. Teeth arrangements and distributions are also described, as well as closing and jaw ends engagement configurations, for example for more easily engaging/piercing connective or other tissue.

Apparatus and Methods for Accessing and Treating a Body Cavity, Lumen, or Ostium

Among the various embodiments, objects and features of the present invention may generally be noted catheter systems which simplify and ease access to one or more target anatomies in various medical procedures thereby reducing procedure time and associated costs. 112-. (canceled)13. A steerable balloon catheter comprising;a shell enclosing a balloon control hub, wherein the balloon control hub can move with respect to the shell;a multi-lumen tubing having a proximal end, a distal end, and at least two lumens coaxially disposed within a balloon shaft having a proximal end, a distal end, and at least one lumen, wherein the distal end of the multi-lumen tubing extends beyond the distal end of the balloon shaft;an expandable balloon element;a flexible element having a proximal end, a distal end, and at least one lumen, wherein the proximal end is joined to the distal end of the multi-lumen tubing;a distal tip having a proximal end, a distal end, and at least one lumen, wherein the proximal end is joined to the distal end of the flexible element;a wire having a proximal end, a distal end, and a cross-sectional geometry residing in at least a portion of at least one of the lumens of the multi-lumen tubing, wherein the distal end of the wire is joined to the distal end of the flexible element and/or the proximal end of the distal tip; anda control knob disposed on the balloon control hub enabling a tensile or compressive load to be applied to the wire.14. The steerable balloon catheter according to claim 13 , wherein the distal tip is substantially less rigid than the multi-lumen tubing.15. The steerable balloon catheter according to claim 13 , wherein the distal tip is atraumatic.16. The steerable balloon catheter according to claim 13 , wherein the distal tip cannot support a compressive load sufficient to cross into and/or through an opening into a diseased paranasal sinus.17. The steerable balloon catheter according to claim 13 , wherein the control knob is joined to ...

Systems for heart treatment

Described are devices and methods for treating degenerative, congestive heart disease and related valvular dysfunction. Percutaneous and minimally invasive surgical tensioning structures offer devices that mitigate changes in the ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These tensioning structures can be implanted within various major coronary blood-carrying conduit structures (arteries, veins and branching vessels), into or through myocardium, or into engagement with other anatomic structures that impact cardiac output to provide tensile support to the heart muscle wall which resists diastolic filling pressure while simultaneously providing a compressive force to the muscle wall to limit, compensate or provide therapeutic treatment for congestive heart failure and/or to reverse the remodeling that produces an enlarged heart ...

APPARATUS AND METHODS FOR TISSUE CLOSURE

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits. 1. A tissue closure assembly , comprising:a longitudinally extending body having a proximal portion for manual disposition and having a distal portion for insertion into an opening in a tissue layer, the distal portion having a first wall extending to a suture holding element supported by the distal portion, and the proximal portion including a shield having a laterally extending surface beyond the first wall,wherein a first needle-receiving opening is defined at a first axial position on the longitudinally extending body and extends through the laterally extending surface of the shield, and an exit opening is defined at a second axial position on the longitudinally extending body distal of the first axial position and on a periphery of the first wall, andwherein the longitudinally extending body defines a linear path through the laterally extending surface of the shield and the first wall the from the first needle-receiving opening to the exit opening, and wherein the linear path is aligned with the suture holding element when the suture holding element is in a deployed position.2. The tissue closure assembly of claim 1 , further comprising a pull rod extending along a length of the longitudinally extending body claim 1 , wherein a distal end of the pull rod is connected to the suture holding element claim 1 , andwherein actuation of the pull rod in a proximal direction, relative to the longitudinally extending body, extends the suture holding element laterally towards the ...

Apparatus and methods for tissue closure

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. The resiliently flexible target material may be included as part of a removable mating component for use with a movable wing. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Apparatus and methods for tissue closure

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Granular access control of inter-process communications in a compartment mode workstation labeled environment

A method and apparatus for maintaining a secure run-time environment in which arbitrary relationships between the subjects and objects of differing sensitivity labels are defined so as to provide for discrete access between arbitrary, normally incomparable sensitivity labels.

Apparatus and methods for delivering sealing materials during a percutaneous procedure to facilitate hemostasis

Apparatus and methods are provided for sealing a puncture extending through tissue to a blood vessel. A delivery sheath is introduced-into the puncture, and a sealing compound, e.g., precursor polymers that mix to create a hydrogel, is introduced through the delivery sheath into the puncture. The delivery sheath is then removed, an introducer sheath is advanced through the puncture into the vessel, and instruments are introduced through the introducer sheath into the vessel to perform a medical procedure. After completing the procedure, the introducer sheath is withdrawn. The sealing compound may expand into the puncture and/or tissue recoil of the surrounding tissue may cause the sealing compound to at least partially occlude the puncture to facilitate sealing and/or hemostasis.

Sliding suture grasper

A device to assist in securing a holding a portion of a suture during an intra-abdominal suturing procedure, the device including an elongated tubular body, a handle, an inner member element, and a push button. The inner member element may include at least one grasping element that expands as the at least one grasping element is extended beyond a distal end of the elongated tubular. The device may include a proximal spring disposed within the push button and abutting against a proximal end of the inner member element to allow the at least one grasping element to retract into the elongated tubular body in a proximal direction.

Systems for heart treatment

Described are devices and methods for treating degenerative, congestive heart disease and related valvular dysfunction. Percutaneous and minimally invasive surgical tensioning structures offer devices that mitigate changes in the ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These tensioning structures can be implanted within various major coronary blood-carrying conduit structures (arteries, veins and branching vessels), into or through myocardium, or into engagement with other anatomic structures that impact cardiac output to provide tensile support to the heart muscle wall which resists diastolic filling pressure while simultaneously providing a compressive force to the muscle wall to limit, compensate or provide therapeutic treatment for congestive heart failure and/or to reverse the remodeling that produces an enlarged heart.

Sliding suture grasper

A device to assist in securing a holding a portion of a suture during an intra-abdominal suturing procedure, the device including an elongated tubular body, a handle, an inner member element, and a push button. The inner member element may include at least one grasping element that expands as the at least one grasping element is extended beyond a distal end of the elongated tubular. The device may include a proximal spring disposed within the push button and abutting against a proximal end of the inner member element to allow the at least one grasping element to retract into the elongated tubular body in a proximal direction.

Apparatus and methods for sealing a vascular puncture

Apparatus for sealing a puncture through tissue to a blood vessel includes a cartridge including a proximal end, a distal end sized for insertion into a puncture, and a lumen extending therebetween. A bioabsorbable plug is disposed within the lumen adjacent the distal end, and an anchoring element is disposed within the lumen proximal to the plug. A pusher member is disposed within the lumen for deploying the plug and anchoring element out the distal end of the cartridge. The plug may be formed from lyophilized hydrogel and the anchoring element may be formed from air-dried hydrogel, the anchoring element hydrating slower than the plug when exposed to an aqueous environment. During use, the plug and anchoring element are delivered into the puncture, the plug is cinched against the vessel wall. Protrusions on the anchoring element engage tissue surrounding the puncture to prevent proximal movement of the plug.

Systems for heart treatment

Described are devices and methods for treating degenerative, congestive heart disease and related valvular dysfunction. Percutaneous and minimally invasive surgical tensioning structures offer devices that mitigate changes in the ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These tensioning structures can be implanted within various major coronary blood-carrying conduit structures (arteries, veins and branching vessels), into or through myocardium, or into engagement with other anatomic structures that impact cardiac output to provide tensile support to the heart muscle wall which resists diastolic filling pressure while simultaneously providing a compressive force to the muscle wall to limit, compensate or provide therapeutic treatment for congestive heart failure and/or to reverse the remodeling that produces an enlarged heart ...

Sliding suture grasper

A device to assist in securing a holding a portion of a suture during an intra-abdominal suturing procedure, the device including an elongated tubular body, a handle, an inner member element, and a push button. The inner member element may include at least one grasping element that expands as the at least one grasping element is extended beyond a distal end of the elongated tubular. The device may include a proximal spring disposed within the push button and abutting against a proximal end of the inner member element to allow the at least one grasping element to retract into the elongated tubular body in a proximal direction.

Minimally invasive cardiac force transfer structures

Devices and methods for treating degenerative, congestive heart disease and related dysfunction are described. Minimally invasive surgical force transfer structures offer devices that mitigate changes in the ventricular structure (i.e. remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These force transfer structures resist diastolic filling pressure while simultaneously transmitting a compressive force to the aorta, the pulmonary artery, the atrium and/or other anatomic structure to improve cardiac output thereby reducing the strain on the heart. In addition, the force transfer structures may compensate or provide therapeutic treatment for congestive heart failure and/or reverse the remodeling that produces an enlarged heart. The force transfer structures are implanted in target heart regions using less invasive surgical techniques involving port access or small ...

Crop residue and soil conditioning agricultural implement

A disc harrow composed of one or more disc gangs has a subframe coupled to the disc gangs to move the disc gangs in response to variations in farmland terrain to limit the impact of obstructions when encountered during the harrowing process. When the obstruction is cleared, the subframe automatically returns the disc gangs to their pre-obstruction position. In addition to reducing the potentially-damaging impact of obstructions, the subframe also maintains a more consistent reel depth during undulations or changes in the farmland terrain, such as during harrowing of slopes or unleveled fields such as valleys, near waterways, and along fence rows.

Noise mitigation hood

Systems and apparatuses include a hood for a machine including a noise inhibitor housing inhibiting transmission of noise in a horizontal plane from the machine, and a noise diffusive panel supported by the noise inhibitor housing and structured to release noise upward.

Apparatus and methods for inflating and deflating balloon catheters

Among the various embodiments, objects and features of the present invention may generally be noted an inflation/deflation syringe that enables one-handed operation to inflate a medical device to a given pressure or volume and one-handed operation to deflate said medical device.

Apparatus and methods for accessing and treating a body cavity, lumen, or ostium

Among the various embodiments, objects and features of the present invention may generally be noted catheter systems which simplify and ease access to one or more target anatomies in various medical procedures thereby reducing procedure time and associated costs.

Intravascular Tissue Disruption

Disrupting tissue and devices and systems for disrupting tissue. The disclosure describes ways to deliver moieties to a target tissue, where the target tissue in general is not at the point of introduction, in such a way that minimal damage is produced in the tissue at the point of introduction. In some embodiments this is accomplished by jetting fluid at high velocity into the target tissue. The disclosure further describes novel agents deliverable in such systems for use in remodeling tissues. Some of these agents comprise a liquid while others do not. Additionally, although not specifically described in detail much of the disclosure may additionally be used in the delivery of therapeutic drugs. 1. A method of treating hypertension , comprising:positioning a medical device within a renal artery adjacent to the renal artery lumen; anddelivering a fluid at a high velocity from the medical device to a renal nerve through the lumen wall to modulate neural transmission along the renal nerve without piercing the renal artery lumen with the medical device.2. The method of wherein positioning the medical device comprises positioning a portion of the medical device to be in contact with the renal artery lumen.3. The method of wherein delivering a fluid at a high velocity comprises delivering a fluid at least about 75 msec.4. The method of further comprising maintaining a substantially constant pressure at a fluid source in communication with the medical device.5. The method of further comprising disrupting renal nerve tissue in a substantially spiral pattern relative to the renal artery.6. The method of wherein the medical device comprises a plurality of fluid controls claim 5 , and wherein delivering the fluid comprises selectively regulating the flow of the fluid out of the plurality of fluid controls to disrupt renal nerve tissue in a substantially spiral pattern relative to the renal artery.7. The method of wherein the medical device comprises at least one fluid ...

