Source: http://www.google.es/patents/US9668765
Timestamp: 2017-10-21 05:18:11
Document Index: 97835719

Matched Legal Cases: ['Application No. 07255018', 'Application No. 07255018', 'Application No. 07255019', 'Application No. 07255018', 'Application No. 07255018', 'Application No. 07255019', 'Application No. 14770860', 'Application No. 07255018', 'Application No. 07255018', 'Application No. 07255018', 'Application No. 2007', 'Application No. 2007', 'Application No. 07255018', 'Application No. 07255019', 'Application No. 2007', 'Application No. 2007', 'Application No. 2007', 'Application No. 2007', 'Application No. 2007', 'Application No. 2007', 'Application No. 2007', 'Application No. 2007']

Patente US9668765 - Retractable blade for lead removal device - Google Patentes
Methods and devices for separating an implanted object, such as a pacemaker lead, from tissue surrounding such object in a patient's vasculature system. Specifically, the tissue separating device includes a handle, an elongate sheath and a circular cutting blade that may extend from the distal end of...http://www.google.es/patents/US9668765?utm_source=gb-gplus-sharePatente US9668765 - Retractable blade for lead removal device
Número de publicación US9668765 B2
Número de solicitud US 13/834,405
Fecha de publicación 6 Jun 2017
También publicado como EP2967520A1, EP2967520A4, US20140277037, US20170224373, WO2014149843A1
Número de publicación 13834405, 834405, US 9668765 B2, US 9668765B2, US-B2-9668765, US9668765 B2, US9668765B2
Inventores Dustin L. GRACE, Kenneth P. Grace
Cesionario original The Spectranetics Corporation
Citas de patentes (768), Otras citas (86), Clasificaciones (6), Eventos legales (3)
Retractable blade for lead removal device
US 9668765 B2
Methods and devices for separating an implanted object, such as a pacemaker lead, from tissue surrounding such object in a patient's vasculature system. Specifically, the tissue separating device includes a handle, an elongate sheath and a circular cutting blade that may extend from the distal end of the sheath upon actuating the handle. The circular cutting blade is configured to engage the tissue surrounding an implanted lead and cut such tissue in a coring fashion as the device translates along the length of the lead, thereby allowing the lead, as well as any tissue remaining attached to the lead, to enter the device's elongate shaft. The tissue separating device includes a cam mechanism at the distal portion of the sheath that allows the user of the device to more accurately control the extension and rotation of the cutting blade upon being actuated by the handle.
1. A device for removing an implanted object from a body vessel, the device comprising:
an elongated sheath having a proximal end, a distal end, and a lumen extending from the distal end toward the proximal end, wherein the lumen is configured to receive an implanted object, the elongated sheath further comprising a proximal portion and a distal portion;
a hollow circular outer member attached to the distal portion of the elongated sheath;
a pin attached to the hollow circular outer member and extending inwardly thereof; and
a hollow circular inner member located within the outer member, the hollow circular inner member comprising a proximal end, a distal end and an exterior surface therebetween, the distal end comprising a cutting surface, the exterior surface of the inner member comprising a cam slot, wherein the cam slot comprises a cam slot configuration to receive the pin, whereupon actuation of the handle, the inner member rotates in a direction, and while rotating in the direction, the distal end of the inner member extends from a refracted position to an extended position beyond the distal end of the elongated sheath and returns to the retracted position based at least in part upon the cam slot configuration.
2. The device of claim 1, wherein the cam slot has a length that is about the same as the circumference of the hollow circular inner member.
3. The device of claim 1, wherein the cam slot has a length that is shorter than the circumference of the hollow circular inner member.
4. The device of claim 1, wherein the cam slot has a length that is longer than the circumference of the hollow circular inner member.
5. The device of claim 4, wherein the length of the cam that is longer than the circumference of the hollow circular inner member is substantially parallel to the proximal end of the hollow circular inner member.
6. The device of claim 1, wherein the cam slot has a length that is about twice the circumference of the hollow circular inner member.
7. The device of claim 1, wherein the cam slot surrounds the entire circumference of the hollow circular inner member.
8. The device of claim 7, wherein the cam slot surrounds the circumference of the hollow circular inner member more than once.
9. The device of claim 7, wherein a portion of the cam slot that surrounds the circumference of the hollow circular inner member more than once is substantially parallel to the proximal end of the hollow circular inner member.
10. The device of claim 7, wherein the cam slot surrounds the circumference of the hollow circular inner member twice.
11. The device of claim 1, wherein the configuration of the cam slot is configured to move the distal end of the hollow circular inner member to extend beyond the distal end of the elongated sheath a predetermined length.
12. The device of claim 11, wherein the hollow circular inner member rotates about one revolution in order to drive the distal end of the hollow circular inner member to extend said predetermined length beyond the distal end of the elongated sheath.
13. The device of claim 11, wherein the hollow circular inner member rotates about two revolutions in order to drive the distal end of the hollow circular inner member to extend said predetermined length beyond the distal end of the elongated sheath.
14. The device of claim 11, wherein the hollow circular inner member rotates between one revolution and two revolutions in order to drive the distal end of the hollow circular inner member to extend said predetermined length beyond the distal end of the elongated sheath.
15. The device of claim 11, wherein the hollow circular inner member rotates more than two revolutions in order to drive the distal end of the hollow circular inner member to extend said predetermined length beyond the distal end of the elongated sheath.
16. The device of claim 1, wherein the cam slot has a first portion and a second portion, wherein the first portion is configured to extend the hollow circular inner member a first predetermined length beyond the distal end of the elongated sheath, and wherein the second portion is configured to extend the hollow circular inner member a second predetermined length beyond the distal end of the elongated sheath.
17. The device of claim 16, wherein the first predetermined length is different than the second predetermined length.
18. The device of claim 17, wherein the first predetermined length is shorter than the second predetermined length.
19. The device of claim 17, wherein the first predetermined length is longer than the second predetermined length.
20. The device of claim 1, wherein the cam slot configuration has a first portion and a second portion, wherein the first portion is configured to extend the hollow circular inner member at a first predetermined rate, and wherein the second portion is configured to extend the inner member a second predetermined rate.
21. The device of claim 20, wherein the first predetermined rate is different than the second predetermined rate.
22. The device of claim 21, wherein the first predetermined rate is less than the second predetermined rate.
23. The device of claim 21, wherein the first predetermined rate is greater than the second predetermined rate.
24. The device of claim 1, further comprising an indicator indicative of the amount of extension that the inner member extends beyond the distal end of the elongated sheath.
25. The device of claim 1, wherein an indicator is located on the handle.
26. A method of cutting tissue surrounding at least a portion of an implanted object using the device of claim 1.
The present disclosure relates generally to devices, methods and systems for separating tissue in a patient, and more specifically, to devices for separating tissue attached to implanted objects, such as leads, in a patient and removing such objects.
Surgically implanted cardiac pacing systems, such as pacemakers and defibrillators, play an important role in the treatment of heart disease. In the 50 years since the first pacemaker was implanted, technology has improved dramatically, and these systems have saved or improved the quality of countless lives. Pacemakers treat slow heart rhythms by increasing the heart rate or by coordinating the heart's contraction for some heart failure patients. Implantable cardioverter-defibrillators stop dangerous rapid heart rhythms by delivering an electric shock.
Cardiac pacing systems typically include a timing device and a lead, which are placed inside the body of a patient. One part of the system is the pulse generator containing electric circuits and a battery, usually placed under the skin on the chest wall beneath the collarbone. To replace the battery, the pulse generator must be changed by a simple surgical procedure every 5 to 10 years. Another part of the system includes the wires, or leads, which run between the pulse generator and the heart. In a pacemaker, these leads allow the device to increase the heart rate by delivering small timed bursts of electric energy to make the heart beat faster. In a defibrillator, the lead has special coils to allow the device to deliver a high-energy shock and convert potentially dangerous rapid rhythms (ventricular tachycardia or fibrillation) back to a normal rhythm. Additionally, the leads may transmit information about the heart's electrical activity to the pacemaker.
For both of these functions, leads must be in contact with heart tissue. Most leads pass through a vein under the collarbone that connects to the right side of the heart (right atrium and right ventricle). In some cases, a lead is inserted through a vein and guided into a heart chamber where it is attached with the heart. In other instances, a lead is attached to the outside of the heart. To remain attached to the heart muscle, most leads have a fixation mechanism, such as a small screw and/or hooks at the end.
Within a relatively short time after a lead is implanted into the body, the body's natural healing process forms scar tissue along the lead and possibly at its tip, thereby fastening it even more securely in the patient's body. Leads usually last longer than device batteries, so leads are simply reconnected to each new pulse generator (battery) at the time of replacement. Although leads are designed to be implanted permanently in the body, occasionally these leads must be removed, or extracted. Leads may be removed from patients for numerous reasons, including but not limited to, infections, lead age, and lead malfunction.
Removal or extraction of the lead may be difficult. As mentioned above, the body's natural healing process forms scar tissue over and along the lead, and possibly at its tip, thereby encasing at least a portion of the lead and fastening it even more securely in the patient's body. In addition, the lead and/or tissue may become attached to the vasculature wall. Both results may, therefore, increase the difficulty of removing the leads from the patient's vasculature.
A variety of tools have been developed to make lead extraction safer and more successful. Current lead extraction techniques include mechanical traction, mechanical devices, and laser devices. Mechanical traction may be accomplished by inserting a locking stylet into the hollow portion of the lead and then pulling the lead to remove it. An example of such a lead locking device is described and illustrated in U.S. Pat. No. 6,167,315 to Coe et al., which is hereby incorporated herein by reference in its entirety for all that it teaches and for all purposes.
A mechanical device to extract leads includes a flexible tube called a sheath that passes over the lead and/or the surrounding tissue. The sheath typically may include a cutting blade, such that upon advancement, the cutting blade and sheath cooperate to separate the scar tissue from other scar tissue including the scar tissue surrounding the lead. In some cases, the cutting blade and sheath may also separate the tissue itself from the lead. Once the lead is separated from the surrounding tissue and/or the surrounding tissue is separated from the remaining scar tissue, the lead may be inserted into a hollow lumen of the sheath for removal and/or be removed from the patient's vasculature using some other mechanical devices, such as the mechanical traction device previously described in United States Patent Publication No. 2008/0154293 to Taylor, which is hereby incorporated herein by reference in its entirety for all that it teaches and for all purposes.
Some lead extraction devices include mechanical sheaths that have trigger mechanisms for extending the blade from the distal end of the sheath. An example of such devices and method used to extract leads is described and illustrated in U.S. Pat. No. 5,651,781 to Grace, which is hereby incorporated herein by reference in its entirety for all that it teaches and for all purposes.
Controlling the extension of the blade within a patient's vasculature may be critical, particularly when the sheath and blade negotiate tortuous paths that exist in certain vascular or physiological environments. Furthermore, in certain cases, using such mechanical devices for lead removal may require more precise control, such as when the leads are located in, and/or attached to a structurally-weak portion of the vasculature. For instance, typical leads in a human may pass through the innominate vein, past the superior vena cava (“SVC”), and into the right atrium of the heart. Tissue growth occurring along the SVC and other locations along the innominate vein may increase the risk and difficulty in extracting the leads from such locations, particularly when the vein(s)' walls are thin. Tissue growth may also occur at other challenging locations within a patient's vasculature which requires the delicate and precise control of the devices used to extract leads from such locations.