Fragmented Hydrogels

Fragmented polysaccharide based hydrogel compositions and methods of making and using the same are provided. The subject polysaccharide based hydrogel compositions are prepared by combining a polysaccharide component with a hydrophilic polymer and a cross-linking agent. Also provided are kits and systems for use in preparing the subject compositions. 1. A hydrogel composition , comprisinga polysaccharide substrate or derivative thereof having a molecular weight of 160 Dalton to 80,300 Dalton and comprising at least two reactive nucleophilic groups;a synthetic, hydrophilic polymer of a molecular weight of 200 Dalton to 100000 Dalton and comprising at least two nucleophilic reactive groups; anda crosslinking agent.2. The composition of claim 1 , wherein the polysaccharide substrate is chitosan claim 1 , carboxymethylcellulose claim 1 , carboxymethylchitosan or a derivative thereof.3. The composition of claim 1 , wherein the synthetic hydrophilic polymer substrate is a polyethylene glycol having at least two nucleophilic active groups.4. The composition of claim 1 , wherein the crosslinking agent is a polyethylene glycol having at least two electrophilic active groups.5. The composition of claim 1 , wherein the crosslinking agent is an aldehyde.6. The composition of claim 1 , wherein the crosslinking agent is a glutaraldehyde.7. The composition of claim 1 , wherein the crosslinking agent is heat treated glutaraldehyde.8. The composition of claim 1 , wherein the composition comprises a thickening agent.9. The composition of claim 1 , wherein the composition comprises a foaming agent.10. The composition of claim 1 , wherein the composition comprises a biologically active agent and or a pharmaceutically active agent.11. The composition of claim 1 , wherein the composition comprises a visualization agent and/or a radiopaque agent.12. The composition of claim 1 , wherein the polysaccharide substrate is soluble in an alkaline aqueous solution.13. The composition of claim 1 , ...

APPARATUS FOR SEALING A VASCULAR PUNCTURE

An apparatus for sealing a puncture through a vessel wall including an elongate tubular body, a balloon carried by the body, an outer tubular member carried over the tubular body, and a sealant carried by the tubular body adjacent the balloon. Retracting the outer tubular member exposes the sealant. 1. An apparatus for sealing a puncture through a vessel wall , comprising:an elongate, tubular body, having a proximal end and a distal end;an inflatable balloon carried by the distal end of the body;an outer tubular member having a distal end and axially movably carried over the elongate tubular body; anda sealant carried by the elongate tubular body adjacent the balloon;wherein the outer tubular member is movable between a first position in which the distal end of the outer tubular member is adjacent the balloon and encloses the sealant, and a second position in which the outer tubular member has been proximally retracted to expose the sealant.2. An apparatus for sealing a puncture through a vessel wall as in claim 1 , further comprising an elongate tamping tube claim 1 , slidably carried inside of the outer tubular member claim 1 , for tamping the sealant following retraction of the outer tubular member to expose the sealant.3. An apparatus for sealing a puncture through a vessel wall as in claim 1 , wherein the sealant comprises hydrogel.4. An apparatus for sealing a puncture through a vessel wall as in claim 1 , wherein the sealant includes a lumen therethrough for receiving the elongate tubular body.5. An apparatus for sealing a puncture through a vessel wall as in claim 1 , wherein the elongate tubular body includes a distal end which extends distally of the balloon. This application is a continuation of U.S. patent application Ser. No. 11/854,534, which was filed on Sep. 12, 2007, which claims priority benefit of U.S. Provisional Application App. Ser. No. 60/825,410, filed Sep. 13, 2006, all of which applications are hereby incorporated by reference in their ...

Polysaccharide Based Hydrogels

Polysaccharide based hydrogel compositions and methods of making and using the same are provided. The subject polysaccharide based hydrogel compositions are prepared by combining a polysaccharide component with a hydrophilic polymer and a cross-linking agent. Also provided are kits and systems for use in preparing the subject compositions.

APPARATUS AND METHODS FOR SEALING A VASCULAR PUNCTURE

Apparatus for sealing a puncture through tissue to a blood vessel includes a cartridge including a proximal end, a distal end sized for insertion into a puncture, and a lumen extending therebetween. A bioabsorbable plug is disposed within the lumen adjacent the distal end, and an anchoring element is disposed within the lumen proximal to the plug. A pusher member is disposed within the lumen for deploying the plug and anchoring element out the distal end of the cartridge. The plug may be formed from lyophilized hydrogel and the anchoring element may be formed from air-dried hydrogel, the anchoring element hydrating slower than the plug when exposed to an aqueous environment. During use, the plug and anchoring element are delivered into the puncture, the plug is cinched against the vessel wall. Protrusions on the anchoring element engage tissue surrounding the puncture to prevent proximal movement of the plug. 140-. (canceled)41. A method for sealing a puncture extending through tissue to a body lumen , comprising:introducing a positioning member into the puncture until a positioning element thereon is disposed within the body lumen;retracting the positioning member until the positioning element contacts a wall of the body lumen; anddelivering a bioabsorbable plug into the puncture over the positioning member until the plug is disposed proximate the positioning element; anddelivering an anchoring element into the puncture above the plug to prevent the plug from moving proximally within the puncture.42. The method of claim 41 , wherein the positioning element comprises an expandable member that is introduced into the puncture in a contracted condition claim 41 , the method further comprising expanding the expandable member within the body lumen before retracting the positioning member.43. The method of claim 42 , further comprising:collapsing the expandable member; andwithdrawing the positioning member from the puncture after the plug is delivered into the puncture.44 ...

Engine Mount Assembly and Mounting System for a Vehicle

An engine mount assembly is provided for mounting an engine to a vehicle frame. The engine mount assembly includes an elastomeric material snubber element having a generally elongated configuration with axial end faces and a coaxial bolt passage defined therethrough. A tubular sleeve has an inner shape sized for sliding receipt of the snubber element therein. The tubular sleeve has a longitudinal cross-sectional profile such that a bottom longitudinal cross-sectional portion of the tubular sleeve extends axially beyond the end faces of the snubber element and defines an enlarged attachment footprint for the tubular sleeve to a vehicle frame flange. 1. An engine mount assembly for mounting an engine to a vehicle frame , said engine mount assembly comprising:an elastomeric material snubber element, said snubber element comprising a generally elongated configuration with axial end faces and a bolt passage defined therethrough coaxial with a longitudinal axis of said snubber element;a tubular sleeve having an inner shape sized for sliding receipt of said snubber element therein; andsaid tubular sleeve comprises a longitudinal cross-sectional profile such that a bottom longitudinal cross-sectional portion of said tubular sleeve extends axially beyond said end faces of said snubber element and defines an enlarged attachment footprint for said tubular sleeve to a vehicle frame flange.2. The engine mount assembly as in claim 1 , wherein said tubular sleeve comprises an upper longitudinal cross-sectional portion that tapers from said bottom longitudinal cross-sectional portion towards said axial end faces of said snubber element.3. The engine mount assembly as in claim 2 , wherein said upper longitudinal cross-sectional portion tapers to said end faces of said snubber element.4. The engine mount assembly as in claim 2 , wherein said snubber element has an axial length so as to fit between mounting arms of an engine frame claim 2 , said upper longitudinal cross-sectional ...

METHODS FOR SEALING A VASCULAR PUNCTURE

Methods for sealing a puncture communicating with a blood vessel are provided that include introducing a porous carrier formed from lyophilized hydrogel or other material into the puncture. The plug may include at least first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture. 1. A method for sealing a puncture extending through tissue to a body lumen , comprising providing a plug , the plug comprising a first precursor disposed thereon in an unreactive state before delivery into the puncture , the plug being exposed to an aqueous physiological environment within the puncture , whereupon the first precursor reacts to form a sticky hydrogel to retain the plug in place within the puncture.2. The method of claim 1 , wherein the plug further comprises a second precursor claim 1 , and the first precursor and the second precursor react to form the hydrogel.3. The method of claim 2 , wherein the plug comprises a core section claim 2 , and the hydrogel covers at least a portion of the core section.4. The method of claim 3 , wherein the core section is disk-shaped.5. The method of claim 3 , wherein the core section comprises lyophilized hydrogel that expands substantially when exposed to fluid within the puncture.6. The method of claim 1 , further comprising:introducing a positioning member into the puncture until a positioning element thereon is disposed within the body lumen;partially retracting the positioning member until the positioning element ...

Implant deployment apparatus

A delivery system including a restraining member maintains a collapsed implant in its collapsed state for delivery through a small passageway to a desired site in a mammalian body. Once the implant is positioned at the desired site, the restraining member is released so that the stent may expand or be expanded to its expanded state. In a preferred embodiment, the restraining member comprises a sheet of material that surrounds at least a portion of the collapsed stent. Portions of the restraining member are releasably coupled to one another with a low profile thread-like member or suture.

APPARATUS AND METHODS FOR SEALING A VASCULAR PUNCTURE

Apparatus for sealing a puncture communicating with a blood vessel includes a porous carrier formed from lyophilized hydrogel or other material. The plug may include at least first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture. 1a cartridge comprising a proximal end, a distal end sized for insertion into a puncture through tissue, and a lumen extending between the proximal and distal ends;a plug disposed within the cartridge lumen, the plug comprising a lumen extending between proximal and distal ends thereof;a pusher member disposed within the cartridge lumen for deploying the plug from the cartridge when the cartridge is retracted relative to the pusher member;a positioning member comprising an elongate member and an expandable positioning element carried on a distal end of the elongate member, the elongate member received through the lumens of the plug and the cartridge such that the cartridge, plug, and pusher member are advanceable from a proximal position on the positioning member to a distal position wherein the plug is disposed adjacent the positioning element; andcooperating elements on the pusher member and the positioning member that limit subsequent movement of the pusher member relative to the positioning member when the pusher member is advanced to the distal position.. An apparatus for sealing a puncture extending through tissue, comprising: This application is a continuation of U.S. patent application Ser. No. 11/929,972, ...

Devices and methods for fluid infusion, drainage, and collection

Containers for collecting fluid are provided that include a reservoir comprising a plurality of panels enclosing an interior, side panels of the reservoir are movable from an expanded position towards to a compressed position and biased to the expanded position for generating a vacuum within the interior. An elongate housing extends along a top side of the reservoir including a passage extending between proximal and distal ends thereof and communicating with the interior of the reservoir. An elongate member extends through the housing including a distal extension, a proximal extension, and a lumen extending therebetween. One-way valves are coupled to the distal and proximal extensions for permitting fluid flow proximally from the distal extension into the interior of the reservoir via and permitting fluid flow proximally from the proximal extension while preventing fluid flow distally out the distal extension and distally into the proximal extension and lumen.

APPARATUS AND METHODS FOR SEALING A VASCULAR PUNCTURE

Apparatus and methods for sealing a puncture through tissue or otherwise treating a body lumen of a patient. The carrier includes at least one, but not all, of the adherent layer components required to form a tacky or sticky adherent layer on the carrier. The remaining adherent layer precursor(s) are delivered to the carrier in situ to form a sticky and/or tacky adherent layer on the carrier that enhances the attachment and retention of the carrier to tissue surrounding a target treatment location in which the carrier is delivered. The carrier may include hydrogel and/or other porous material, e.g., for releasing one or more agents carried by the carrier at the treatment location. 1. A system for sealing a puncture extending through tissue , comprising:a carrier sized for delivery into the puncture, the carrier carrying at least one adherent layer component;a delivery device for delivering at least one additional adherent layer component to the carrier in situ; andwherein contact between the at least one adherent layer component and the at least one additional adherent layer component creates an adherent layer on the carrier.2. The system of claim 1 , wherein the carrier comprises a bioabsorbable mass.3. The system of claim 1 , wherein the at least one adherent layer component comprises at least one of a first hydrogel precursor claim 1 , a second hydrogel precursor claim 1 , and an activating agent claim 1 , and wherein the at least one additional adherent layer component comprises the other of the first hydrogel precursor claim 1 , the second hydrogel precursor claim 1 , and the activating agent that are not carried by the carrier claim 1 , the first and second hydrogel precursors combining to create a hydrogel in the presence of the activating agent.4. The system of claim 3 , wherein the activating agent comprises a pH adjusting agent.5. The system of claim 1 , wherein the at least one adherent layer component comprises at least one of an amine-terminated polymer ...