Accordingly, there is a need for a device, method and/or system such as a surgical device that has the capability to precisely control the extension and rotation of a blade from a sheath. For example, it may be desirable for the blade to initially extend a relatively short distance and/or rotate relatively slowly initially upon actuation, and it may be desirable for the blade to extend further and/or rotate relatively more quickly later during actuation. The present disclosure discusses a cam mechanism incorporated within a surgical device, thereby providing the clinician the appropriate and variable precision and coarse control during using this device. Additionally, the present disclosures discusses a distal tip having a configuration that assists in holding the device in place as the blade extends and rotates therefrom, thereby potentially further increasing the clinician's precision during use of the device.
A method in accordance with this disclosure may include tissue surrounding at least a portion an object implanted within a body vessel, the method comprising the steps of (a) placing an the implanted object into a lumen of an elongated sheath, the elongated sheath comprising a distal tip and a tubular member housed within at least a portion of the distal tip, wherein the tubular member has a cutting surface facing distally, (b) rotating and extending the cutting surface of the tubular member beyond the distal tip and into the tissue at a first rate for a first distance, (c) and rotating and extending the cutting surface of the tubular member beyond the distal tip and into the tissue at a second rate for a second distance.
A device in accordance with this disclosure for removing an implanted object from a body vessel, may comprising a (i) handle, (ii) an elongated sheath having a proximal end, a distal end, and a lumen extending from the distal end toward the proximal end, wherein the lumen is configured to receive an implanted object, the elongated sheath further comprising a proximal portion and a distal portion, (iii) a hollow circular outer member attached to the distal portion of the elongated sheath, (iv) a pin attached to the hollow circular outer member and extending inwardly thereof, and (v) a hollow circular inner member located within the outer member, the hollow circular inner member comprising a proximal end, a distal end and an exterior surface therebetween, the distal end comprising a cutting surface, the exterior surface of the inner member comprising a cam slot for receipt of and cooperation with the pin such that upon actuation of the handle, the inner member rotates and the distal end of the inner member extends beyond the distal end of the elongated sheath.
The device may include a means for rotating the elongated sheath, whereupon rotation of the elongated sheath, the inner member moves according to the predetermined profile. The means for rotating the elongated sheath may include a handle, and one or more gears connecting the handle to the elongated inner sheath. Alternatively, the means for rotating the elongated sheath may include a switch, and a motor comprising a shaft connected to the elongated inner sheath.
The device may also include an indicator indicative of the amount of extension that the inner member extends beyond the distal end of the elongated sheath.
The term “a” or “an” entity refers to one or more of that entity. As such, the terms “a” (or “an”), “one or more” and “at least one” may be used interchangeably herein. It is also to be noted that the terms “comprising”, “including”, and “having” may be used interchangeably.
A “lead” is a conductive structure, typically an electrically insulated coiled wire. The electrically conductive material may be any conductive material, with metals and intermetallic alloys common. The outer sheath of insulated material is biocompatible and bio stable (e.g., non-dissolving in the body) and generally includes organic materials such as polyurethane and polyimide. Lead types include, by way of non-limiting example, epicardial and endocardial leads. Leads are commonly implanted into a body percutaneously or surgically.
A “serration” or “serrated edge” or “serrated blade” or other variations, as used herein, shall mean the configuration of a cutting surface having a notched edge or saw-like teeth. The notched edges create a plurality of smaller points that contact (and therefore less contact area with) the material being cut in comparison to an un-notched blade. Additionally, the pressure applied by each serrated point of contact is relatively greater and the points of contact are at a sharper angle to the material being cut. One example of a serrated blade may include one notch adjacent to and abutting another notch such that there is very little, if any, blade between such notches, thereby creating points of contact. There are multiple variations and/or features of serrations. For example, one type of serrated feature is referred to as a “crown.” As used herein, a serrated blade, or other variation, in the shape of a “crown,” shall mean a blade comprising a plurality of notches and adjacent un-notched areas such that the combination of notched and un-notched areas resembles a crown for a royal member (e.g., king, queen, etc.), particularly when the blade is circular. A further type of “crown” includes a “hook crown.” As used herein, a serrated blade, or other variation, in the shape of a “hook crown,” shall mean a blade comprising a plurality of notches and adjacent un-notched areas, wherein the length of un-notched areas of the blade are longer than the notched areas of the blade.
The accompanying drawings are incorporated into and form a part of the specification to illustrate several examples of the present disclosure. These drawings, together with the description, explain the principles of the disclosure. The drawings simply illustrate preferred and alternative examples of how the disclosure may be made and used and are not to be construed as limiting the disclosure to only the illustrated and described examples. Further features and advantages will become apparent from the following, more detailed, description of the various aspects, embodiments, and configurations of the disclosure, as illustrated by the drawings referenced below.
FIG. 1 is a perspective view of a human having a pacemaker lead located in the venous system and terminating electrode anchored to the ventricular heart chamber, with an embodiment of a surgical device being shown inserted into the body and partly advanced over the lead;
FIG. 2 is an elevation view of an embodiment of a surgical device;
FIG. 2A is an elevation view of an alternative embodiment of a surgical device;
FIG. 3 is a cross-sectional view of a cutting sheath assembly within a blood vessel with an extendable and rotatable blade for removing a lead according to an embodiment of the disclosure;
FIG. 4A is an end view of the distal portion of the cutting sheath assembly according to an embodiment of the disclosure;
FIG. 4B is a cross-sectional view of the distal portion of the cutting sheath assembly according to an embodiment of the disclosure, wherein an inner member is in a retracted position within the cutting sheath assembly;
FIG. 4C is a cross-sectional view of the distal portion of the cutting sheath assembly according to an embodiment of the disclosure, wherein an inner member is in an extended position within the cutting sheath assembly;
FIG. 5A is a cross-sectional view of the distal portion of the cutting sheath assembly according to an embodiment of the disclosure, wherein an inner sheath is in a retracted position;
FIG. 5B is cross-sectional view of the distal portion of the cutting sheath assembly according to an alternate embodiment of the disclosure, wherein an inner sheath is in an extended position;
FIG. 6A is perspective view of an outer band member according to an embodiment of the disclosure;
FIG. 6B is an end view of the outer band member illustrated in FIG. 6A;
FIG. 6C is cross-sectional view of the outer band member illustrated in FIG. 6A taken along line 6C-6C of FIG. 6B;
FIG. 7A is perspective view of an inner band member according to an embodiment of the disclosure;
FIG. 7B is side view of the inner band member illustrated in FIG. 7A;
FIG. 7C is end view of the inner band member illustrated in FIG. 7A;
FIG. 7D is cross-sectional view of the inner band member illustrated in FIG. 7A taken along line 7D-7D in FIG. 7C;
FIG. 8A is perspective view of an inner band member according to an embodiment of the disclosure;
FIG. 8B is side view of the inner band member illustrated in FIG. 8A;
FIG. 8C is end view of the inner band member illustrated in FIG. 8A;
FIG. 8D is cross-sectional view of the inner band member illustrated in FIG. 8A taken along line 8D-8D in FIG. 8C;
FIG. 9A is perspective view of an inner band member according to an embodiment of the disclosure;
FIG. 9B is side view of the inner band member illustrated in FIG. 9A;
FIG. 9C is end view of the inner band member illustrated in FIG. 9A;
FIG. 9D is cross-sectional view of the inner band member illustrated in FIG. 9A taken along line 9D-9D in FIG. 9C;
FIG. 10A is perspective view of an inner band member according to an embodiment of the disclosure;
FIG. 10B is side view of the inner band member illustrated in FIG. 10A;
FIG. 10C is end view of the inner band member illustrated in FIG. 10A;
FIG. 10D is cross-sectional view of the inner band member illustrated in FIG. 10A taken along line 10D-10D in FIG. 10C;
FIG. 11A is perspective view of an inner band member according to an embodiment of the disclosure;
FIG. 11B is side view of the inner band member illustrated in FIG. 11A;
FIG. 11C is end view of the inner band member illustrated in FIG. 11A;
FIG. 11D is cross-sectional view of the inner band member illustrated in FIG. 11A taken along line 11D-11D in FIG. 11C;
FIG. 12A is perspective view of an inner band member according to an embodiment of the disclosure;
FIG. 12B is side view of the inner band member illustrated in FIG. 12A;
FIG. 12C is end view of the inner band member illustrated in FIG. 12A;
FIG. 12D is cross-sectional view of the inner band member illustrated in FIG. 12A taken along line 12D-12D in FIG. 12C;
FIG. 13A is perspective view of an inner band member according to an embodiment of the disclosure;
FIG. 13B is side view of the inner band member illustrated in FIG. 13A;
FIG. 13C is end view of the inner band member illustrated in FIG. 13A;
FIG. 13D is cross-sectional view of the inner band member illustrated in FIG. 13A taken along line 13D-13D in FIG. 13C;
FIG. 14A is a side view of the outer member with the inner member of FIGS. 7A-7D positioned in a retracted position within the outer sheath;
FIG. 14B is a side view of the outer member with the inner member of FIGS. 7A-7D positioned in an extended position within the outer sheath;
FIG. 15 is an illustration of the geometry of the cam slot of the inner member illustrated in FIGS. 7A-7D portrayed on a single plane;
FIG. 16A is a side view of the outer member with the inner member of FIGS. 8A-8D positioned in a retracted position within the outer sheath;
FIG. 16B is a side view of the outer member with the inner member of FIGS. 8A-8D positioned in a partially extended position within the outer sheath;
FIG. 16C is a side view of the outer member with the inner sheath of FIGS. 8A-8D positioned in a fully extended position within the outer member;
FIG. 17 is an illustration of the geometry of the cam slot of the inner member illustrated in FIGS. 8A-8D portrayed on a single plane;
FIG. 18 is a perspective view of an inner member having a cam slot with an extended stow region;
FIG. 19A is a side view of the outer member with the inner member of FIG. 18 positioned in a retracted position within the outer sheath;
FIG. 19B is a side view of the outer member with the inner member of FIG. 18 positioned in a partially extended position within the outer sheath;
FIG. 19C is a side view of the outer member with the inner member of FIG. 18 positioned in a fully extended position within the outer sheath;
FIG. 20 is an illustration of the geometry of the cam slot of the inner member illustrated in FIG. 18 portrayed on a single plane;
FIG. 21 is a perspective view of an inner member having a duplex cam slot;
FIG. 22A is a side view of the outer member with the inner member of FIG. 21 positioned in a retracted position within the outer sheath;
FIG. 22B is a side view of the outer member with the inner member of FIG. 21 positioned in a partially extended position within the outer sheath.