DEVICES AND METHODS FOR THE MANAGEMENT AND PREVENTION OF HERNIA AND OTHER MUSCULOSKELETAL INJURIES

Systems and methods are provided for mitigating and/or preventing a hernia using a wearable device worn by a user such that an output device is positioned at a predetermined location corresponding to a target hernia mitigation site on the user's body. One or more physical parameters of the user are monitored to identify when the user is about to perform a predetermined physical activity, and the output device is activated to provide an output to mitigate a hernia or prevent a hernia from occurring at the mitigation site when the predetermined activity is performed. 1. A system for mitigating or preventing a hernia , comprising:a wearable device configured to be worn on a user;one or more sensors configured to generate signals corresponding to one or more physical parameters of the user;a controller coupled to the one or more sensors to receive the signals, the controller configured to identify when the user inhales sufficiently to indicate the user is about to perform a predetermined physical activity based at least in part on the signals; andan output device carried on the device at a predetermined location corresponding to a target hernia mitigation site on the user's body, the controller communicating with the output device to activate the output device to provide an output to mitigate a hernia or prevent a hernia from occurring at the mitigation site.2. (canceled)3. The system of claim 1 , wherein the wearable device comprises a garment.4. The system of claim 1 , wherein the garment is configured to at least partially surround the user's torso.5. The system of claim 3 , wherein the garment is configured to at least partially cover the user's abdomen.6. The system of claim 5 , wherein the garment is configured to overly an inguinal ring of the user.7. The system of claim 3 , wherein one or more of the one or more sensors claim 3 , the controller claim 3 , and the output device are removably mounted to the garment.8. The system of claim 3 , wherein the garment ...

Hydrogel compositions

Fragmented polysaccharide based hydrogel compositions and methods of making and using the same are provided. The subject polysaccharide based hydrogel compositions are prepared by combining a polysaccharide component with a hydrophilic polymer and a cross-linking agent. Also provided are kits and systems for use in preparing the subject compositions. 142-. (canceled)43. A hydrogel composition , comprisinga polysaccharide or derivative thereof having a molecular weight of 160 Dalton to 80,300 Dalton, a degree of deacetylation of 70% to 99%, and at least two nucleophilic groups, wherein the polysaccharide or derivative thereof is soluble in an aqueous solution;a multifunctional, multi-armed polyethylene glycol polymer of a molecular weight of 5,000 Dalton to 30,000 Dalton, and comprising at least two nucleophilic groups; anda multifunctional, multi-armed crosslinker of polyethylene glycol having a molecular weight of 5,000 Dalton to 30,000 Dalton, and comprising at least two electrophilic groups,wherein each one of the polysaccharide or derivative thereof, polyethylene glycol polymer and multi-armed crosslinker are crosslinked to each other.44. The composition of claim 43 , wherein the aqueous solution is alkaline and the polysaccharide is soluble in the aqueous solution up to a concentration of 30 mM.45. A hydrogel composition claim 43 , comprisinga chitosan or derivative thereof having a molecular weight of less than or equal to 5,000 Dalton, a degree of deacetylation of 70% to 99%, and at least two nucleophilic groups, wherein the chitosan or derivative thereof is soluble in an aqueous solution;a multifunctional, multi-armed polyethylene glycol polymer of a molecular weight of 5,000 Dalton to 30,000 Dalton, and comprising at least two nucleophilic groups; anda multifunctional, multi-armed crosslinker of polyethylene glycol having a molecular weight of 5,000 Dalton to 30,000 Dalton, and comprising at least two electrophilic groups;wherein the polyethylene glycol ...

Apparatus and Methods for Tissue Closure

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. The resiliently flexible target material may be included as part of a removable mating component for use with a movable wing. Introducers can be used having a suture holder, an alignment indicator and insertion limits 148-. (canceled)49. A device for use in suturing tissue , the device comprising a proximal portion for being positioned on a first side of tissue and a distal portion for being positioned on a second side of tissue , and wherein at least one of the proximal and distal portions of the device includes a first structure defining a first mating component; anda second mating component for the first mating component wherein the second mating component includes first and second elements where the first and second elements have different characteristics, and wherein at least one of the first and second elements is configured for receiving a suture.5060-. (canceled)61. The device of wherein the first structure on the first mating component is a movable element having a cavity and the second mating component is configured to be insertable into the cavity.62. The device of wherein the second mating component includes first and second separable elements made from materials having different hardnesses.63. The device of wherein the second mating component includes a first element configured to be removably retained in the cavity and a second element supported by the first element.64. The device of wherein the first element is a housing and the second element is a suture-receiving pad.65. The device of wherein the first structure on the first mating component is a movable ...

ENGINE MOUNT ASSEMBLY AND MOUNTING SYSTEM FOR A VEHICLE

An engine mount assembly is provided for mounting an engine to a vehicle frame. The engine mount assembly includes an elastomeric material snubber element having a generally elongated configuration with axial end faces and a coaxial bolt passage defined therethrough. A tubular sleeve has an inner shape sized for sliding receipt of the snubber element therein. The tubular sleeve has a longitudinal cross-sectional profile such that a bottom longitudinal cross-sectional portion of the tubular sleeve extends axially beyond the end faces of the snubber element and defines an enlarged attachment footprint for the tubular sleeve to a vehicle frame flange. 112-. (canceled)13. An engine mounting system , comprising:an engine frame, said engine frame further comprising spaced-apart mounting arms at a mount position;a vehicle frame, said vehicle frame comprising a mounting flange proximate to said mount position; and an elastomeric material snubber element, said snubber element comprising a generally elongated configuration with axial end faces and a bolt passage defined therethrough coaxial with a longitudinal axis of said snubber element; and', 'a tubular sleeve having an inner shape sized for sliding receipt of said snubber element therein,', 'said tubular sleeve comprising a longitudinal cross-sectional profile such that a bottom longitudinal cross-sectional portion of said tubular sleeve extends axially beyond said end faces of said snubber element and defines an enlarged attachment footprint for attaching said tubular sleeve to said mounting flange on said vehicle frame,, 'an engine mount assembly at said mount position, said engine mount assembly further comprisingwherein said tubular sleeve comprises an upper longitudinal cross-sectional portion that tapers from said bottom longitudinal cross-sectional portion towards said end faces of said snubber element, andwherein said snubber element has an axial length so as to fit between said mounting arms, said upper ...

APPARATUS AND METHODS FOR TISSUE CLOSURE

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. The resiliently flexible target material may be included as part of a removable mating component for use with a movable wing. Introducers can be used having a suture holder, an alignment indicator and insertion limits. 1. A device for use in suturing tissue , the device comprising:a proximal portion for being positioned on a first side of tissue and a distal portion for being positioned on a second side of tissue,wherein at least one of the proximal and distal portions of the device includes a first structure defining a first mating component, and a second mating component for the first mating component,wherein the second mating component includes first and second elements where the first and second elements have different characteristics, andwherein at least one of the first and second elements is configured to receive a suture.2. The device of claim 1 , wherein the first and second elements are different materials.3. The device of claim 1 , wherein the first and second elements have different hardnesses.4. The device of claim 1 , wherein the first element is a carrier and the second element is a suture receiving portion supported by the carrier.5. The device of claim 4 , wherein the suture receiving portion includes a receptacle configuration and the carrier has a configuration complementary to the receptacle configuration.6. The device of claim 5 , wherein the receptacle includes a cavity having an opening configuration complementary to a configuration of the carrier.7. The device of claim 5 , wherein the receptacle and the mating component have complementary keying ...

LAPAROSCOPIC FASCIAL CLOSURE SYSTEM

A tissue closure device to assist in retrieving a suture during a suturing procedure, the device including an elongated body having a proximal end, a distal end, and a lumen extending axially through the elongated body. The device further including an actuator rod at least partially extending through the lumen of the elongated body to actuate a plurality of wings and a plurality of shields attached to a distal end of the elongated body. The elongated body including at least one needle guide lumen with an opening an exit, the at least one needle guide lumen traversing the elongated body at an angle with respect to a central axis of the elongated body to guide a suture grasper to an enclosed suture retrieval cavity. 1. A tissue closure device comprising:a suture;an elongated body defining a central longitudinal axis and including a proximal end, a distal end, and at least one guide lumen with an opening and an exit, the at least one guide lumen traversing the elongated body at an angle with respect to the central longitudinal axis of the elongated body;at least one proximal pivot member pivotally connected to a distal portion of the elongated body;at least one distal pivot member pivotally connected to the at least one proximal pivot member; anda suture retrieval space defined between each of the at least one proximal pivot member and the at least one distal pivot member when the respective proximal and distal pivot members are extended away from the elongated body in a deployed position, the suture retrieval space receiving a portion of the suture,wherein the at least one proximal pivot member includes an opening to allow passage of a suture grasper into the suture retrieval space to engage the portion of the suture.2. The tissue closure device of claim 1 , wherein the opening is round or oval.3. The tissue closure device of claim 1 , wherein the at least one distal pivot member is connected to a corresponding one of the at least one proximal pivot member via a ...

LIGATION CLIP

A surgical ligation clip and method of operation are described and include a top jaw member and bottom jaw member joined at a hinge section for movement about the hinge section. The hinge section can be offset or space laterally from one or both of the jaw members. Teeth arrangements and distributions are also described, as well as closing and jaw ends engagement configurations, for example for more easily engaging/piercing connective or other tissue. 1first and second jaws having proximal portions extending generally longitudinally and movably coupled to each other by a flexible portion at the proximal portions; andwherein the flexible portion includes a first angularly-extending element having first and second end points on different sides of an intermediate point and extending angularly from the first jaw and wherein the flexible portion is flexible between endpoints of the angularly-extending element and configured to allow the first and second jaws to move relative to each other as a result of flexibility at the intermediate point.. A ligation clip comprising: This application is a Continuation of U.S. patent application Ser. No. 15/845,825, filed Dec. 18, 2017, which claims priority of U.S. Continuation application Ser. No. 14/353,022, filed Apr. 19, 2014 and now U.S. Pat. No. 9,855,053, which is a U.S. National Stage of International Application No. PCT/US2012/061384, filed Oct. 22, 2012 and now expired, which claims priority to U.S. Provisional Patent Application No. 61/549,740, filed Oct. 20, 2011 and now expired. Priority to all of the above-mentioned applications are claimed herein, and the disclosure of these applications are incorporated herein by reference in their entirety.Ligation of vessels or other anatomical structures is a common step in a large number of surgical procedures. Traditionally, a ligation procedure comprises the placement of a suture about the target vessel or anatomical structure (e.g. artery, vein, duct, Fallopian tube, etc.) and ...

MODIFIED FIXED FLAT WIRE BIFURCATED CATHETER AND ITS APPLICATION IN LOWER EXTREMITY INTERVENTIONS

A bifurcated catheter and methods of use are disclosed herein. The bifurcated catheter can include a fixed flat wire that is configurable as a stabilization wire. The bifurcated catheter can be configured to improve the initial access and directability by application of a pull force to the stabilization wire, in addition to a push force from the proximal end of the bifurcated catheter. The stabilization wire is anchored once the bifurcated catheter is positioned. The anchored, bifurcated catheter provides stability and pushability to assist the procedural catheter in traversing the tortuous peripheral vasculature. 1. A system comprising:a bifurcated catheter for enabling access for a procedural catheter to a site in a vasculature, the bifurcated catheter comprising a proximal end and a distal end, and a side hole near the distal end of the bifurcated catheter; anda stabilization wire attached to the bifurcated catheter, wherein the stabilization wire is configured to emerge from the side hole.2. The system of claim 1 , wherein the bifurcation is 2 cm from the distal end of the bifurcated catheter.3. The system of claim 1 , wherein the stabilization wire is configured to emerge from the side hole and extend for at least 10 cm beyond the bifurcation.4. The system of claim 1 , wherein the bifurcated catheter further comprises a procedural lumen and a stabilization lumen5. The system of claim 4 , wherein the stabilization wire is configured to emerge from the stabilization lumen at the side hole.6. The system of claim 4 , wherein the procedural lumen is larger than the stabilization lumen.7. The system of claim 1 , wherein the bifurcated catheter is configured for arterial access via a percutaneous contralateral arterial access.8. The system of claim 1 , wherein the bifurcated catheter comprises a procedural lumen claim 1 , and wherein the stabilization wire is configured to emerge from the procedural lumen at the side hole.9. The system of claim 1 , further comprising ...