FIG. 22C is a side view of the outer member with the inner member of FIG. 21 positioned in a fully extended position within the outer sheath;
FIG. 23 is an illustration of the geometry of the cam slot of the inner member illustrated in FIG. 21 portrayed on a single plane;
FIG. 24 is a perspective view of an embodiment of a handle portion, including an indicator, of the surgical device;
FIG. 25 is a perspective view of an alternate embodiment of a handle portion, including an alternate indicator, of the surgical device;
FIG. 26 is a side view of an alternate embodiment of a handle portion, including an alternate indicator, of the surgical device;
FIG. 27 is a perspective view of an alternate embodiment of a handle portion, including an alternate indicator, of the surgical device;
FIG. 28 is a cross-sectional view of the distal portion of the cutting sheath assembly according to an alternate embodiment of the disclosure, wherein a cutting blade in a refracted position;
FIG. 29A is perspective view of a distal tip of the outer sheath according to an embodiment of the disclosure;
FIG. 29B is side view of the distal tip illustrated in FIG. 29A;
FIG. 29C is proximal end view of the distal tip illustrated in FIG. 29A;
FIG. 29D is distal end view of the distal tip illustrated in FIG. 29A;
FIG. 30A is perspective view of a distal tip of the outer sheath according to an embodiment of the disclosure;
FIG. 30B is side view of the distal tip illustrated in FIG. 30A;
FIG. 30C is proximal end view of the distal tip illustrated in FIG. 30A;
FIG. 30D is distal end view of the distal tip illustrated in FIG. 30A;
FIG. 31A is perspective view of a distal tip of the outer sheath according to an embodiment of the disclosure;
FIG. 31B is side view of the distal tip illustrated in FIG. 31A;
FIG. 31C is proximal end view of the distal tip illustrated in FIG. 31A;
FIG. 31D is distal end view of the distal tip illustrated in FIG. 31A;
FIG. 32A is a perspective view of an inner member in a retracted position within a distal tip of an outer according to an embodiment of the disclosure; and
FIG. 32B is a perspective view of the inner member of FIG. 32A in an extended or partially extended position with respect to the distal tip.
Embodiments according to this disclosure provide a surgical device that includes a sheath, which can be deployed safely within a vascular system of a patient and separate implanted objects, such as leads, from a patient's vasculature system. FIG. 1 depicts a surgical device 108 having a sheath 112 inserted within an exemplary patient 104. The sheath 112 surrounds an implanted lead (not shown) running along the left innominate vein past the SVC and connected into, or about, the right ventricle of the heart. Upon surrounding the lead with the sheath, the user of the surgical device may actuate the handle, thereby extending a cutting blade (not shown) beyond the distal end of the sheath 112 to cut the tissue surrounding the lead within the patient's SVC. When the clinician releases the handle, the cutting blade returns within the sheath 112, thereby allowing the clinician to force and advance the distal portion of the sheath against additional uncut tissue. The clinician repeats the actuation step, thereby causing the cutting blade to re-appear and extend beyond the distal end of the sheath 112 to cut the adjacent tissue. Each time actuation occurs, the proximal portion of the implanted lead and/or surrounding tissue enters into a hollow passageway within the sheath 112. This process is again repeated until the implanted lead and/or surrounding tissue is completely or substantially separated from the tissue attached to the SVC. At that time, the implanted lead may safely be removed from the patient's SVC.
With reference to FIG. 2, an exemplary surgical device 200 is depicted. The surgical device 200 includes a handle 204 and an outer sheath 208. The surgical device also includes an inner sheath (not shown) located within the outer sheath 208. It may be preferable for the outer sheath 208 to remain stationary while the inner sheath is capable of moving (e.g., rotating and extending) with respect to the outer sheath 208. The inner sheath and outer sheath 208 can both be flexible, rigid or a combination thereof.
The handle 204 includes a trigger 212 which pivots about a pin (not shown) that attaches the trigger 212 to the handle 204. Attached to the portion of the trigger 212 within the handle 204 is a first gear (not shown). Also included within the handle 204 is second gear and a third gear (both of which are not shown). The first gear meshes with the second gear, which in turn meshes with the third gear. The third gear has an opening through its center, wherein the opening is sized and configured to allow the inner sheath to be inserted and affixed thereto. When a user (i.e., clinician) actuates the handle 204, it pivots about the pin, thereby causing the handle 204 and first gear to move in a counter clockwise direction. The first gear engages the second gear and causes the second gear to rotate. The second gear, in turn, engages the third gear initiating it and the inner sheath to rotate about the sheath's longitudinal axis A-A.
The handle may also include a spring (not shown) that is attached to the gears, sheath and/or some other member therein such that, upon the clinician's release of the handle, the spring facilitates rotation of the inner sheath in a direction opposite to that in which it rotated upon actuation of the handle 204. It may be preferable for the inner sheath to rotate in a clockwise direction about its longitudinal axis from the perspective of the proximal end of the surgical device 200. If so, the spring will facilitate the inner sheath rotation in a counter-clockwise direction upon the clinician's release of the trigger 212.
The trigger 212 and gears are one example of an actuation means for causing the inner sheath to rotate about its longitudinal axis. However, a variety of different triggers and gearing may cooperate to rotate the inner sheath. For example, the trigger 212 depicted in FIG. 1 includes two openings 216, 220. A trigger, however, may have less than or more than two openings. Additionally, a trigger may also be comprised of a straight or non-linear member without any openings. Furthermore, a trigger may be in the shape of a button capable of being depressed. As long as the trigger, either alone or in conjunction with the handle, is ergonomically correct and comfortable for the clinician, the trigger may have a variety of sizes and shapes.
The actuation means discussed above includes three gears. A lower or higher number of gears, however, may be used in lieu of three gears. Many different types of gears are available. Non-limiting examples of gears include, but are not limited to, spur gears, helical gears, double helical gears, bevel gears, spiral bevel gears, hypoid gears, crown gears, worm gears, non-circular gears, rack and pinion gears, epicyclic gears, sun and planet gears, harmonic drive gears, cage gears, and magnetic gears. Any one and/or combination of these types or other types of gears could be used.
The trigger 212 and gear(s) configuration discussed above is an example of a mechanical actuation means to rotate the inner sheath. In an alternate embodiment, the actuation means may comprise electromechanical components. For example, the actuation means may comprise an electric motor (not shown) having a driven shaft that is directly or indirectly coupled to the inner sheath. The motor's shaft may be indirectly coupled to the inner sheath by one or more gears discussed hereinbefore. The motor may be controlled by a switch, thereby causing the inner sheath to rotate in a clockwise and/or a counterclockwise direction upon actuating a switch that may also act as the trigger. The electric motor may be either a direct current (DC) motor or an alternating current (AC) motor. Accordingly, the motor may be powered by a DC source, such as a battery, or an AC source, such as a conventional power cord. Additionally, those skilled in the art will appreciate that there are numerous other ways in which a surgical device comprising a rotatable sheath may be actuated and driven.
It may be preferable for a portion of the outer sheath to be rigid and a portion of the outer sheath to be flexible. With reference to FIG. 2A, an exemplary surgical device 200′ comprising an outer sheath having a rigid outer portion 222 and a flexible outer portion 224 is depicted. Both the rigid outer portion 222 and a flexible outer portion 224 are constructed of materials suitable for insertion into the human body. For example, the rigid outer portion 222 may be constructed of stainless steel, and the flexible outer portion 224 may be constructed of a flexible polymer such as polytetrafluoroethylene or thermoplastic elastomers.
The rigid outer portion 222 and flexible outer portion 224 form a unitary outer sheath. The rigid outer portion 222 has a proximal end 236 and a distal end 238. Similarly, the flexible outer portion 224 has a proximal end 228 and a distal end 232. The distal end 238 of the rigid outer portion 222 is connected to the proximal end 228 of the flexible outer portion 224, thereby forming a unitary outer sheath. The mechanism(s) to connect the distal end 238 of the rigid outer portion 222 and the proximal end 228 of the flexible outer portion 224 are not described herein and are conventional, and need not be further explained or illustrated to enable one skilled in the art to utilize the mechanism for the purposes described. For example, the configuration and/or shape of the proximal end 228 may be such that it may interlock with the distal end 238 for example via a barbed joint. Although the interlock mechanism described herein may be preferred, it is not intended to represent the only way that such a connection can be accomplished. All such techniques within the knowledge of one skilled in the art are considered within the scope of this disclosure.
Similar to the flexible outer sheath 224, the inner sheath is generally flexible in order to accept, accommodate and navigate the patient's vasculature system. In addition to being flexible, the inner sheath may also have a high degree of stiffness in order to receive the torque transferred from the actuation means and transfer sufficient torque to the cutting blades discussed in more detail below. The inner sheath may be formed of a polymer extrusion, braided reinforced polymer extrusion, coils, bi-coils, tri-coils, laser cut metal tubing and any combination of the above. The inner sheath may be a unitary structure comprised of multiple portions. If the inner sheath has multiple portions, some of those portions may be rigid. For example, similar to the rigid outer sheath 222, some or all of the portions of the inner sheath located within the rigid outer sheath 222 may also be rigid. If the inner sheath has multiple portions, those multiple portions may be attached in a manner similar to the manner in which the rigid outer sheath 222 and flexible outer sheath 224 are connected.
With reference to FIGS. 4A, 4B and 4C, an exemplary distal portion of the flexible inner and outer sheaths of a surgical device is depicted. The assembly 400 includes a flexible inner sheath 426 located within flexible outer sheath 404. Attached to the distal portion of the flexible outer sheath 404 is an outer cam member 408, which is discussed in more detail below. The distal end of the flexible outer sheath 404 is generally smooth and evenly rounded at its most distal point, thereby allowing it to act as a dilator when pressed and forced against tissue. And the distal end of the outer cam member 408 is also longitudinally aligned with the distal end of the flexible outer sheath 404. The distal end 430 of the flexible inner sheath 426 is connected to the proximal end 418 of inner cam member 412, which is discussed in more detail below. The distal end 422 of inner cam member 412 includes a cutting surface capable of cutting tissue.
The inner sheath 426 is coupled to the outer sheath 404 through the inner cam member 412 and the outer cam member 408 via pin 410. One end of the pin 410 is fixed within the outer cam member 412, and the other end of the pin 410 is located within the cam slot 414 of the inner cam member 412. As the inner sheath 426 extends, via the actuation means discussed above, the inner cam member 412 extends distally in the direction of the arrow (→) and rotates according to the profile of the cam slot 414. As the inner cam member 412 extends distally and rotates, the outer sheath 404, outer cam member 408 and pin 412 remain stationary. Thus, as the inner cam member 412 extends distally (and potentially proximally according to the cam slot profile) and rotates the cutting surface at the distal end 422 of the inner cam member 412 is able to perform a slicing action against the tissue and cut it.
FIG. 4B depicts the inner cam member 412 within a retracted (and un-actuated) position because the inner cam member 412 is in its most proximal position. Stated differently, the distal end 422 of the inner cam member 412 of FIG. 4B is located within the interior of the outer cam member 408 and does not extend beyond the distal end of the outer cam member 408. With reference to FIG. 4C, the inner cam member 412 is depicted in an extended (and actuated) position because the inner cam member 412 is in its most distal position extending beyond the distal end of the flexible outer sheath 404 and the outer cam member 408.
FIG. 3 depicts the distal portion of the flexible outer sheath and flexible inner sheath of FIG. 4C surrounding a lead 530 within a patient's vein 534 with the inner cam member 412 in its extended position. The circumferential nature of the cutting blade at the distal end of the inner cam member causes the surgical device to act as a coring device, thereby cutting tissue 538 either partially (i.e., less than 360 degrees) or completely (i.e., 360 degrees) around the lead or implanted object being extracted. The amount of tissue that the blade cuts depends upon the size, shape and configuration of the lead, as well as the diameter and thickness of the circular cutting blade. For example, if the diameter of the circular blade is substantially greater than the diameter of the lead, then the blade will cut and core more tissue in comparison to a cutting blade having a smaller diameter. Once the desired cut has been made, the operator releases trigger and the inner cam member (including the blade) returns to its retracted position. Once the blade is in the retracted position, the distal tip 408 of the cam member 404 (and/or outer sheath) safely acts as a dilating device, thereby stretching tissue as the sheaths move over the lead or implanted object to be extracted.
Although the inner sheath and outer sheath are coupled to one another via the inner cam member, outer cam member, and pin, the sheaths may be coupled to one another in other ways. Stated differently, those of skill in the art will understand how to make and use the disclosed aspects, embodiments, and/or configurations after understanding the present disclosure to couple the sheaths in a manner to allow a cutting surface to extend and rotate beyond the distal end of the outer sheath. All such configurations within the knowledge of one skilled in the art are considered within the scope of this disclosure. For example, referring to FIGS. 5A and 5B, the assembly 500 may include an outer sheath 504 and an inner sheath 526 coupled to one another via pin 510 without the use of an outer cam member or inner member as in FIGS. 4B and 4C. The outer sheath 504 may have a pin 510 connected to it, and the inner sheath 526 may include cam slot 514 such that as the inner sheath 526 extends upon actuation of the actuation means discussed earlier herein, the inner sheath 526 along with its cutting surface, also rotates according to the cam slot 514 profile. While the inner sheath 526 extends and rotates, the outer sheath 504 and pin 510 remain stationary. FIG. 5A depicts the inner sheath 526 (and cutting surface 522) of assembly 500 in an initially retracted and stowed position. FIG. 5B depicts the inner sheath 526 (and cutting surface 522) of assembly 500′ in an extended position. As the actuation means is actuated and un-actuated, the assembly moves from a refracted position to an extended position and vice versa.
With reference to FIGS. 6A, 6B and 6C, an exemplary outer cam member 600 is depicted. The outer cam member 600 is a sleeve in the shape of a hollow cylinder. Although the exterior of the outer cam member 600 is uniform, it need not be. The interior of the outer cam member 600 is not uniform. For example, the interior of the outer cam member 600 includes an abutment 616 to prevent the inner cam member (not shown) from traveling further from the proximal end 612 to the distal end 608 within the outer cam member 600. The outer cam member 600 also includes a hole 604 for receipt and possible attachment of a pin (not shown) which protrudes radially inward. As discussed in more detail below, the pin engages the cam slot of the inner cam member. The size, shape and configuration of the outer cam member 600 may differ depending upon how it is attached to the flexible outer sheath. As discussed above, the outer sheath may be stationary. If so, the outer cam member 600 and the pin remain stationary as the inner cam member moves relatively thereto.
With reference to FIGS. 7A, 7B, 7C and 7D, an exemplary inner cam member 700 is depicted. The inner cam member 700 has a generally hollow cylindrical shape. The inner cam member 700 comprises a proximal portion 724, an intermediate portion 728, and a distal portion 732. The outside diameter of the proximal portion 724 is sized to allow the distal end 704 of the inner cam member 700 to be inserted to and engage (or otherwise attached to) the interior diameter of the inner flexible sheath (not shown). The distal end 708 of the inner cam member 700 comprises a cutting surface 712 having a flat, sharp blade profile. The intermediate portion 728 comprises a cam slot 716 cut within its exterior surface. As the inner flexible sheath rotates and moves within the outer sheath—from its proximal end to distal end—the outer sheath and pin may remain stationary. If so, the inner sheath, which is connected to the inner cam member, forces the inner cam member to rotate and move toward the distal end of the outer sheath. The cam slot 716 engages the pin, and the shape and profile of the cam slot 716 controls the rate and distance with which the inner cam member 700 travels. That is, the configuration of the cam slot controls how the inner cam member travels both laterally and rotationally.
The cam slot 716 in FIGS. 7A, 7B, 7C and 7D can have a linear profile (not shown). An alternative example of a two dimensional representation of the profile of the cam slot is depicted in FIG. 15. When the pin is position A on the left hand side of FIG. 15, the inner cam member (and blade) is in the retracted position, as depicted in FIG. 14A. As the inner cam member rotates about 180 degrees and extends (from left to right in FIG. 15), the cam slot 1504 travels along the pin from position A to position B at a relatively constant rate because the slope of the cam slot between these two points is relatively linear. That is, there is a substantially linear portion within the cam slot 1504 between position A and position B even though the overall shape of the cam slot 1504 is generally sinusoidal. The sinusoidal shape, particularly at the transition points, namely position A and position B, allows for a smooth transition from extension to retraction through such positions while maintaining a relatively constant rate of rotation. Upon reaching position B, the inner cam member is in its fully extended position, as depicted in FIG. 14B. As the inner cam member continues to rotate another 180 degrees, the cam slot travels along the pin from position B back to its original retracted position A at a relatively constant rate because the slope of the cam slot between these two points is relatively linear. FIG. 15 illustrates the cam slot 1504 in an open and continuous configuration. Accordingly, as the inner cam member continues to rotate beyond 360 degrees, the path of inner cam member is repeated and it continues to travel from position A to position B to position A. And due to the substantially linear configuration of the cam slot profile from position A to position B, and vice versa, the inner cam member (and blade) extends and/or rotates at a substantially constant rate between positions.
Referring again to FIGS. 7A, 7B, 7C and 7D, the inner cam member 700 may also comprise a step up 720 such that the diameter of the intermediate portion 728 is greater than the distal portion 732. As the inner cam member 700 rotates, and the cutting surface 712 extends beyond the distal end of the outer cam member into its extended position, the step up 720 of the inner cam member 700 contacts the abutment of the outer cam member, thereby limiting the distance that the inner cam member 700 may travel and/or may prevent the inner cam member from exiting or extending beyond the distal tip of the outer sheath (or outer cam member) in the event that the pin is sheared.
With reference to FIGS. 8A, 8B, 8C and 8D, an alternative exemplary inner cam member 800 is depicted. The inner cam member 800 depicted in FIGS. 8A-8D is similar to the inner cam member 700 depicted in FIGS. 7A-7D because the inner cam member 800 has a proximal portion 824, an intermediate portion 828, a distal portion 832 and a sharp cutting surface 712 with a flat profile at its distal end 808. Unlike the inner cam member 700, which has a linear cam slot profile, however, the inner cam member 800 has a cam slot 816, which when extended in a two-dimensional plane, has a non-linear profile. For example, an illustration of a two-dimensional, non-linear cam slot profile 1700 is depicted in FIG. 17.
Continuing to refer to FIG. 17, there is depicted cam slot 1704. As the flexible inner sheath extends distally within the outer sheath, the cooperation between the pin and the cam slot causes the inner cam member to also rotate and travel toward and beyond the distal end of the outer cam member. The rate and distance at which the inner cam member travels is dependent upon the configuration of the cam slot, particularly the slope of the cam slot. If the profile of the cam slot, such as its slope, is non-linear, then the rate and distance at which the inner cam member travels will vary as the inner cam member rotates and moves over the pin along the cam slot path. For example, when the inner cam member is in its fully retracted position (see FIG. 16A), the pin contacts the cam slot 1704 at position A identified as a first point marked + within the left hand side of FIG. 17. When the inner cam member is in its partially extended position (see FIG. 16B), the pin contacts the cam slot 1704 at a second point marked + and identified as position B within FIG. 17. When the inner cam member is in its fully extended position (see FIG. 16C), the pin contacts the cam slot 1704 at another point marked + and identified as position C within FIG. 17. This two-dimensional representation of the cam slot 1704 illustrates a non-linear profile of the cam slot because in order for the inner cam member to fully extend, it must travel at more than one rate from position A to position C. That is, the blade rotates at a first predetermined rate from position A to position B (partially extended position), and the blade rotates at a second predetermined rate from position A′ to position C (fully extended position).
For example, as the inner cam member rotates and the pin contacts the cam slot 1704, the cutting surface travels at a rate according to the profile of the cam slot 1704 from its fully retracted position (see FIG. 16A) to a position that is slightly beyond the distal end of the outer cam member (see FIG. 16B) over about 90 degrees of rotation by the inner cam member. The profile of the cam slot from position A to position B is generally linear, thereby causing the inner cam member to travel at a generally constant rate between those two positions. As depicted in FIG. 17, the blade extends a predetermined distance for the about of rotation (90 degrees) from position A to position B. Once the blade travels to its partially extended position B, the blade continues to rotate and the blade returns to its retracted position A′ over about 90 degrees of rotation by the inner cam member. The profile of the cam slot from position B to position A′ is generally linear; therefore, the blade extends at a generally constant rate between these two positions. As the as the inner cam member continues to rotate and the pin contacts the cam slot 1704 beyond position A′ and toward position C over about another 90 degrees of rotation, the blade extends a second predetermined distance. That is, the cutting surface travels beyond its partially extended position and to its fully extended position (see FIG. 16C). The profile of the cam slot from position A′ to position C is different than the profile of the cam slot from position A to position B. Although the profile of the cam slot from position A to position B is generally linear, the first predetermined amount of extension (from position A to position B) is less than the second predetermined amount of extension (from position A′ to position C). Thus, the profile of the cam slot from position A to position B is such that the blade extends a shorter distance in comparison to extending from position A′ to position C for a predetermined amount of rotation (90 degrees), thereby providing more precise and finer control of the blade as it rotates and extends. Moving and extending the inner cam member at a generally constant rate for a short distance provides the clinician precise control of the blade as it initially extends beyond the outer sheath. Stated differently, the profile of the cam slot from position A′ to position C is such that the blade extends further and more quickly for a predetermined amount of rotation (90 degrees) after it is initially extended, thereby providing relatively less precision and coarser control of the blade in comparison to extending from position A to position B. Accordingly, the inner cam member and blade travel at a faster rate from position to A′ to position C (and from position C to position A″) in comparison to traveling from position A to position B. In order for the blade to fully extend to position C, the blade travels at more than one rate—one rate from position A to position B (and from position B to position A′) and another rate from position A′ to position C. Thus, even though the rates of travel from the position A to position B (and from position B to position A′) and from position A′ to position C may both be relatively constant for each individual portion of travel, the overall rate of travel is variable.