SLIDING SUTURE GRASPER

A device to assist in securing a holding a portion of a suture during an intra-abdominal suturing procedure, the device including an elongated tubular body, a handle, an inner member element, and a push button. The inner member element may include at least one grasping element that expands as the at least one grasping element is extended beyond a distal end of the elongated tubular. The device may include a proximal spring disposed within the push button and abutting against a proximal end of the inner member element to allow the at least one grasping element to retract into the elongated tubular body in a proximal direction. 1. A suture grasper for securing and holding a portion of a suture , the suture grasper comprising:an elongated tubular body defining an inner lumen, the elongated tubular body having a proximal end and a distal end;a handle attached to the proximal end of the elongated tubular body;an inner member element slidably disposed within the lumen of the elongated tubular body, the inner member element having a proximal end configured to slidably extend from and retract into the handle, and having a distal end configured with at least one grasping element; anda push button extending from a proximal end of the handle, the push button being coupled to the inner member element for actuation or movement of the inner member element in a distal direction or a proximal direction,a proximal spring disposed within the push button, the proximal spring abutting against the proximal end of the inner member element, to bias the inner member element distally,an intermediate spring for biasing the push button and the inner member element in the proximal direction, anda distal spring disposed between a distal end of the handle and a flanged proximal end of the elongated tubular body, the push button including a distal end for contacting the flanged proximal end,wherein actuation of the push button in the distal direction beyond a predetermined point after compression ...

INTRAVASCULAR TISSUE DISRUPTION

Disrupting tissue and devices and systems for disrupting tissue. The disclosure describes ways to deliver moieties to a target tissue, where the target tissue in general is not at the point of introduction, in such a way that minimal damage is produced in the tissue at the point of introduction. In some embodiments this is accomplished by jetting fluid at high velocity into the target tissue. The disclosure further describes novel agents deliverable in such systems for use in remodeling tissues. Some of these agents comprise a liquid while others do not. Additionally, although not specifically described in detail much of the disclosure may additionally be used in the delivery of therapeutic drugs. 17.-. (canceled)8. A method for treating a human patient with diagnosed hypertension , the method comprising:positioning an elongate delivery member having a distal fluid delivery region within a renal blood vessel and proximate to renal nerves of the patient;transforming the fluid delivery region from a low-profile delivery configuration to an expanded treatment configuration,wherein the fluid delivery region comprises a plurality of tubular elements, and wherein, in the expanded treatment configuration, each tubular element is bent along a bending region of the respective tubular element to position a portion of the individual tubular elements in contact with a wall of the renal blood vessel;delivering a neuromodulatory fluid via one or more of the tubular elements to attenuate or block neural signaling along the renal nerves; andremoving the elongate delivery member and fluid delivery region from the patient after delivering the neuromodulatory fluid to conclude the procedure.9. The method of wherein positioning the elongate delivery member having the distal fluid delivery region within a renal blood vessel comprises intravascularly delivering the elongate delivery member and fluid delivery region through an abdominal aorta to a renal artery of the patient.10. The ...

APPARATUS AND METHODS FOR SEALING A VASCULAR PUNCTURE

Apparatus for sealing a puncture communicating with a blood vessel includes a porous carrier formed from lyophilized hydrogel or other material. The plug may include at least first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture. 1. (canceled)2. An apparatus for sealing a blood vessel wall penetration disposed at an end of a tissue tract , said apparatus comprising:a shaft having a proximal end and a distal end;an occlusion element near the distal end of the shaft, said occlusion element being transformable between a radially contracted configuration for passage through the tissue tract and a radially expanded configuration for deployment within the blood vessel to occlude the penetration;a hemostatic implant disposed on an exterior surface of the shaft proximal to the occlusion element; anda protective sleeve retractably disposed over the hemostatic implant.3. An apparatus as in claim 2 , wherein the occlusion element comprises an expandable wire mesh.4. An apparatus as in claim 2 , wherein the occlusion element comprises an expandable frame.5. An apparatus as in claim 2 , wherein the occlusion element comprises an inflatable balloon.6. An apparatus as in claim 3 , further comprising an actuator for moving the expandable wire mesh between the radially contracted and radially expanded configurations.7. An apparatus as in claim 2 , wherein the hemostatic implant comprises a cylindrical plug carried by the shaft.8. An apparatus as in claim 2 ...

LAPAROSCOPIC FASCIAL CLOSURE SYSTEM

A tissue closure device to assist in retrieving a suture during a suturing procedure, the device including an elongated body having a proximal end, a distal end, and a lumen extending axially through the elongated body. The device further including an actuator rod at least partially extending through the lumen of the elongated body to actuate a plurality of wings and a plurality of shields attached to a distal end of the elongated body. The elongated body including at least one needle guide lumen with an opening an exit, the at least one needle guide lumen traversing the elongated body at an angle with respect to a central axis of the elongated body to guide a suture grasper to an enclosed suture retrieval cavity. 1. A tissue closure device , comprising:an elongated body defining a central longitudinal axis and including a proximal end, a distal end, and at least one needle guide lumen with an opening and an exit, the at least one needle guide lumen traversing the elongated body at an angle with respect to the central longitudinal axis of the elongated body,a plurality of wings pivotally connected to a distal portion of the elongated body; anda plurality of shields pivotally connected to the plurality of wings,wherein the plurality of wings each include an opening to allow passage into a suture retrieval space defined between one each of the plurality of wings and plurality of shields when said wings and shield are extended away from the elongated body in a deployed position.2. The tissue closure device of claim 1 , wherein the opening is a round or oval shape.3. The tissue closure device of claim 1 , wherein each of the plurality of shields is connected to a corresponding one of the plurality of wings via living hinges.4. The tissue closure device of claim 1 , wherein the plurality of shields and the plurality of wings are pivotally retractable to be parallel to the elongated body as the tissue closure device is moved from the deployed position to a collapsed ...

APPARATUS AND METHODS FOR TISSUE CLOSURE

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits. 1. A tissue closure assembly , comprising:a longitudinally extending body having a proximal portion for manual disposition and having a distal portion for insertion into an opening in a tissue layer, the distal portion having a first wall extending to a suture receiving element supported by the distal portion, and the proximal portion including a shield having a laterally extending surface beyond the first wall,wherein a first needle-receiving opening is defined at a first axial position on the longitudinally extending body and extends through the laterally extending surface of the shield, and an exit opening is defined at a second axial position on the longitudinally extending body distal of the first axial position and on a periphery of the first wall, andwherein the laterally extending surface of the shield and the first wall are perpendicularly oriented relative to each other such that the body defines a linear path from the first needle-receiving opening to the exit opening, wherein the linear path is aligned with the suture receiving element when the suture receiving element is in a deployed position.2. The tissue closure assembly of claim 1 , further comprising a pull rod extending along a length of the longitudinally extending body claim 1 , wherein a distal end of the pull rod is connected to the suture receiving element claim 1 , andwherein actuation of the pull rod in a proximal direction, relative to the longitudinally extending body, extends the suture receiving element ...

APPARATUS AND METHODS FOR SEALING A VASCULAR PUNCTURE

An apparatus for sealing a puncture through tissue to a vessel includes an elongate occlusion member including an expandable member, a cartridge carried on the occlusion member, and a sealant carried within the cartridge. The cartridge includes an outer member and a pusher member within the outer member. The sealant is disposed within the outer member adjacent the expandable member distal to the pusher member. During use, the occlusion member is introduced into a puncture until the expandable member and the sealant extend from the puncture into the vessel. The expandable member is expanded, and withdrawn until the expanded expandable member contacts the vessel wall, thereby withdrawing the sealant back into the puncture. The outer member is withdrawn to expose the sealant within the puncture, while the pusher member prevents removal of the sealant, and then the cartridge, occlusion member, and pusher member are successively removed. 138-. (canceled)39. A method for closing a puncture extending through tissue to a body lumen , comprising: providing an apparatus comprising an elongate occlusion member including an expandable member on a distal end thereof; a tubular member slideably disposed around the occlusion member; and a sealant disposed within the tubular member adjacent the expandable member;', 'introducing the occlusion member distal end including the sealant disposed thereon and adjacent the expandable member, into the puncture with the expandable member in a contracted condition until the expandable member and the sealant extend from the puncture into the body lumen;', 'radially enlarging the expandable member;', 'at least partially withdrawing the occlusion member from the puncture until the expanded expandable member contacts a wall of the body lumen adjacent the puncture, thereby withdrawing the sealant back into the puncture;', 'disengaging the tubular member from the occlusion member;', 'exposing the sealant within the puncture by at least partially ...

Devices and Methods for Delivery of Materials into the Nose

The various embodiments of the subject invention included herein provide devices and methods to deliver nasal packing material to a body lumen, cavity, or other anatomical structure along with methods of use of the same. 1. A device for use in positioning a material in a nasal cavity of a subject , comprising;a handle having a distal end, a proximal end and a channel wherein the handle is disposed at the proximal end of the device;an actuator slidably disposed on the handle;an elongate member having a distal end, a proximal end and at least one lumen, wherein the proximal end is joined to the distal end of the handle;a shuttle having a distal end and a proximal end slidably disposed on the elongate member;a link member having a distal end and a proximal end slidably disposed on the elongate member and the handle, wherein the distal end of the link member is joined to the shuttle and the proximal end is joined to the actuator.2. The device of claim 1 , wherein movement of the actuator along the handle is directly translated to the shuttle via the link member.3. The device of claim 1 , wherein the shuttle comprises at least two tines.4. The device of claim 1 , wherein the shuttle comprises a shape that is U-shaped in cross section.5. The device of claim 1 , wherein the shuttle extends beyond the distal end of the elongate member6. The device of claim 1 , wherein a portion of the actuator is disposed within the handle and a portion of the actuator is external to a surface of the handle.7. The device of claim 1 , wherein a longitudinal axis of the elongate member is offset from a longitudinal axis of the handle.8. A device for use in positioning a material in a nasal cavity of a subject claim 1 , comprising;a handle having a distal end, a proximal end and a channel wherein the handle is disposed at the proximal end of the device;an actuator disposed on the handle;a disk slidably disposed in the channel of the handle;an elongate member having a distal end, a proximal end ...

Sliding suture grasper

A device to assist in securing a holding a portion of a suture during an intra-abdominal suturing procedure, the device including an elongated tubular body, a handle, an inner member element, and a push button. The inner member element may include at least one grasping element that expands as the at least one grasping element is extended beyond a distal end of the elongated tubular. The device may include a proximal spring disposed within the push button and abutting against a proximal end of the inner member element to allow the at least one grasping element to retract into the elongated tubular body in a proximal direction.

HYDROGEL COMPOSITIONS

Fragmented polysaccharide based hydrogel compositions and methods of making and using the same are provided. The subject polysaccharide based hydrogel compositions are prepared by combining a polysaccharide component with a hydrophilic polymer and a cross-linking agent. Also provided are kits and systems for use in preparing the subject compositions. 142-. (canceled)43. A method comprising administering a hydrogel composition to a subject , the hydrogel composition comprising an acetylated polysaccharide , a multifunctional , multi-armed polyethylene glycol polymer and a multifunctional , multi-armed crosslinker of polyethylene glycol , wherein:the acetylated polysaccharide or derivative thereof has a molecular weight of 1000 Dalton to 80,300 Dalton, a degree of deacetylation of 70% to 99%, and at least two nucleophilic groups and is directly covalently bonded to the multifunctional, multi-armed polyethylene glycol polymer and directly covalently bonded to the multifunctional, multi-armed crosslinker of polyethylene glycol;the multifunctional, multi-armed polyethylene glycol polymer has a molecular weight of 5,000 Dalton to 30,000 Dalton, and comprises at least two nucleophilic groups and is directly covalently bonded to the acetylated polysaccharide or derivative thereof and is directly covalently bonded to the multifunctional, multi-armed crosslinker of polyethylene glycol; andthe multifunctional, multi-armed crosslinker of polyethylene glycol has a molecular weight of 5,000 Dalton to 30,000 Dalton, and comprises at least two electrophilic groups and is directly covalently bonded to the acetylated polysaccharide or derivative thereof and is directly covalently bonded to the multifunctional, multi-armed polyethylene glycol polymer,wherein the acetylated polysaccharide or derivative thereof does not act as a cross-linking agent in the hydrogel.44. The method according to claim 43 , wherein administering comprises positioning the hydrogel composition over at least a ...