The discussion above discusses that the inner cam member travels at certain rates (e.g., constant, variable). However, the rates are also dependent upon the speed at which the inner sheath extends, and in turn, upon the speed of the means for actuating. For example, if the means for actuation includes a handle and one or more gears connecting the handle to the elongated inner sheath, then the rate at which the inner cam member rotates and extends is dependent upon how quickly the clinician operating the surgical device compresses the handle. Accordingly, the discussion and/or comparison of the rates at which the blade extends travels assumes that the means for actuating extends the inner sheath at a relatively constant speed. Regardless of whether this assumption is correct, the greater the amount of blade extension per predetermined amount of rotation, the blade will extend at a greater rate and speed, thereby providing the surgical device with the ability to cut more tissue per rotation.
Although the discussion above with respect to FIGS. 8 and 17 only discuss a certain number of linear and non-linear profile portions of the cam slot, that discussion is not intended to limit the scope of this disclosure to only a fixed number of linear and non-linear profile portions. Depending upon the desired rate(s) at which the blade may rotate and extend, the cam slot may have additional multiple linear and non-linear profile portions of the cam slot. Those of skill in the art will understand how to make and use the disclosed aspects, embodiments, and/or configurations after understanding the present disclosure to adjust the distance, rate and rotational aspects at which the inner cam member (or other cam members) travels. All such configurations within the knowledge of one skilled in the art are considered within the scope of this disclosure.
As mentioned above, the cam slot profile of FIG. 15 is an open and continuous configuration, thereby allowing the inner cam member to continuously rotate. The cam slot profile of FIG. 17, however, is a closed configuration such that when the inner cam member reaches its fully extended position (i.e., position C) or returns to position A″, the actuation means must be releases or reversed so that the inner cam may return to initial retracted position A. Although certain figures in this disclosure only illustrated either the open or closed cam slot configuration, either configuration may be used with any of the inner cam embodiments disclosed and/or discussed herein and are considered within the scope of this disclosure.
With reference to FIGS. 9A, 9B, 9C and 9D, an alternative exemplary inner cam member 900 is depicted. The inner cam member 900 depicted in FIGS. 9A-9D is similar to the inner cam member 900 depicted in FIGS. 8A-8D because the inner cam member 900 has a proximal portion 924, an intermediate portion 928, a distal portion 932, and a cam slot 916 that is similar to cam slot 816. Unlike the inner cam member 800, which has a smooth cutting surface, inner cam member 900 has a serrated cutting surface 912. The cutting surface 912 depicts fourteen (14) serrations. However, it may be preferable to have between twelve (12) and sixteen (16) serrations.
Although the cutting surface 912 illustrates a certain number of serrations, FIGS. 9A-9D are not intended to represent the only number and type of serrations that may be included in a serrated cutting surface. Depending upon the size of the surgical device, including the sheaths, and cam members, those of skill in the art will understand how to make and use the disclosed aspects, embodiments, and/or configurations after understanding the present disclosure to adjust the number, size and configurations of the serrations. All such configurations within the knowledge of one skilled in the art are considered within the scope of this disclosure. For example, referring to FIGS. 11A, 11B, 11C and 11D, an alternative exemplary inner cam member 1100 is depicted having a cutting surface 1112 comprising multiple serrations in the form of a crown. Also, referring to FIGS. 12A, 12B, 12C and 12D, an alternative exemplary inner cam member 1200 is depicted having a cutting surface 1212 comprising multiple serrations in the form of a hook crown. The cutting surface also need not be serrated, but merely include a plurality of notches formed therein. For example, with reference to FIGS. 13A, 13B, 13C and 13D, a further alternative exemplary inner cam member 1300 is depicted having a cutting surface with four notches 1350 included therein. Furthermore, the notches may comprise a myriad of different shapes and configurations, including but not limited to any variation of a square, rectangle, rhombus, parallelogram, trapezoid, triangle, circle, ellipse, kite, etc.
The cutting surfaces discussed hereinbefore with respect to FIGS. 7, 8, 9, 11, 12 and 13 are substantially parallel to the proximal edge of the inner cam members. In other words, the plane of the proximal end of the inner cam member and the plane of the distal end (e.g., cutting surface) of the inner cam member in these figures are substantially parallel. The proximal and distal ends of the inner cam member, however, need not be parallel or co-planer. Rather, any of the cutting surfaced depicted in FIGS. 7, 8, 9, 11, 12 and 13 may be offset from the plane of the proximal end of the inner cam member. With reference to FIGS. 10A, 10B, 10C and 10D, an alternative exemplary inner cam member 1000 is depicted. The plane of the cutting surface 1008 of the inner cam member 1000 is offset from a plane parallel to the plane of the proximal end 1004 of the inner cam member at an angle α. It may be preferable for angle α to be at an angle between zero degrees and ninety degrees.
The cam slots included within the inner cam members depicted FIGS. 7-13 surround the circumference of the inner cam member one time. It may advantageous, however, for the cam slot to surround the inner cam member's circumference more than once. For example, with reference to FIG. 18, there is depicted an inner cam member 1800 having a cam slot 1816 that travels more than 360 degrees around its circumference. The portion 1848 of the cam slot 1816 that is closest to the distal end 1808 of the inner cam member 1800 and that extends beyond the other end of the cam slot 1816 is substantially parallel to the planes of the proximal end 1804 and distal end 1808. The profile of cam slot 1816 depicted in one dimension is illustrated in FIG. 20 as the inner cam member 1800 moves from a retracted position (see FIG. 19A) to a partially extended position (see FIG. 19B) and eventually to a fully extended position (see FIG. 19C).
The configuration and profile of portion 1848 of the cam slot 1816 prevents the inner cam member 1800 from moving from its refracted position, even if the inner cam member 1800 begins to rotate. That is, the inner cam member 1800 remains stowed in its retracted position as long as the pin engages only portion 1848 of cam slot 1816, thereby insuring that the blade is completely retracted as the clinician maneuvers the surgical device within the patient's vascular system. Referring to FIG. 20, there is depicted a two-dimensional cam slot profile of the configuration of the cam slot 1816 of FIG. 18. The cam slot profile depicted in FIG. 20 is similar to the configuration of the cam slot profile depicted in FIG. 17, with the exception that the cam slot profile depicted in FIG. 20 further includes a portion that surrounds the circumference of the inner cam member more than once. That is, the cam slot is included in about another 90 degrees of travel around the circumference of the inner cam member over and above the 360 degrees of travel. This additional portion—the portion that extends around the circumference of the inner cam member more than 360 degrees—is depicted as the substantially flat profile portion to the bottom right hand side of FIG. 20 that begins with a point marked + and identified as position A. This substantially flat profile portion insures that the blade remains stowed within the outer cam member as the inner cam member begins to rotate, thereby increasing the safety of the device and minimizing the likelihood of the blade being exposed beyond the distal end of the outer cam prior to actuation. Although FIG. 20 illustrates the flat portion of the cam slot as an extended in an embodiment with a cam slot greater than 360 degrees around the circumference of the inner cam member, the flat portion, which creates the stowed position, can be included within a cam slot that is equal to or less than 360 degrees around the circumference of the inner cam member.
With reference to FIG. 21, there is depicted an inner cam member 2100 having a cam slot 2116 that travels about 720 degrees around its circumference. The profile of cam slot 2116 depicted in two dimensions is illustrated in FIG. 23 as the inner cam member 2100 moves from a retracted position (see FIG. 22A) to a partially extended position (see FIG. 22B) and eventually to a fully extended position (see FIG. 22C). Referring to FIG. 23, the blade extends from position A, which corresponds to the retracted position of FIG. 22A, to position B, which corresponds to the partially extended position of FIG. 22B over about 180 degrees of rotation by the inner cam member 2100. The blade then retracts from position B to position A′ over about 180 degrees of rotation by the inner cam member 2100. The blade can then extends from position A′, which corresponds to the retracted position of FIG. 22A, to position C, which corresponds to the fully extended position of FIG. 22C over about 180 degrees of rotation by the inner cam member 2100. Lastly, the blade retracts from position C to position A″ over about 180 degrees of rotation by the inner cam member 2100. The benefit of increasing the length of the cam slot 2116 to a length greater than the circumference of the inner cam member to twice as long as the circumference of the inner cam member (i.e., 720 degrees) in comparison to the cam slot of FIG. 17, which is only passes over the circumference one time (i.e., 360 degrees), is that the blade and inner cam member can rotate about twice as much for the same amount of extension. Accordingly, the blade has the ability to rotate and potentially create a greater amount of cutting action against the tissue for a predetermined amount of extension.
The discussion above with respect to FIG. 23 explains how the blade travels according to the cam slot profile for a full 720 degrees of rotation because the inner cam member includes a double lobe cam profile. During actuation, however, the inner cam member does not need to travel the entire 720 degrees of rotation. For example, the clinician operating the surgical device can actuate the means for actuation such that the inner cam member repeats the travel from position A to position B rather than continuing onward to position C. Allowing the clinician to repeat the inner cam member's path of travel from position A to position B allows the clinician to operate the surgical device in a precision cutting mode for a longer period of time. Alternatively, the clinician operating the surgical device can actuate the means for actuation such that the inner cam member repeats the travel from position A′ to position C rather than restarting from position A and moving to position C. Allowing the clinician to repeat the inner cam member's path of travel from position A′ to position C allows the clinician to operate the surgical device in a coarser cutting mode for a longer period of time. This allows the clinician to alternate the use of the surgical device (1) in either a precision cutting mode or a coarse cutting mode, (2) by alternating between the precision cutting mode and the coarse cutting mode, and/or (3) using a variable mode, which includes the combination of both the precision cutting mode and coarse cutting mode.
As previously discussed with respect to FIG. 4, the distal end of the flexible outer sheath 404 may be smooth and evenly rounded at its most distal point. Alternatively, the distal end of the outer sheath may not be smooth. Rather, the distal end of the outer sheath may be uneven in order to increase the outer sheath's ability to engage tissue. By engaging tissue, the outer sheath may increase its ability to remain stationary within the subject's vascular system as the inner cam member and blade rotate and extend into such tissue, thereby potentially minimizing undesirable rotation and/or movement of the outer sheath or surgical device.
FIGS. 29A, 29B, 29C and 29D depict a distal tip 2900 of the outer sheath according to an embodiment of the disclosure. The distal tip 2900 illustrated in these figures is depicted as a separate component. Those of skill in the art will understand how to make and use the disclosed aspects, embodiments, and/or configurations of the distal tip after understanding the present disclosure to adjust the location, size, configuration and/or type of indicator. For example, the distal tip, particularly its uneven configuration, may be created in the distal portion of the outer sheath, the outer cam member and/or a combination of the outer sheath and outer cam member. All such configurations within the knowledge of one skilled in the art are considered within the scope of this disclosure. For the purposes of this disclosure, the “distal tip,” particularly the distal tip of the outer sheath, shall mean and include a separate component attached to the outer sheath, the distal portion of the outer sheath, the outer cam member located at the distal end of the sheath, a combination of any of the preceding, and/or any other distal portion or component of the surgical device intended to contact tissue.