DEVICES AND METHODS FOR NASAL SPLINTING

A nasal splint and methods for using such splints are provided. The nasal splint may include an elongate generally planar member comprising first and second ends, and a first outer surface and an opposite second outer surface; a tubular airway extending along the first outer surface at least partially between the first and second ends, thereby defining a lumen having an opening adjacent the first end; and a structure on one of the elongate member and tubular airway adjacent the first end supporting a feature that is spaced apart from the first outer surface and configured to support a suture across the opening when the suture is directed through the elongate member adjacent the first end and the feature. 1. A nasal splint , comprising:an elongate generally planar member comprising first and second ends, and a first outer surface and an opposite second outer surface extending between the first and second ends;a tubular airway extending along the first outer surface at least partially between the first and second ends, thereby defining a lumen having an opening adjacent the first end; anda structure on one of the elongate member and the tubular airway adjacent the first end supporting a feature that is spaced apart from the first outer surface and configured to support a suture at least partially across the opening when the suture is directed through the elongate member adjacent the first end to the feature.2. The nasal splint of claim 1 , wherein the structure comprises a tubular segment connected to the tubular airway adjacent the opening claim 1 , and wherein the feature is an opening in the tubular segment spaced at least partially across the opening from the first outer surface.3. The nasal splint of claim 2 , wherein the tubular segment is sized to accommodate a suture needle.4. The nasal splint of claim 1 , wherein the structure comprises an annular ridge connected to the first outer surface of the elongate member.5. The nasal splint of claim 1 , wherein the ...

DEVICES AND METHODS FOR THE TREATMENT OF VASCULAR DISEASE

Apparatus and methods are provided for delivering fluid into a body lumen. The apparatus may include a catheter including proximal and distal ends, a fluid delivery lumen extending from the proximal end to a transit port on a distal portion of the catheter, and an inflatable infusion element on the distal portion such that an interior of the inflatable infusion element communicates with the fluid delivery lumen. During use, a distal end of the catheter is introduced into a lumen or conduit with the inflatable infusion element in a collapsed condition, the inflatable infusion element is expanded to an expanded condition to partially or totally occlude the lumen or conduit, and fluid is infused from the catheter into the lumen or conduit proximally relative to the inflatable infusion element while the inflatable infusion element remains in the expanded condition. 1. A catheter for treating a body lumen , comprising;an elongate member comprising a proximal end, a distal end sized for introduction into a body lumen, a hub on the proximal end, and a fluid delivery lumen communicating between an inlet port on the hub and a transit port on a distal portion of the elongate member; andan inflatable infusion element on the distal portion such that an interior of the inflatable infusion element communicates with the fluid delivery lumen via the transit port, an infusion exit port on a proximal side of the inflatable infusion element configured to deliver fluid introduced into the interior of the inflatable infusion element out the infusion exit port towards the proximal end.2. The catheter of claim 1 , wherein the elongate member comprises a plurality of transit ports on the distal portion communicating between the fluid delivery lumen and the interior of the inflatable infusion element.3. The catheter of claim 1 , wherein the inflatable infusion element comprises a plurality of exit ports on the proximal side thereof for delivering fluid from the interior of the inflatable ...

VASCULAR ACCESS DEVICES AND METHODS FOR LOWER LIMB INTERVENTIONS

A guide sheath device with an integrated stabilization wire is provided. The guide sheath device includes an elongate member having a proximal and distal end and a lumen there between and a stabilization wire integrated to the elongate member. 1. A guide sheath apparatus for performing a lower extremity endovascular procedure , the apparatus comprising:an elongate member having a proximal and distal end and a lumen therebetween, the elongate member configured to be inserted into a lower extremity vasculature via a contralateral percutaneous access; anda stabilization wire having a proximal end and a distal end partially integrated into and along a wall of the elongate member, the stabilization wire configured to bifurcate away from the elongate member at a transition point between the proximal end and the distal end of the elongate member, and the stabilization wire configured to exit the lower extremity vasculature via an ipsilateral percutaneous access.2. The guide sheath apparatus of claim 1 , further comprising a snare device configured to be inserted into the lower extremity vasculature via an ipsilateral percutaneous access.3. The guide sheath apparatus of claim 2 , wherein the snare device comprises a snare sheath containing a snare wire having a snare loop at a distal end of the snare wire claim 2 , the snare loop configured to snare and capture the distal end of the stabilization wire.4. The apparatus of claim 1 , wherein the transition point of the bifurcation comprises at least a radio opaque marker.5. The guide sheath apparatus of claim 1 , wherein the transition point of bifurcation is closer to the distal end of the elongate member than the proximal end of the elongate member.6. The guide sheath apparatus of claim 1 , wherein the stabilization wire is one of a flat wire or a round wire.7. The guide sheath apparatus of claim 1 , wherein the proximal end of the elongate member is outside the contralateral percutaneous access and the distal end of the ...

APPARATUS AND METHODS FOR TISSUE CLOSURE

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits. 1a longitudinally extending body having a proximal portion for manual disposition and having a distal portion for insertion into an opening in a tissue layer, the distal portion having a first wall extending to a suture holding element supported by the distal portion,wherein a first needle-receiving opening is defined at a first axial position on the longitudinally extending body, and an exit opening is defined at a second axial position on the longitudinally extending body distal of the first axial position and on a periphery of the first wall, andwherein the longitudinally extending body defines a path from the first needle-receiving opening to the exit opening, and the path is aligned with the suture holding element when the suture holding element is in a deployed position.. A tissue closure assembly, comprising: This application is a continuation of U.S. patent application Ser. No. 15/583,879 (filed May 1, 2017), which is a continuation of U.S. patent application Ser. No. 14/589,647 (filed Jan. 5, 2015, now U.S. Pat. No. 9,636,105), which is a continuation of U.S. patent application Ser. No. 13/144,291 (filed Oct. 3, 2011, now U.S. Pat. No. 8,926,639), which is the national stage of International Application No. PCT/US2010/020652 (filed Jan. 11, 2010), which claims the benefit of U.S. Provisional Patent Application No. 61/144,151 (filed Jan. 12, 2009), the disclosures of which are hereby incorporated by reference as if set forth in its entirety herein.This relates to tissue ...

Fragmented Hydrogels

Fragmented polysaccharide based hydrogel compositions and methods of making and using the same are provided. The subject polysaccharide based hydrogel compositions are prepared by combining a polysaccharide component with a hydrophilic polymer and a cross-linking agent. Also provided are kits and systems for use in preparing the subject compositions. 142-. (canceled)43. A composition , comprisinga biologically active agent; and a polysaccharide or derivative thereof having a molecular weight of 1000 Dalton to 80,300 Dalton, a degree of deacetylation of 70% to 99%, and at least two nucleophilic groups;', 'a multifunctional, multi-armed polyethylene glycol polymer of a molecular weight of 5,000 Dalton to 30,000 Dalton, and comprising at least two nucleophilic groups; and', 'a multifunctional, multi-armed crosslinker of polyethylene glycol having a molecular weight of 5,000 Dalton to 30,000 Dalton, and comprising at least two electrophilic groups,', 'wherein the polysaccharide or derivative thereof does not act as a cross-linking agent in the hydrogel., 'a hydrogel, comprising44. The composition of claim 43 , wherein the biologically active agent is a steroid.45. The composition of claim 44 , wherein the steroid is mometasone furoate or triamcinolone.46. The composition of claim 43 , wherein the biologically active agent is an antibiotic.47. The composition of claim 46 , wherein the antibiotic is gentamicin.48. The composition of claim 43 , wherein the biologically active agent is a plasma protein claim 43 , an enzyme claim 43 , an antiseptic agent claim 43 , an antineoplastic agent claim 43 , an antifungal agent claim 43 , an antiviral agent claim 43 , an anti-inflammatory agent claim 43 , a growth factor claim 43 , an anesthetic claim 43 , a cell suspension claim 43 , a cytotoxin claim 43 , a cell proliferation inhibitor claim 43 , a biomimetic claim 43 , an analgesic claim 43 , a chemotherapeutic claim 43 , a vasoconstrictor claim 43 , a vasodilator claim 43 , a ...

Regroomable Balloon Catheter System and Methods of Use

The various embodiments of the subject invention included herein provide devices, systems and methods for aiding the regrooming or refolding of balloons upon deflation. The scope of the inventions in this specification includes methods and devices that reduce the profile of balloons after deflation, reduce or eliminate wings, high-points, irregularities, bunching, thickening, and the like, and facilitate passage of a deflated balloon through a body void or lumen, or through a medical device such as a guide catheter, guide sheath, femoral or radial introducer sheath, and the like. 1. A device to return an inflated balloon to a substantially low profile following deflation , comprising:an elongate catheter shaft comprising a proximal end and a distal end defining a longitudinal axis there between and a lumen extending between the proximal end and the distal end;an expandable member comprising an interior, an exterior, a proximal end, and a distal end, wherein the proximal end is coupled to the distal end of the elongate catheter shaft such that the interior of the expandable member is in communication with the lumen of the elongate catheter shaft, and wherein the expandable member is expandable from a collapsed state to an expanded state when pressurized;a stationary inner member comprising a proximal end and a distal end, wherein the distal end of the expandable member is positioned at the distal end of the stationary inner member;a catheter hub comprising a biasing member, wherein the catheter hub comprises an inflation port and is positioned at the proximal end of the stationary inner member;wherein the biasing member is slidably disposed within the catheter hub and wherein the distal end of the biasing member is positioned at the proximal end of the elongate catheter shaft, and wherein the biasing member is configured to pull the elongate catheter shaft in a lateral motion in a proximal direction when the expandable member is not pressurized to thereby at least ...

DEVICES AND METHODS FOR NASAL SPLINTING

A nasal splint and methods for using such splints are provided. The nasal splint may include an elongate generally planar member comprising first and second ends, and a first outer surface and an opposite second outer surface; a tubular airway extending along the first outer surface at least partially between the first and second ends, thereby defining a lumen having an opening adjacent the first end; and a structure on one of the elongate member and tubular airway adjacent the first end supporting a feature that is spaced apart from the first outer surface and configured to support a suture across the opening when the suture is directed through the elongate member adjacent the first end and the feature. 123-. (canceled)24. A method for treating a patient , comprising:inserting a nasal splint into the patient's sinus, the nasal splint comprising an elongate planar member and an airway lumen extending along a first surface of the elongate member;positioning a second surface of the elongate member against the sinus septum such that the airway lumen extends along the patient's sinus; anddirecting a suture through the patient's septum, the elongate member, and a structure on the nasal splint such that the suture extends across a portion of the airway lumen.25. The method of claim 24 , further comprising:inserting a cutting instrument into the portion of the airway lumen;cutting the suture; andremoving the nasal splint.26. The method of claim 24 , wherein the nasal splint comprises a first nasal splint claim 24 , the method further comprising:inserting a second nasal splint into the patient's sinus opposite the nasal septum from the first nasal splint, the second nasal splint comprising an elongate planar member, an airway lumen extending along a first surface of the elongate member; andpositioning a second surface of the elongate member of the second nasal splint adjacent the sinus septum such that the airway lumen extends along the patient's sinus,wherein directing a ...