Continuing to refer to FIGS. 29A-29D, distal tip 2900 has a proximal end 2908 and a distal end 2912. The proximal end 2908 of the distal tip 2900 extends from or is attached to the outer sheath, the outer cam member, etc., and/or a combination thereof. The distal tip 2900 also includes a plurality of notches 2904 extending proximally from its distal end 2912. The notches 2904 create an uneven profile at the distal end 2912 of the distal tip, and this uneven profile facilitates the distal tip's engagement with the tissue or other material within the subject's vasculature, thereby holding the outer sheath stationary while the blade rotates and extends into the tissue.
FIGS. 29A-29D depicts six notches 2904 that have a generally rectangular shape that taper upwardly from the distal end 2904 toward the proximal end 2908 until the notches intersect and become flush with the exterior surface of the distal tip 2900. The notches 2904 are formed by removing material from the distal end 2904 of the distal tip. Notches may also be formed by adding material at predetermined intervals along the perimeter of the distal tip, such that the notches are created and located between the additional materials. Depending upon the size and configuration of the surgical device, particularly its distal tip, those of skill in the art will understand how to make and use the disclosed aspects, embodiments, and/or configurations after understanding the present disclosure to adjust the number, location, size, configuration and/or type of notches. All such notch configurations within the knowledge of one skilled in the art are considered within the scope of this disclosure.
With reference to FIGS. 30A-30D there is depicted an alternative exemplary distal tip 3000 has a proximal end 3008 and a distal end 3012. The notches 3104 included within this distal tip 3000 have a generally narrower rectangular shape in comparison to the notches 2904 of distal tip 2900 depicted in FIGS. 29A-29D. Due to the narrower configuration of the notches 3014 illustrated in FIGS. 30A-30D, the distal tip 3000 includes three times as many notches, for a total of eighteen, in comparison to the number of notches 2904 in distal tip 2900. Although FIGS. 29A-D and FIGS. 30A-D depict rectangular shaped notches 2904, 3004, the distal tip may include notches of any desirable shape that will engage tissue, including but not limited to any variation of a square, rhombus, parallelogram, trapezoid, triangle, circle, ellipse, kite, etc. For example, FIGS. 31A-31D depict a further alternative exemplary distal tip 3100 having V-shaped notches 3104 extending from distal end 3112 toward proximal end 3108.
The notches 2904, 3004, and 3104 included in distal tips 2900, 3000, and 3100, respectively, are configured to engage tissue and to prevent the outer sheath from rotating as the blade rotates and extends into such tissue. Inclusion of the notches in the outer sheath may also enhance the surgical devices ability to cut tissue because the combination of notches within the distal tip and notches within the cutting surface of the inner cam member may create a shearing force, thereby increasing the overall amount of cutting force applied to the tissue. Accordingly, the notches of the distal tip may also be configured to include a sharp blade profile, such as the serrated and notched blades depicted in FIGS. 9, 11, 12 and 13 and any equivalents thereof.
With reference to FIGS. 32A and 32B, there is depicted a distal tip 3202 and an inner cam member 3208. The inner cam member 3208 has a plurality of notches 3212 creating a serrated-type blade, and distal tip 3202 has a plurality of notches 3204 that have a substantially similar size and shape as the notches 3212 within the inner cam member 3208. FIG. 32A depicts the inner cam member 3208 in a retracted position because the cutting surface does not extend beyond the distal end of the distal tip. When the inner cam member 3208 is in its distal position, it may be preferable that the notches 3204, 3212 of the inner cam member 3208 and the distal tip 3202 substantially align in order to improve the surgical device's ability, particularly the distal tip's ability, to engage tissue. Referring to FIG. 32B, as the inner cam member 3208 begins to rotate and extend outwardly from its retracted position, the serrations 3216 begin to pass over the notches 3204 in the distal tip 3202, thereby creating a shearing force against the tissue and potentially increasing the device's cutting ability.
With reference to FIG. 24, there is a depicted an alternative embodiment of surgical device 2400 that comprises an indicator 2440 indicative of how far the blade of the inner cam member has traveled and/or has traveled beyond the distal end of the outer sheath. The indicator 2440 in FIG. 24 is located on the top of the distal portion of the handle 2404. Specifically, the indicator 2440 is located between the distal end of the handle 2404 and a vertically extending portion 2438 of the handle that encases components, such as gears, within the handle 2404. Indicator 2440 may include indicia, such as numbers or dimensions indicative of the length that the blade has traveled and/or has traveled beyond the distal end of the outer sheath. In addition and/or in lieu of the indicia, the indicator 2440 may include color coded regions (e.g., green, yellow, orange, red, etc.), such that differently colored regions convey to the clinician whether it is more or less safe to move the entire surgical device, including the sheaths, within the patient's vasculature depending upon whether the cutting blade is exposed and/or how much of it is exposed. The indicator 2440 may also be directly and/or indirectly connected to the actuating means of the surgical device.
Although the indicator 2440 in FIG. 24 is located on the top of the distal portion of the handle 2404, FIG. 24 is not intended to represent the only location and type of indicator that may be included in a serrated cutting surface. Depending upon the size and configuration of the surgical device, particularly its handle and actuating mechanism(s), those of skill in the art will understand how to make and use the disclosed aspects, embodiments, and/or configurations after understanding the present disclosure to adjust the location, size, configuration and/or type of indicator. All such configurations within the knowledge of one skilled in the art are considered within the scope of this disclosure. For example, referring to FIG. 25, an alternative exemplary surgical device 2500 comprising an indicator 2540 depicted on the proximal, top portion of handle 2504. Also, referring to FIG. 26, an alternative exemplary surgical device 2600 comprising an indicator 2640 depicted on the side of the handle 2640, particularly, the indicator 2640 is located on a vertically extending portion 2638 of the handle 2604 that encases components, such as gears. The indicator also does not need to be a mechanically actuated indicator. For example, if a motor is used to actuate the sheath, the indicator can be a color-coded light, or other type of electrically based indicators, located on the top of the handle as depicted with reference to FIG. 27. Additionally, the color (e.g., green, yellow, orange, red, etc.) of the light, the brightness of the light and/or whether light remains constant or blinks (including the frequency of blinking) may change as the blade travels from its retracted position to its extended position.
Additionally, the indicator need not be located on the surgical device or any portion thereof, such as the handle. Rather, the indicator can be located external to the surgical device. That is, the surgical device may include a communication port that transmits the indictor signal(s) to a remote display and/or a remote device. For example, the surgical device may be connected to a remote fluoroscopy monitor, either via a cable or wirelessly, thereby allowing the monitor to display the position of the cutting surface (i.e., blade), inner cam, inner sheath and/or any other component of the surgical device. Transmitting the device's positional information to the monitor potentially allows the clinician to view the position of the blade on the same monitor that the clinician is using to perform the surgical procedure while navigating the patient's vasculature.
A number of variations and modifications of the disclosure may be used. It would be possible to provide for some features of the disclosure without providing others.
In some embodiments, the systems and methods of this disclosure may be implemented in conjunction with a special purpose computer, a programmed microprocessor or microcontroller and peripheral integrated circuit element(s), an ASIC or other integrated circuit, a digital signal processor, a hard-wired electronic or logic circuit such as discrete element circuit, a programmable logic device or gate array such as PLD, PLA, FPGA, PAL, special purpose computer, any comparable means, or the like. In general, any device(s) or means capable of implementing the methodology illustrated herein may be used to implement the various aspects of this disclosure. Exemplary hardware that may be used for the disclosed embodiments, configurations and aspects includes computers, handheld devices, telephones (e.g., cellular, Internet enabled, digital, analog, hybrids, and others), and other hardware known in the art. Some of these devices include processors (e.g., a single or multiple microprocessors), memory, nonvolatile storage, input devices, and output devices. Furthermore, alternative software implementations including, but not limited to, distributed processing or component/object distributed processing, parallel processing, or virtual machine processing may also be constructed to implement the methods described herein.
The present disclosure, in various aspects, embodiments, and/or configurations, includes components, methods, processes, systems and/or apparatus substantially as depicted and described herein, including various aspects, embodiments, configurations embodiments, sub combinations, and/or subsets thereof. Those of skill in the art will understand how to make and use the disclosed aspects, embodiments, and/or configurations after understanding the present disclosure. The present disclosure, in various aspects, embodiments, and/or configurations, includes providing devices and processes in the absence of items not depicted and/or described herein or in various aspects, embodiments, and/or configurations hereof, including in the absence of such items as may have been used in previous devices or processes, e.g., for improving performance, achieving ease and/or reducing cost of implementation.
For example, the disclosure discusses two sheaths—and inner sheath and an outer sheath. Additionally, the disclosure discusses using two cam members—an outer stationary cam member and an inner telescopically, rotatable cam member. With reference to FIG. 28, it may be beneficial to use additional rotatable sheaths, stationary sheaths, stationary cam members and/or rotatable cam members. FIG. 28 depicts an alternate exemplary embodiment of the distal portion of the sheaths. This figure illustrates a flexible stationary outer sheath 2816, a flexible extendable intermediate sheath 2804, and a flexible extendable inner sheath 2826. Coupled to the outer sheath 2816 is a rotatable outer cam member 2826. Coupled to the intermediate sheath 2804 is a rotatable intermediate cam member 2808. Coupled to the inner sheath 2826 is a rotatable inner cam member 2812. The inner cam member 2812 is connected to the intermediate cam member 2808 by pin 2810. The intermediate cam member 2808 is connected to the outer cam member by pin 2824. As the inner sheath 2826 extends distally, the inner cam member rotates and travels according to the profile of cam slot 2830 in which the pin 2810 sits. Similarly, as the intermediate sheath 2804 extends distally, the intermediate cam member rotates and travels according to the profile of cam slot 2834 in which the pin 2824 sits. Utilizing multiple rotatable and extendable sheaths, as well as rotatable cam members, allows the device to increase the extension and rotation of the cutting surface. This is only one example of an alternative embodiment, and depending upon the amount of blade extension and/or desired rotation and/or movement of the cutting blade, those of skill in the art will understand how to make and use the disclosed aspects, embodiments, and/or configurations after understanding the present disclosure to adjust the location, size, configuration and/or type of indicator. All such configurations within the knowledge of one skilled in the art are considered within the scope of this disclosure.
Additionally, various types of cams, such as single lobe cams and double lobe cams are discussed within this disclosure. Other lobe cam configurations, such as triple lob cams, may be used. Similarly, the increment of the additional length of cam slot need not be 90 degrees beyond 360 degrees. For example, the additional length of cam slot can be in increments of 5, 10, 15, 30, 45, 60 degrees, etc. Furthermore, although the slope of the cam slot between two positions and/or points has been described as generally linear, the slope between two points need not be linear. Rather, the cam slot and/or slope of the cam slot can be non-linear, such as a sinusoidal shape, which may or may not have a generally linear portion. The sinusoidal shape, particularly at the transition points allows for a smooth transition of the inner cam member, inner sheath, and/or cutting surface from an extended direction to retracted direction through such positions while maintaining a relatively constant rate of rotation, thereby allowing the cutting surface to continue to rotate and cut the tissue through such transition.
Moreover, although a pin and slot cam configuration is discussed within this disclosure, other possible cam configurations may be used. For example, a captured ring cam configuration may be used. A captured ring cam configuration may include a ring that is attached to one of the inner sheath (or inner member attached to the inner sheath) or the outer sheath (or outer member attached to the outer sheath) that is captured by two angled lobes on the other sheath (or member). Although the ring may be captured by one lobe, it may be preferred for the ring to be captured by two lobes—one on each side of the ring—such that cutting surface may be forced in both a proximal direction (toward a refraction position) and distal direction (toward an extended direction). The benefit of being able to force the cutting surface in both directions with the aid of the captured cam configuration potentially negates the need for a spring or other retraction mechanism to force the inner sheath (or inner member) and cutting surface back within the outer sheath (or outer member.
US3400708 24 Nov 1965 10 Sep 1968 Robert A. Scheidt Cytologic endocrine evaluation device
US3614953 21 Ene 1969 26 Oct 1971 Nat Res Dev Drills for clearing obstructions in arteries
US3756242 4 Ene 1972 4 Sep 1973 Micro Motors Inc Mechanical scarifier
US4051596 2 Sep 1976 4 Oct 1977 U.S. Philips Corporation Wire cutter, particularly for cutting electrical connection wires
US4471777 30 Mar 1983 18 Sep 1984 Mccorkle Jr Charles E Endocardial lead extraction apparatus and method
US4598710 20 Ene 1984 8 Jul 1986 Urban Engineering Company, Inc. Surgical instrument and method of making same
US4662869 19 Nov 1984 5 May 1987 Wright Kenneth W Precision intraocular apparatus
US4674502 27 Sep 1985 23 Jun 1987 Coopervision, Inc. Intraocular surgical instrument
US4729763 6 Jun 1986 8 Mar 1988 Henrie Rodney A Catheter for removing occlusive material
US4754755 27 Jul 1987 5 Jul 1988 Husted Royce Hill Catheter with a rotary blade
US4767403 9 Feb 1987 30 Ago 1988 The Boc Group, Inc. Positive pulse device and system
US4932419 21 Mar 1988 12 Jun 1990 Boston Scientific Corporation Multi-filar, cross-wound coil for medical devices
US4943289 9 Jun 1989 24 Jul 1990 Cook Pacemaker Corporation Apparatus for removing an elongated structure implanted in biological tissue
US4950277 23 Ene 1989 21 Ago 1990 Interventional Technologies, Inc. Atherectomy cutting device with eccentric wire and method
US4988347 9 Nov 1988 29 Ene 1991 Cook Pacemaker Corporation Method and apparatus for separating a coiled structure from biological tissue
US5011482 3 May 1989 30 Abr 1991 Cook Pacemaker Corporation Apparatus for removing an elongated structure implanted in biological tissue
US5013310 17 Ene 1989 7 May 1991 Cook Pacemaker Corporation Method and apparatus for removing an implanted pacemaker lead
US5031634 19 Ene 1990 16 Jul 1991 Beth Israel Hospital Assoc., Inc. Adjustable biopsy needle-guide device
US5201316 18 Mar 1991 13 Abr 1993 Cardiovascular Imaging Systems, Inc. Guide wire receptacle for catheters having rigid housings
US5207683 26 Abr 1991 4 May 1993 Cook Pacemaker Corporation Apparatus for removing an elongated structure implanted in biological tissue
US5217454 1 Ago 1991 8 Jun 1993 Angiolaz, Incorporated Laser delivery catheter
US5263928 14 Jun 1991 23 Nov 1993 Baxter International Inc. Catheter and endoscope assembly and method of use
US5290275 16 Jul 1991 1 Mar 1994 Massachusetts Institute Of Technology Catheter for laser angiosurgery
US5290303 8 Sep 1992 1 Mar 1994 Vance Products Incorporated D/B/A Cook Urological Incorporated Surgical cutting instrument
US5383199 2 Jul 1992 17 Ene 1995 Advanced Interventional Systems, Inc. Apparatus and method for optically controlling the output energy of a pulsed laser source
US5395328 19 Ene 1994 7 Mar 1995 Daig Corporation Steerable catheter tip having an X-shaped lumen
US5423330 10 Mar 1993 13 Jun 1995 The University Of Miami Capsule suction punch instrument and method of use
US5456680 14 Sep 1993 10 Oct 1995 Spectranetics Corp Fiber optic catheter with shortened guide wire lumen
US5484433 30 Dic 1993 16 Ene 1996 The Spectranetics Corporation Tissue ablating device having a deflectable ablation area and method of using same
US5507751 8 Jun 1994 16 Abr 1996 Cook Pacemaker Corporation Locally flexible dilator sheath
US5562694 11 Oct 1994 8 Oct 1996 Lasersurge, Inc. Morcellator
US5575797 23 Sep 1994 19 Nov 1996 Siemens Elema Ab Device for explanting a medical electrode device
US5632749 2 Abr 1993 27 May 1997 Cook Pacemaker Corporation Apparatus for removing an elongated structure implanted in biological tissue
US5651781 * 20 Abr 1995 29 Jul 1997 Grace-Wells Technology Partners No. 1, L.P. Surgical cutting instrument
US5697936 4 May 1995 16 Dic 1997 Cook Pacemaker Corporation Device for removing an elongated structure implanted in biological tissue
US5718237 30 Mar 1995 17 Feb 1998 Haaga; John R. Biopsy needle
US5725523 29 Mar 1996 10 Mar 1998 Mueller; Richard L. Lateral-and posterior-aspect method and apparatus for laser-assisted transmyocardial revascularization and other surgical applications
US5782823 5 Abr 1996 21 Jul 1998 Eclipse Surgical Technologies, Inc. Laser device for transmyocardial revascularization procedures including means for enabling a formation of a pilot hole in the epicardium
US5807399 23 Oct 1996 15 Sep 1998 Medtronic, Inc. Method for removal of chronically implanted leads and leads optimized for use therewith
US5814044 10 Feb 1995 29 Sep 1998 Enable Medical Corporation Apparatus and method for morselating and removing tissue from a patient
US5863294 26 Ene 1996 26 Ene 1999 Femrx, Inc. Folded-end surgical tubular cutter and method for fabrication
US5910150 27 May 1997 8 Jun 1999 Angiotrax, Inc. Apparatus for performing surgery
US5941893 27 May 1997 24 Ago 1999 Angiotrax, Inc. Apparatus for transluminally performing surgery
US5951581 19 Feb 1998 14 Sep 1999 Angiotrax, Inc. Cutting apparatus having disposable handpiece
US5972012 19 Feb 1998 26 Oct 1999 Angiotrax, Inc. Cutting apparatus having articulable tip
US5980515 19 Dic 1997 9 Nov 1999 Irvine Biomedical, Inc. Devices and methods for lead extraction
US6007512 5 Sep 1997 28 Dic 1999 Enable Medical Corporation Apparatus and method for morselating and removing tissue from a patient
US6010476 17 Oct 1997 4 Ene 2000 Angiotrax, Inc. Apparatus for performing transmyocardial revascularization
US6019756 30 Ene 1997 1 Feb 2000 Eclipse Surgical Technologies, Inc. Laser device for transmyocardial revascularization procedures
US6027497 3 Feb 1997 22 Feb 2000 Eclipse Surgical Technologies, Inc. TMR energy delivery system
US6033402 28 Sep 1998 7 Mar 2000 Irvine Biomedical, Inc. Ablation device for lead extraction and methods thereof
US6042553 15 Abr 1997 28 Mar 2000 Symbiosis Corporation Linear elastic member
US6080175 29 Jul 1998 27 Jun 2000 Corvascular, Inc. Surgical cutting instrument and method of use
US6099537 25 Feb 1997 8 Ago 2000 Olympus Optical Co., Ltd. Medical treatment instrument
US6102926 23 Mar 1999 15 Ago 2000 Angiotrax, Inc. Apparatus for percutaneously performing myocardial revascularization having means for sensing tissue parameters and methods of use
US6117149 11 Feb 1999 12 Sep 2000 Optex Ophthalmologics, Inc. Rotary device and method for removing ophthalmic lens
US6120520 17 Mar 1999 19 Sep 2000 Angiotrax, Inc. Apparatus and methods for stimulating revascularization and/or tissue growth
US6126654 24 Feb 1999 3 Oct 2000 Eclipse Surgical Technologies, Inc. Method of forming revascularization channels in myocardium using a steerable catheter
US6136005 6 May 1997 24 Oct 2000 Cook Pacemaker Corporation Apparatus for removing a coiled structure implanted in biological tissue, having expandable means including a laterally deflectable member
US6152918 9 Abr 1998 28 Nov 2000 Eclipse Surgical Technologies, Inc. Laser device with auto-piercing tip for myocardial revascularization procedures
US6159203 15 Ago 1990 12 Dic 2000 Cardiofocus, Inc. Infrared laser catheter system
US6159225 27 Oct 1998 12 Dic 2000 Transvascular, Inc. Device for interstitial transvascular intervention and revascularization
US6162214 30 Oct 1998 19 Dic 2000 Eclipse Surgical Technologies, Inc. Corning device for myocardial revascularization
US6165188 23 Mar 1999 26 Dic 2000 Angiotrax, Inc. Apparatus for percutaneously performing myocardial revascularization having controlled cutting depth and methods of use
US6167315 5 Abr 1999 26 Dic 2000 Spectranetics Corporation Lead locking device and method
US6174307 8 Ene 1999 16 Ene 2001 Eclipse Surgical Technologies, Inc. Viewing surgical scope for minimally invasive procedures
US6190352 1 Oct 1997 20 Feb 2001 Boston Scientific Corporation Guidewire compatible port and method for inserting same
US6210400 2 Oct 1998 3 Abr 2001 Endovasix, Inc. Flexible flow apparatus and method for the disruption of occlusions
US6228076 9 Ene 1999 8 May 2001 Intraluminal Therapeutics, Inc. System and method for controlling tissue ablation
US6235044 4 Ago 1999 22 May 2001 Scimed Life Systems, Inc. Percutaneous catheter and guidewire for filtering during ablation of mycardial or vascular tissue
US6241692 6 Oct 1998 5 Jun 2001 Irvine Biomedical, Inc. Ultrasonic ablation device and methods for lead extraction
US6245011 3 Jul 1999 12 Jun 2001 Karl Storz Gmbh & Co. Kg Endoscopic instrument with cutting tool
US6258083 6 Ene 1999 10 Jul 2001 Eclipse Surgical Technologies, Inc. Viewing surgical scope for minimally invasive procedures
US6290668 30 Abr 1998 18 Sep 2001 Kenton W. Gregory Light delivery catheter and methods for the use thereof