SLIDING SUTURE GRASPER

A device to assist in securing a holding a portion of a suture during an intra-abdominal suturing procedure, the device including an elongated tubular body, a handle, an inner member element, and a push button. The inner member element may include at least one grasping element that expands as the at least one grasping element is extended beyond a distal end of the elongated tubular. The device may include a proximal spring disposed within the push button and abutting against a proximal end of the inner member element to allow the at least one grasping element to retract into the elongated tubular body in a proximal direction. 1. An instrument comprising:an elongated body defining an inner lumen, the elongated tubular body having a proximal end and a distal end;a handle attached to the proximal end of the elongated body;an inner member slidably disposed within the lumen of the elongated body, the inner member having a distal end effector;a push button extending from a proximal end of the handle, the push button configured to actuate or move the inner member;a first spring disposed between the push button and the inner member, the first spring being configured to bias the inner member in a distal direction; anda second spring configured to bias the push button and the inner member in a proximal direction.2. The instrument of claim 1 , wherein the first spring is configured to compress when the distal end effector is pushed into the elongated body claim 1 , and the second spring is configured to compress when the push button is pushed distally to advance the end effector out of the elongated body3. The instrument of claim 1 , wherein the second spring engages the push button.4. The instrument of claim 3 , wherein the second spring engages a distal end of the push button.5. The instrument of claim 1 , wherein the second spring is disposed around the inner member.6. The instrument of claim 1 , wherein the second spring biases the push button against a proximal end of the ...

DEVICES AND METHODS FOR DRAINAGE, INFUSION, OR INSTILLATION OF FLUIDS

Valve devices are provided for draining fluids from and/or infusing fluids into a patient's body that include a housing including first, second, and third connectors, a primary fluid path communicating between the first and second connectors, and a secondary fluid path communicating from the primary fluid path to the third connector. First and second valve members are movable within the housing between first positions wherein the valve members do not obstruct the primary fluid path and second positions wherein the primary fluid path is at least partially closed. The third connector may be configured to prevent fluid flow therethrough unless a mating connector is fully coupled thereto. The valve members may be selectively closed to isolate portions of the flow path to allow a source of vacuum or fluid coupled to the third connector to aspirate or infuse fluid along portions of the primary fluid path. 1. A valve device for draining fluids from and/or infusing fluids into a patient's body , comprising:a housing comprising first, second, and third connectors, and a primary fluid path communicating between the first and second connectors and a secondary fluid path communicating from the primary fluid path to the third connector, wherein the third connector is configured to prevent fluid flow therethrough unless a mating connector is fully coupled thereto;a first valve member movable within the housing between a first position wherein the first valve member does not obstruct the primary fluid path and a second position wherein the primary fluid path is closed to prevent fluid flow through the first connector; anda second valve member movable within the housing between a first position wherein the second valve member does not obstruct the primary fluid path and a second position wherein the primary fluid path is closed to prevent fluid flow through the second connector.2. The valve device of claim 1 , wherein the first valve member is biased to the first position.3. The ...

Superabsorbent, freeze dried hydrogels for medical applications

Methods are provided for making freeze dried hydrogel and structures therefrom that may be introduced into a patient's body for medical applications. Precursor components are combined to initiate crosslinking. The combined precursor components are placed in a chilled tray, and allowed to crosslink to a desired level of complete crosslinking before and/or after being placed onto the tray. The partially crosslinked hydrogel is frozen and freeze dried. After freeze drying, the hydrogel is conditioned to substantially complete crosslinking, and formed into one or more structures, e.g., plugs, hemostatic, or other medical devices. For example, the hydrogel may be cut, machined, rolled, folded, compressed, and/or cored into that may be loaded into delivery devices that may be introduced into a body to implant or otherwise deliver the structures into the body, e.g., to seal a puncture or other passage through tissue.

VASCULAR ACCESS DEVICES AND METHODS FOR LOWER LIMB INTERVENTIONS

A guide sheath device with an integrated stabilization wire is provided. The guide sheath device includes an elongate member having a proximal and distal end and a lumen there between and a stabilization wire integrated to the elongate member. 1. A guide sheath apparatus for performing endovascular procedures , the apparatus comprising:an elongate member having a proximal and distal end and a lumen therebetween, wherein the elongate member comprises one or more radiopaque markers along its length; anda stabilization wire connected at or near the distal end of the elongate member, andwherein the proximal end comprises a hub with a hemostasis valve.2. The apparatus of claim 1 , further comprising a removable dilator having a second elongate member with a proximal and a distal end and a lumen therebetween.3. The apparatus of claim 1 , further comprising a tool configured to anchor the stabilization wire in place.4. The apparatus of claim 2 , wherein the lumen is capable of allowing passage of guide wires.5. The apparatus of claim 1 , wherein the stabilization wire extends beyond the distal tip of the elongate member.6. The apparatus of claim 1 , wherein the elongate member comprises at least one radiopaque marker.7. The apparatus of claim 1 , wherein the stabilization wire bifurcates away from the surface of the elongate member at a transition point.8. The apparatus of claim 7 , wherein a transition point of bifurcation is located between the proximal and distal end of the elongate member.9. The apparatus of claim 8 , wherein the transition point of bifurcation comprises a radiopaque marker.10. An apparatus of claim 1 , wherein the elongate member comprises a radiopaque filler.11. The apparatus of claim 1 , wherein the stabilization wire comprises at least one of a round or flat material.12. A method for performing an endovascular procedure claim 1 , the method comprising:obtaining bilateral, percutaneous retrograde access sites in the left and right common femoral ...

MODIFIED FIXED FLAT WIRE BIFURCATED CATHETER AND ITS APPLICATION IN LOWER EXTREMITY INTERVENTIONS

A bifurcated catheter and methods of use are disclosed herein. The bifurcated catheter can include a fixed flat wire that is configurable as a stabilization wire. The bifurcated catheter can be configured to improve the initial access and directability by application of a pull force to the stabilization wire, in addition to a push force from the proximal end of the bifurcated catheter. The stabilization wire is anchored once the bifurcated catheter is positioned. The anchored, bifurcated catheter provides stability and pushability to assist the procedural catheter in traversing the tortuous peripheral vasculature. 1. A system for performing a lower extremity intervention procedure , the system comprising:a bifurcated catheter comprising a proximal end and a distal end, wherein the distal end of the bifurcated catheter comprises a bifurcation, and wherein the bifurcated catheter further comprises at least one lumen that extends from the proximal end to the distal end of the bifurcated catheter, and wherein the bifurcated catheter further comprises a side hole; anda flat wire attached within the at least one lumen of the bifurcated catheter, wherein the flat wire is attached to an inner wall of the at least one lumen of the bifurcated catheter from the proximal end to the bifurcation at the distal end;wherein the flat wire is configured to emerge from the side hole and function as a stabilization wire.2. The system of claim 1 , wherein the bifurcation is 2 cm from the distal end of the bifurcated catheter.3. The system of claim 1 , wherein the flat wire is configured to emerge as the stabilization wire from the side hole and extend for a length up to 10 cm beyond the bifurcation.4. The system of claim 1 , wherein the bifurcated catheter further comprises a procedural lumen and a stabilization lumen claim 1 , wherein the stabilization lumen is smaller than the procedural lumen.5. The system of claim 4 , wherein the side hole is in the stabilization lumen claim 4 , and ...

FRAGMENTED HYDROGELS

Fragmented polysaccharide based hydrogel compositions and methods of making and using the same are provided. The subject polysaccharide based hydrogel compositions are prepared by combining a polysaccharide component with a hydrophilic polymer and a cross-linking agent. Also provided are kits and systems for use in preparing the subject compositions. 142-. (canceled)43. A composition comprising a plurality of hydrogel fragments , wherein each hydrogel fragment in the composition comprises:a biologically active agent; and the acetylated polysaccharide or derivative thereof has a molecular weight of 1000 Dalton to 80,300 Dalton, a degree of deacetylation of 70% to 99%, and at least two nucleophilic groups and is directly covalently bonded to the multifunctional, multi-armed polyethylene glycol polymer and directly covalently bonded to the multifunctional, multi-armed crosslinker of polyethylene glycol;', 'the multifunctional, multi-armed polyethylene glycol polymer has a molecular weight of 5,000 Dalton to 30,000 Dalton, and comprises at least two nucleophilic groups and is directly covalently bonded to the acetylated polysaccharide or derivative thereof and is directly covalently bonded to the multifunctional, multi-armed crosslinker of polyethylene glycol; and', 'the multifunctional, multi-armed crosslinker of polyethylene glycol has a molecular weight of 5,000 Dalton to 30,000 Dalton, and comprises at least two electrophilic groups and is directly covalently bonded to the acetylated polysaccharide or derivative thereof and is directly covalently bonded to the multifunctional, multi-armed polyethylene glycol polymer,', 'wherein the acetylated polysaccharide or derivative thereof does not act as a cross-linking agent in the hydrogel., 'a hydrogel comprising an acetylated polysaccharide, a multifunctional, multi-armed polyethylene glycol polymer and a multifunctional, multi-armed crosslinker of polyethylene glycol, wherein44. The composition of claim 43 , wherein the ...

APPARATUS AND METHODS FOR SEALING A VASCULAR PUNCTURE

Apparatus for sealing a puncture communicating with a blood vessel includes a porous carrier formed from lyophilized hydrogel or other material. The plug may include at least first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture. 145-. (canceled)46. An apparatus for sealing a blood vessel wall penetration disposed at an end of a tissue tract , said apparatus comprising:a shaft having a proximal end and a distal end;a mechanically expandable structure near the distal end of the shaft, said mechanically expandable structure configured for deployment within the blood vessel to occlude the penetration; anda carrier disposed on an exterior surface of the shaft proximal to the mechanically expandable structure.47. The apparatus as in claim 46 , wherein the mechanically expandable structure is an expandable wire mesh.48. The apparatus as in claim 46 , wherein the carrier is a pro-thrombotic material.49. The apparatus as in claim 48 , wherein the pro-thrombotic material is selected from the group consisting of collagen claim 48 , fibrin claim 48 , carboxymethylcellulose claim 48 , oxidized cellulose claim 48 , alginates claim 48 , gelatin claim 48 , polyglycolic acids (PGA) claim 48 , polyactides (PLA) claim 48 , and polyvinyl alcohol.50. The apparatus as in claim 48 , wherein the pro-thrombotic material is collagen.51. The apparatus as in claim 46 , wherein the mechanically expandable structure is transformable between a radially contracted ...

METHODS FOR SEALING A CASCULAR PUNCTURE

Apparatus and methods for sealing a puncture communicating with a blood vessel are provided that include introducing a porous carrier formed from lyophilized hydrogel or other material into the puncture. The plug may include at least one of first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture. 1. A device for sealing a puncture extending through tissue , comprising:a carrier in a predetermined shape;a first hydrogel precursor disposed at least partially on an exterior surface of the carrier;a second hydrogel precursor disposed on the exterior surface of the carrier, the first and second precursors remaining in an unreactive state on the carrier prior to exposure to an aqueous physiological environment, whereupon the first and second precursors react to form a hydrogel.2. The device of claim 1 , wherein the predetermined shape comprises a disk shape claim 1 , a solid cylindrical shape claim 1 , a rolled sheet cylindrical shape claim 1 , or a folded sheet cylindrical shape.3. The device of claim 1 , the carrier comprising a lumen extending between proximal and distal ends thereof.4. The device of claim 1 , the carrier comprising hydrogel.5. The device of claim 4 , the hydrogel comprising PEG.6. The device of claim 1 , the carrier comprising lyophilized or dehydrated hydrogel.7. The device of claim 1 , the carrier comprising pro thrombotic material.8. The device of claim 7 , the carrier comprising a material selected from the group consisting ...

DEVICES AND METHODS FOR THE DILATION OF SINUS OSTIA AND OTHER BODY PASSAGES

Apparatus and methods are disclosed to dilate a sinus ostium or other body passage. In one embodiment, the apparatus includes an elongate inner member, one or more dilation members disposed concentrically around the inner member, and an outer sheath. The inner member includes a distal portion that extends beyond distal end of the dilation member(s). The sheath is disposed around the inner member and dilation member(s) and is at least partially expandable to accommodate advancement of the dilation member(s) relative to the inner member, e.g., to translate axial forces into radial dilating forces, and dilate surrounding tissue within which the distal portion is introduced. Optionally, an elastic cover is provided over at least a portion of the inner member distal portion to enhance constraining the sheath, e.g., after withdrawing the dilation member(s). 1. An apparatus for dilating a body passage , comprising:an elongate inner member comprising a proximal end, a distal end, and a distal portion;a first dilation member comprising a proximal end, a distal end, and a first lumen extending between the first dilation member proximal and distal ends, the inner member disposed within the first lumen such that the distal portion extends beyond the first dilation member distal end;a second dilation member comprising a proximal end, a distal end, and a second lumen extending between the second dilation member proximal and distal ends, the first dilation member disposed within the second lumen such that the first dilation member distal end is disposed distally to the second dilation member distal end;a sheath disposed concentrically around at least the distal portion of the inner member and at least around the distal ends of the first and second dilation members, the sheath being expandable to accommodate advancement of the second dilation member over the distal portion;a handle coupled to a proximal end of the sheath and including an interior housing the proximal ends of the ...

APPARATUS AND METHODS FOR SEALING A PUNCTURE IN TISSUE

An occlusion device for sealing a puncture through tissue includes a tubular wire member having a proximal end, a distal end sized for insertion into the puncture, a lumen extending between the proximal and distal ends, a port adjacent the proximal end communicating with the 5 lumen, and a balloon on the distal end. A source of fluid is connectable to the wire member for delivering fluid via the port into the lumen for expanding the balloon. A fluid loading device is disposed on the proximal end of the wire member to receive the source of fluid and to deliver fluid within the lumen into the balloon to expand the balloon. 1. An occlusion device for sealing a puncture through tissue , comprising:an elongate tubular member comprising a proximal end, a distal end sized for insertion into a puncture, a lumen extending at least partially between the proximal and distal ends, and an expandable occlusion element carried on a distal region of the tubular member, the occlusion element having an interior communicating with a distal opening in the lumen, the tubular member having a substantially uniform diameter extending between the proximal end and the distal region; anda fluid loading device receivable on the proximal end of the elongate tubular member for delivering fluid into, and drawing fluid out of, the interior of the occlusion element to thereby expand and collapse the occlusion element.2. The device of claim 1 , wherein the fluid loading device further comprises a connector to connect a source of fluid to a housing of the fluid loading device.3. The device of claim 2 , wherein the source of fluid is a syringe.4. The device of claim 2 , wherein the housing further comprises a shut-off mechanism having an open and a closed position.5. The device of claim 4 , wherein the open position of the shut-off mechanism allows for the source of fluid to evacuate substantially all the air out of the lumen of the elongate tubular member and/or out of the interior of the occlusion ...

DEVICES, SYSTEMS, AND METHODS FOR THE EMBOLIZATION OF BODY LUMENS

Systems and methods for embolizing body lumens are provided that include a mixing component provided in a flow path between two chambers, e.g., syringes, such that one or more actuators may direct embolic material back and forth between the two chambers through the mixing component to mix the embolic material. Once mixed, the embolic material may be delivered from one of the chambers through a catheter into a patient's body to embolize a target location. 1. A system for delivering embolic material into a target location within a patient's body , comprising:a first chamber including a first piston movable between a retracted position and a discharge position adjacent a first port, the first chamber comprising a flowable embolic material therein;a first actuator coupled to the first piston for directing the first piston from the retracted position to the discharge position to deliver the flowable embolic material from the first chamber out the first port when the first piston is moved from the retracted position to the discharge position;a second chamber including a second piston movable between a retracted position and a discharge position adjacent a second port, the second piston biased to move towards the discharge position;a diverter communicating with the first and second ports, and comprising a second actuator for opening one of a first flow path communicating between the first and second ports and a second flow path communicating between the first port and an outlet of the diverter; anda mixing component communicating with the first flow path for mixing the embolic material as the embolic material flows between the first chamber and the second chamber.2. The system of claim 1 , wherein:a) with the second actuator opening the first flow path, actuation of the first actuator causes the embolic material to exit the first chamber, pass along the first flow path through the mixing component to mix the embolic material and into the second chamber, thereby directing ...

Apparatus for treating vascular occlusions

An intravascular catheter system for the treatment of occluded blood vessels that includes tissue displacement or hinged expansion members that are movable from a closed to an open position. An actuating assembly may be, provided for moving the tissue expansion members between an open and closed position to exert a substantially lateral distal end force upon the region surrounding an occluded blood vessel. The tissue expansion members may stretch apart, tear or otherwise disrupt a vascular occlusion sufficiently to create a pathway that may support the passage or placement of a guidewire or an interventional vascular device across the occlusion or obstruction. Methods of crossing or displacing a vascular occlusion are further provided that include the positioning of a vascular catheter having at least one hinged spreading member positioned at the distal region of the catheter that is responsive to directed force along the longitudinal axis of the catheter. A directed force is applied to the actuator in order to deploy the spreading member and displace a vascular occlusion creating a path to permit the passage of a guidewire or device therethrough.

Implant deployment apparatus

Polysaccharide based hydrogels

599524 Disclosed herein are polysaccharide based hydrogel compositions and methods of making and using the same are provided. The subject polysaccharide based hydrogel compositions are prepared by combining a polysaccharide component with a hydrophilic polymer and a cross-linking agent. Also provided are kits and systems for use in preparing the subject compositions. Disclosed is a hydrogel composition comprising a polysaccharide substrate, such as chitosan, carboxymethylcellulose, carboxymethylchitosan, having a molecular weight of 160 Dalton to 80,300 Dalton and comprising at least two reactive nucleophilic groups; a synthetic, hydrophilic polymer, such as polyethylene glycol, with a molecular weight of 200 Dalton to 100,000 Dalton and comprising at least two nucleophilic reactive groups; and a crosslinking agent.

Apparatus and methods for sealing a vascular puncture

Apparatus and methods for sealing a puncture through tissue or otherwise treating a body lumen of a patient. The carrier includes at least one, but not all, of the adherent layer components required to form a tacky or sticky adherent layer on the carrier. The remaining adherent layer precursor(s) are delivered to the carrier in situ to form a sticky and/or tacky adherent layer on the carrier that enhances the attachment and retention of the carrier to tissue surrounding a target treatment location in which the carrier is delivered. The carrier may include hydrogel and/or other porous material, e.g., for releasing one or more agents carried by the carrier at the treatment location.

Intravascular tissue disruption

Disrupting tissue and devices and systems for disrupting tissue. The disclosure describes ways to deliver moieties to a target tissue, where the target tissue in general is not at the point of introduction, in such a way that minimal damage is produced in the tissue at the point of introduction. In some embodiments this is accomplished by jetting fluid at high velocity into the target tissue. The disclosure further describes novel agents deliverable in such systems for use in remodeling tissues. Some of these agents comprise a liquid while others do not. Additionally, although not specifically described in detail much of the disclosure may additionally be used in the delivery of therapeutic drugs.

Apparatus for sealing a puncture in tissue

Apparatus and method for sealing a puncture in tissue

An apparatus for sealing a puncture through tissue includes an elongate member having a lumen extending between proximal and distal ends thereof, and a balloon carried on the distal end. In one embodiment, a housing on the proximal end includes an interior communicating with the lumen, and a valve assembly, e.g., with a one-way valve allowing access into the interior upon applying a pressure differential across the valve, and a plunger for overriding and opening the valve. In another embodiment, a port adjacent the proximal end communicates with the lumen, and a fluid source is connectable to the elongate member for delivering fluid via the port into the lumen for expanding the balloon. A piston is movable axially within the elongate member to deliver fluid into the lumen, to isolate the lumen, and/or to deliver fluid within the lumen into the balloon to expand the balloon.

Fragmented hydrogels

Fragmented polysaccharide based hydrogel compositions and methods of making and using the same are provided. The subject polysaccharide based hydrogel compositions are prepared by combining a polysaccharide component with a hydrophilic polymer and a cross-linking agent. Also provided are kits and systems for use in preparing the subject compositions.

Devices, systems, and methods for the embolization of body lumens

Systems and methods for embolizing body lumens are provided that include a mixing component provided in a flow path between two chambers, e.g., syringes, such that one or more actuators may direct embolic material back and forth between the two chambers through the mixing component to mix the embolic material. Once mixed, the embolic material may be delivered from one of the chambers through a catheter into a patient's body to embolize a target location.

Methods and apparatus for treating vascular occlusions

An intravascular catheter system for the treatment of occluded blood vessels that includes tissue displacement or hinged expansion members that are movable from a closed to an open position. An actuating assembly may be provided for moving the tissue expansion members between an open and closed position to exert a substantially lateral distal end force upon the region surrounding an occluded blood vessel. The tissue expansion members may stretch apart, tear or otherwise disrupt a vascular occlusion sufficiently to create a pathway that may support the passage or placement of a guidewire or an interventional vascular device across the occlusion or obstruction. Methods of crossing or displacing a vascular occlusion are further provided that include the positioning of a vascular catheter having at least one hinged spreading member positioned at the distal region of the catheter that is responsive to directed force along the longitudinal axis of the catheter. A directed force is applied to the actuator in order to deploy the spreading member and displace a vascular occlusion creating a path to permit the passage of a guidewire or device therethrough.

Engine mount assembly and mounting system for a vehicle

An engine mount assembly is provided for mounting an engine to a vehicle frame. The engine mount assembly includes an elastomeric material snubber element having a generally elongated configuration with axial end faces and a coaxial bolt passage defined therethrough. A tubular sleeve has an inner shape sized for sliding receipt of the snubber element therein. The tubular sleeve has a longitudinal cross-sectional profile such that a bottom longitudinal cross-sectional portion of the tubular sleeve extends axially beyond the end faces of the snubber element and defines an enlarged attachment footprint for the tubular sleeve to a vehicle frame flange.

Systems and methods for providing penile modeling

A device for remodeling a penis, comprising a generally cylindrical hollow assembly having a lumen extending between proximal and distal ends, the distal end being in communication with the lumen to facilitate insertion of the penis into the lumen, the generally cylindrical structure having an interior surface facing the lumen and an exterior surface facing away from the lumen, a longitudinal direction and a transverse direction, the transverse direction being orthogonal to the longitudinal direction, the generally cylindrical assembly adapted to snugly and resiliently grip the penis, and includes an elastic fabric with one or more regions reinforced with a plastically deformable member.

Ligation clip

A surgical ligation clip and method of operation are described and include a top jaw member and bottom jaw member joined at a hinge section for movement about the hinge section. The hinge section can be offset or space laterally from one or both of the jaw members. Teeth arrangements and distributions are also described, as well as closing and jaw ends engagement configurations, for example for more easily engaging/piercing connective or other tissue.

A tool for inserting a stent into a catheter

In accordance with the present invention there is provided a stent insertion tool for insertion into a catheter prior to insertion of a balloon catheter having a stent crimped on the balloon. The tool is a rigid tubular member having a distal end for insertion into a catheter, a proximal for end for remaining outside of the catheter, and a longitudinal axis extending therebetween. The tool has a substantially smooth inner surface. The tool further includes a slot, having a predetermined width, extending along the longitudinal axis of the tubular member from its distal end to its proximal end.

Ligation clip

Laparoscopic fascial closure system

A tissue closure device to assist in retrieving a suture during a suturing procedure, the device including an elongated body having a proximal end, a distal end, and a lumen extending axially through the elongated body. The device further including an actuator rod at least partially extending through the lumen of the elongated body to actuate a plurality of wings and a plurality of shields attached to a distal end of the elongated body. The elongated body including at least one needle guide lumen with an opening an exit, the at least one needle guide lumen traversing the elongated body at an angle with respect to a central axis of the elongated body to guide a suture grasper to an enclosed suture retrieval cavity.

Crop residue and soil conditioning agricultural implement

A disc harrow composed of one or more disc gangs has a subframe coupled to the disc gangs to move the disc gangs in response to variations in farmland terrain to limit the impact of obstructions when encountered during the harrowing process. When the obstruction is cleared, the subframe automatically returns the disc gangs to their pre-obstruction position. In addition to reducing the potentially-damaging impact of obstructions, the subframe also maintains a more consistent reel depth during undulations or changes in the farmland terrain, such as during harrowing of slopes or unleveled fields such as valleys, near waterways, and along fence rows.

Apparatus and methods for accessing and treating a body cavity, lumen, or ostium

Apparatus and methods for sealing a puncture in tissue

An apparatus for sealing a puncture through tissue includes an elongate member having a lumen extending between proximal and distal ends thereof, and a balloon carried on the distal end. In one embodiment, a housing on the proximal end includes an interior communicating with the lumen, and a valve assembly, e.g., with a one-way valve allowing access into the interior upon applying a pressure differential across the valve, and a plunger for overriding and opening the valve. In another embodiment, a port adjacent the proximal end communicates with the lumen, and a fluid source is connectable to the elongate member for delivering fluid via the port into the lumen for expanding the balloon. A piston is movable axially within the elongate member to deliver fluid into the lumen, to isolate the lumen, and/or to deliver fluid within the lumen into the balloon to expand the balloon.

Laparoscopic fascial closure system

A tissue closure device to assist in retrieving a suture during a suturing procedure, the device including an elongated body having a proximal end, a distal end, and a lumen extending axially through the elongated body. The device further including an actuator rod at least partially extending through the lumen of the elongated body to actuate a plurality of wings and a plurality of shields attached to a distal end of the elongated body. The elongated body including at least one needle guide lumen with an opening an exit, the at least one needle guide lumen traversing the elongated body at an angle with respect to a central axis of the elongated body to guide a suture grasper to an enclosed suture retrieval cavity.

Devices and methods for the treatment of vascular disease

Apparatus and methods are provided for delivering fluid into a body lumen. The apparatus may include a catheter including proximal and distal ends, a fluid delivery lumen extending from the proximal end to a transit port on a distal portion of the catheter, and an inflatable infusion element on the distal portion such that an interior of the inflatable infusion element communicates with the fluid delivery lumen. During use, a distal end of the catheter is introduced into a lumen or conduit with the inflatable infusion element in a collapsed condition, the inflatable infusion element is expanded to an expanded condition to partially or totally occlude the lumen or conduit, and fluid is infused from the catheter into the lumen or conduit proximally relative to the inflatable infusion element while the inflatable infusion element remains in the expanded condition.

Devices and methods for the management and prevention of hernia and other musculosketal injuries

Implant deployment apparatus

A delivery system (100), including a restraining member (102), maintains a collapsed implant (106) in its collapsed state for delivery through a small passageway to a desired site in a mammalian body. Once the implant is positioned at the desired site, the restraining member is released so that the stent may expand or be expanded to its expanded state. In a preferred embodiment, the restraining member comprises a sheet of material that surrounds at least a portion of the collapsed stent. Portions of the restraining member are releasably coupled to one another with a low profile thread-like member or suture.

DEVICE FOR SEALING A POINT IN TISSUE

Apparatus for sealing a puncture in tissue

Systems and methods for providing penile modeling

A device for remodeling a penis, comprising a generally cylindrical hollow assembly having a lumen extending between proximal and distal ends, the distal end being in communication with the lumen to facilitate insertion of the penis into the lumen, the generally cylindrical structure having an interior surface facing the lumen and an exterior surface facing away from the lumen, a longitudinal direction and a transverse direction, the transverse direction being orthogonal to the longitudinal direction, the generally cylindrical assembly adapted to snugly and resiliently grip the penis, and includes an elastic fabric with one or more regions reinforced with a plastically deformable member.

Auto-retraction apparatus and methods for sealing a vascular puncture

Apparatus for sealing a puncture communicating with a blood vessel includes an introducer sheath, an occlusion member with a balloon thereon, a retraction assembly, and a syringe assembly including sealing material therein. During use, the introducer sheath is introduced into the puncture. With the balloon in a collapsed state, the occlusion member is introduced through the introducer sheath until the balloon is disposed within the vessel. The introducer sheath is coupled to the retraction assembly, the balloon is expanded, and the occlusion member is partially withdrawn to seal the puncture. A sealing compound is delivered from the syringe assembly through the introducer sheath into the puncture, the syringe assembly triggering the retraction assembly, whereupon the introducer sheath is automatically withdrawn at least partially from the puncture, delivering the sealing compound along the puncture.

Implant deployment apparatus

A delivery system including a restraining member maintains a collapsed implant in its collapsed state for delivery through a small passageway to a desired site in a mammalian body. Once the implant is positioned at the desired site, the restraining member is released so that the stent may expand or be expanded to its expanded state. In a preferred embodiment, the restraining member comprises a sheet of material that surrounds at least a portion of the collapsed stent. Portions of the restraining member are releasably coupled to one another with a low profile thread-like member or suture.

Systems for heart treatment

Devices and methods for treating degenerative, congestive heart disease and related dysfunction are described. Passive and active cardiac support structures mitigate changes in ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. Cardiac efficiency is improved by providing reinforcement that restores or maintains an elliptical ventricular shape and mimics the position and positive inotropic effects of helical wound myofibrils to provide active contraction of the ventricle in synchrony with the metabolically required cardiac pace or output. In addition, the cardiac support structures compensate or provide therapeutic treatment for congestive heart failure and/or reverse the remodeling that produces an enlarged heart. The structures may be implanted in target heart regions using less invasive surgical techniques, such as those involving port access or small incisions into the thoracic cavity.

Occlusion member and tensioner apparatus and methods of their use for sealing a vascular puncture

Apparatus for sealing a puncture includes an elongate occlusion member having a balloon attached to distal ends of telescoping inner and outer members. A housing on the proximal end of the outer member includes a piston coupled to the inner member and slidable within a chamber communicating with a fluid reservoir. A switch on the housing is actuated to direct fluid from the reservoir through the outer member into the balloon to expand the balloon and into the chamber to move the piston and pull the inner member, shortening the balloon as it expands. During use, the distal end of the occlusion member is introduced into a puncture communicating with a vessel until the collapsed balloon is disposed within the vessel. The balloon is expanded, and a tensioner is connected to the housing to apply a proximal force holding the balloon against the vessel wall to seal the puncture.

Devices and methods for the treatment of vascular disease

Apparatus and methods are provided for delivering fluid into a body lumen. The apparatus may include a catheter including proximal and distal ends, a fluid delivery lumen extending from the proximal end to a transit port on a distal portion of the catheter, and an inflatable infusion element on the distal portion such that an interior of the inflatable infusion element communicates with the fluid delivery lumen. During use, a distal end of the catheter is introduced into a lumen or conduit with the inflatable infusion element in a collapsed condition, the inflatable infusion element is expanded to an expanded condition to partially or totally occlude the lumen or conduit, and fluid is infused from the catheter into the lumen or conduit proximally relative to the inflatable infusion element while the inflatable infusion element remains in the expanded condition.

Implant deployment apparatus

Devices and methods for nasal splinting

A nasal splint and methods for using such splints are provided. The nasal splint may include an elongate generally planar member comprising first and second ends, and a first outer surface and an opposite second outer surface; a tubular airway extending along the first outer surface at least partially between the first and second ends, thereby defining a lumen having an opening adjacent the first end; and a structure on one of the elongate member and tubular airway adjacent the first end supporting a feature that is spaced apart from the first outer surface and configured to support a suture across the opening when the suture is directed through the elongate member adjacent the first end and the feature.

Implant deployment apparatus

Implant deployment apparatus

A delivery system (100), including a restraining member (102), maintains a collapsed implant (106) in its collapsed state for delivery through a small passageway to a desired site in a mammalian body. Once the implant is positioned at the desired site, the restraining member is released so that the stent may expand or be expanded to its expanded state. In a preferred embodiment, the restraining member comprises a sheet of material that surrounds at least a portion of the collapsed stent. Portions of the restraining member are releasably coupled to one another with a low profile thread-like member or suture.

TEXTURIZATION PROCEDURE FOR IMPLANTS OF SOFT FABRICS USING A POROUS MANDREL.

SE DESCRIBE UN METODO DE FABRICACION DE UN IMPLANTE DE TEJIDO BLANDO CON TEXTURA Y EL IMPLANTE REALIZADO MEDIANTE EL METODO. EL IMPLANTE SE REALIZA MEDIANTE LA FORMACION DE UNA CAPA SOBRE UN MANDRIL FABRICADO DE MATERIAL POROSO. EL MATERIAL ES PREFERIBLEMENTE CERAMICA POROSA O PLASTICO POROSO. EL TAMAÑO DE LOS POROS ES INFERIOR A 300 MICRONES Y PREFERIBLEMENTE EN EL RANGO DE 87 A 108 MICRONES. A METHOD OF MANUFACTURE OF A SOFT TEXTURE IMPLANT WITH TEXTURE AND THE IMPLANT PERFORMED THROUGH THE METHOD IS DESCRIBED. THE IMPLANT IS CARRIED OUT BY FORMING A LAYER ON A MANDRILE MANUFACTURED OF POROUS MATERIAL. THE MATERIAL IS PREFERIBLY CERAMIC POROUS OR PLASTIC POROUS. THE SIZE OF THE PORES IS LESS THAN 300 MICRONS AND PREFERIBLY IN THE RANGE OF 87 TO 108 MICRONS.

Ligation clip

A surgical ligation clip and method of operation are described and include a top jaw member and bottom jaw member joined at a hinge section for movement about the hinge section. The hinge section can be offset or space laterally from one or both of the jaw members. Teeth arrangements and distributions are also described, as well as closing and jaw ends engagement configurations, for example for more easily engaging/piercing connective or other tissue.

Laparoscopic fascial closure system

A tissue closure device to assist in retrieving a suture during a suturing procedure, the device including an elongated body having a proximal end, a distal end, and a lumen extending axially through the elongated body. The device further including an actuator rod at least partially extending through the lumen of the elongated body to actuate a plurality of wings and a plurality of shields attached to a distal end of the elongated body. The elongated body including at least one needle guide lumen with an opening an exit, the at least one needle guide lumen traversing the elongated body at an angle with respect to a central axis of the elongated body to guide a suture grasper to an enclosed suture retrieval cavity.

Sliding suture grasper

A device to assist in securing a holding a portion of a suture during an intra-abdominal suturing procedure, the device including an elongated tubular body, a handle, an inner member element, and a push button. The inner member element may include at least one grasping element that expands as the at least one grasping element is extended beyond a distal end of the elongated tubular. The device may include a proximal spring disposed within the push button and abutting against a proximal end of the inner member element to allow the at least one grasping element to retract into the elongated tubular body in a proximal direction.

Apparatus and methods for inflating and deflating balloon catheters

Among the various embodiments, objects and features of the present invention may generally be noted an inflation/deflation syringe that enables one-handed operation to inflate a medical device to a given pressure or volume and one-handed operation to deflate said medical device.

Apparatus for delivering haemostatic sealing materials

An apparatus for sealing a puncture extending through tissue to a blood vessel includes a guidewire including an expandable tamp, a retaining sheath for covering the tamp, and a delivery sheath including a primary lumen for receiving the guidewire therethrough and a secondary lumen for delivering sealing compound into the puncture. After introducing the sealing compound, the delivery sheath is removed, and an introducer sheath is advanced over the guidewire to provide access to perform a medical procedure via the vessel after removing the guidewire.

Apparatus and methods for accessing and treating a body cavity, lumen, or ostium

A method of treating a paranasal sinus ostium and a steerable balloon catheter are disclosed. The catheter has a tip indication mechanism that can be transformed inside a human or animal body into various geometric shapes without the aid of visualization of the transformed segment to treat or aid in the treatment of a body cavity, lumen, ostium.