US6324434 4 Dic 2000 27 Nov 2001 Spectranetics Corporation Lead locking device and method
US6395002 * 18 Ene 2000 28 May 2002 Alan G. Ellman Electrosurgical instrument for ear surgery
US6402771 23 Dic 1999 11 Jun 2002 Guidant Endovascular Solutions Snare
US6419684 * 16 May 2000 16 Jul 2002 Linvatec Corporation End-cutting shaver blade for axial resection
US6423051 16 Sep 1999 23 Jul 2002 Aaron V. Kaplan Methods and apparatus for pericardial access
US6428539 9 Mar 2000 6 Ago 2002 Origin Medsystems, Inc. Apparatus and method for minimally invasive surgery using rotational cutting tool
US6428556 25 Jul 2001 6 Ago 2002 Origin Medsystems, Inc. Longitudinal dilator and method
US6432119 27 Oct 1999 13 Ago 2002 Angiotrax, Inc. Apparatus and methods for performing percutaneous myocardial revascularization and stimulating angiogenesis using autologous materials
US6461349 23 Oct 1998 8 Oct 2002 Carl Zeiss Meditec Ag Medical handpiece with a light guide which can be displaced in an axial direction
US6478777 25 May 2000 12 Nov 2002 Medtronic, Inc. Introducer system for medical electrical lead
US6488693 26 Ene 2001 3 Dic 2002 Hearport, Inc. Vascular incisor and method
US6502606 19 Feb 2002 7 Ene 2003 Cook Inc. Guidewire
US6512959 28 Nov 2000 28 Ene 2003 Pacesetter, Inc. Double threaded stylet for extraction of leads with a threaded electrode
US6527752 25 Sep 2000 4 Mar 2003 Cook Urological, Inc. Embryo transfer catheter
US6540865 6 Jun 2000 1 Abr 2003 Avery Dennison Corporation Prelaminate pressure-sensitive adhesive constructions
US6575997 24 Ago 2001 10 Jun 2003 Endovascular Technologies, Inc. Embolic basket
US6592607 15 Abr 2002 15 Jul 2003 Endovascular Technologies, Inc. Snare
US6602241 17 Ene 2001 5 Ago 2003 Transvascular, Inc. Methods and apparatus for acute or chronic delivery of substances or apparatus to extravascular treatment sites
US6610046 27 Abr 2000 26 Ago 2003 Usaminanotechnology Inc. Catheter and guide wire
US6613013 14 Ene 1999 2 Sep 2003 Boston Scientific Corporation Guidewire compatible port and method for inserting same
US6620153 11 May 2001 16 Sep 2003 Richard L. Mueller Intraoperative myocardial device and stimulation procedure
US6620160 10 Ene 2002 16 Sep 2003 Nanoptics, Inc. Method and device for electro microsurgery in a physiological liquid environment
US6660021 31 Jul 2001 9 Dic 2003 Advanced Cardiovascular Systems, Inc. Intravascular device and system
US6669685 15 Nov 2000 30 Dic 2003 Biolase Technology, Inc. Tissue remover and method
US6687548 17 May 2001 3 Feb 2004 Cook Vascular Incorporated Apparatus for removing an elongated structure implanted in biological tissue
US6706018 4 Dic 2001 16 Mar 2004 Cardiac Pacemakers, Inc. Adjustable length catheter assembly
US6706052 4 Dic 2001 16 Mar 2004 Origin Medsystems, Inc. Longitudinal dilator and method
US6764499 18 May 2001 20 Jul 2004 Cook Urological Incorporated Medical device handle
US6772014 20 Ago 2001 3 Ago 2004 The Spectranetics Corporation Lead locking device and method
US6802838 22 Abr 2002 12 Oct 2004 Trimedyne, Inc. Devices and methods for directed, interstitial ablation of tissue
US6818001 4 Abr 2001 16 Nov 2004 Pathway Medical Technologies, Inc. Intralumenal material removal systems and methods
US6871085 30 Sep 2002 22 Mar 2005 Medtronic, Inc. Cardiac vein lead and guide catheter
US6884240 * 7 Dic 2001 26 Abr 2005 Ronald Dykes Protection system for surgical instruments
US6962585 22 Nov 2002 8 Nov 2005 Poleo Jr Louis A Catherization system and method
US6976955 31 Oct 2003 20 Dic 2005 Wilson-Cook Medical Inc. Handle for medical devices, and medical device assemblies including a handle
US6979290 29 May 2003 27 Dic 2005 The Board Of Trustees Of The Leland Stanford Junior University Apparatus and methods for coronary sinus access
US6979319 31 Dic 2001 27 Dic 2005 Cardiac Pacemakers, Inc. Telescoping guide catheter with peel-away outer sheath
US6999809 16 Jul 2002 14 Feb 2006 Edwards Lifesciences Corporation Central venous catheter having a soft tip and fiber optics
US7004956 25 Abr 2003 28 Feb 2006 Endovascular Technologies, Inc. Embolic basket
US7033335 17 Jun 2003 25 Abr 2006 Boston Scientific Corporation Guidewire compatible port and method for inserting same
US7063693 29 Jul 2004 20 Jun 2006 Medtronic, Inc. Methods and tools for accessing an anatomic space
US7092765 23 Sep 2002 15 Ago 2006 Medtronic, Inc. Non-sheath based medical device delivery system
US7104983 16 Mar 2004 12 Sep 2006 Boston Scientific Scimed, Inc. Laser lithotripsy device with suction
US7149587 26 Sep 2003 12 Dic 2006 Pacesetter, Inc. Cardiovascular anchoring device and method of deploying same
US7151965 18 Jul 2003 19 Dic 2006 Oscor Inc. Device and method for delivering cardiac leads
US7191015 11 Abr 2003 13 Mar 2007 Medtronic Vascular, Inc. Devices and methods for transluminal or transthoracic interstitial electrode placement
US7204824 29 Jul 2003 17 Abr 2007 Harry Moulis Medical liquid delivery device
US7273478 3 Jul 2003 25 Sep 2007 Angiodynamics, Inc. Endovascular treatment device having a fiber tip spacer
US7276052 15 Ene 2004 2 Oct 2007 Nipro Corporation Medical aspirator
US7306588 12 Oct 2004 11 Dic 2007 Trimedyne, Inc. Devices and methods for directed, interstitial ablation of tissue
US7344546 20 May 2003 18 Mar 2008 Pathway Medical Technologies Intralumenal material removal using a cutting device for differential cutting
US7357794 17 Ene 2002 15 Abr 2008 Medtronic Vascular, Inc. Devices, systems and methods for acute or chronic delivery of substances or apparatus to extravascular treatment sites
US7359756 5 Dic 2003 15 Abr 2008 Cook Vascular Incorporated Method of removing an elongated structure implanted in biological tissue
US7396354 5 Ago 2003 8 Jul 2008 Rychnovsky Steven J Light delivery catheter
US7449010 8 Jul 2003 11 Nov 2008 Motoya Hayase Material removal catheter and method
US7462167 26 Ene 2005 9 Dic 2008 Thomas Medical Products, Inc. Catheter sheath slitter and method of use
US7494484 27 Nov 2001 24 Feb 2009 Beck Robert C Method of removing particulate debris with an interventional device
US7509169 27 Abr 2005 24 Mar 2009 Pacesetter, Inc. Implantable pressure transducer system optimized for anchoring and positioning
US7513892 18 Oct 2000 7 Abr 2009 Navilyst Medical, Inc. Guidewire compatible port and method for inserting same
US7559941 19 Dic 2003 14 Jul 2009 Depuy Products, Inc. Instrument for delivery of implant
US7597698 10 Jul 2003 6 Oct 2009 Maquet Cardiovascular Llc Apparatus and method for endoscopic encirclement of pulmonary veins for epicardial ablation
US7606615 10 Jun 2003 20 Oct 2009 Medtronic Vascular, Inc. Methods and apparatus for acute or chronic delivery of substances or apparatus to extravascular treatment sites
US7611474 29 Dic 2004 3 Nov 2009 Ethicon Endo-Surgery, Inc. Core sampling biopsy device with short coupled MRI-compatible driver
US7637904 19 Dic 2003 29 Dic 2009 Vance Products Incorporated Catheter with snap on feature
US7651503 26 Oct 2005 26 Ene 2010 The Spectranetics Corporation Endocardial lead cutting apparatus
US7651504 5 Feb 2003 26 Ene 2010 Cook Vascular Incorporated Device for removing an elongated structure implanted in biological tissue
US7674272 20 Ene 2004 9 Mar 2010 Pathway Medical Technologies, Inc. Bearing system to support a rotatable operating head in an intracorporeal device
US7697996 28 Sep 2006 13 Abr 2010 Cardiac Pacemakers, Inc. Telescoping guide catheter with peel-away outer sheath
US7713231 10 Mar 2004 11 May 2010 Pathway Medical Technologies, Inc. Interventional catheter assemblies and control systems
US7713235 3 Oct 2007 11 May 2010 Pathway Medical Technologies, Inc. Interventional catheters incorporating an active aspiration system
US7713281 4 Oct 2004 11 May 2010 Medtronic, Inc. Expandable guide sheath and apparatus and methods for making them
US7722549 29 Nov 2005 25 May 2010 Granit Medical Innovations, Llc Rotating fine needle for core tissue sampling
US7740626 17 Nov 2004 22 Jun 2010 Terumo Kabushiki Kaisha Laser induced liquid jet generating apparatus
US7798813 20 Nov 2007 21 Sep 2010 Harrel Stephen K Rotary tissue removing instrument
US7811281 27 Dic 2006 12 Oct 2010 Peter Rentrop Excimer laser catheter
US7842009 3 Oct 2007 30 Nov 2010 Pathway Medical Technologies, Inc. Interventional catheters incorporating aspiration and/or infusion systems
US7875018 30 Dic 2004 25 Ene 2011 Cardiac Pacemakers, Inc. Method for manipulating an adjustable shape guide catheter
US7890186 5 Dic 2006 15 Feb 2011 Pacesetter, Inc. Retrieval devices for anchored cardiovascular sensors
US7890192 5 Jun 2009 15 Feb 2011 Greatbatch Ltd. Method for inserting a lead electrode into body tissue using a rotatable lead introducer
US7914493 30 Nov 2006 29 Mar 2011 Cook Medical Technologies Llc Wire guide with engaging portion
US7914520 12 Dic 2006 29 Mar 2011 Cook Medical Technologies Llc Medical catheters of modular construction
US7930040 4 Jun 2009 19 Abr 2011 Greatbatch Ltd. Rotatable lead introducer
US7963040 18 Sep 2008 21 Jun 2011 Ela Medical S.A.S. Slitter tool for cutting a tubular sheath of a guide catheter
US7974710 28 Abr 2005 5 Jul 2011 Medtronic, Inc. Guide catheters for accessing cardiac sites
US7991258 2 Oct 2008 2 Ago 2011 Omniguide, Inc. Photonic crystal fibers and medical systems including photonic crystal fibers
US7993351 24 Jul 2002 9 Ago 2011 Pressure Products Medical Supplies, Inc. Telescopic introducer with a compound curvature for inducing alignment and method of using the same
US7993359 11 Jul 2006 9 Ago 2011 The Spectrametics Corporation Endocardial lead removing apparatus
US8007488 29 Jul 2008 30 Ago 2011 Phase One Medical Llc Catheter device
US8007506 19 Oct 2006 30 Ago 2011 Atheromed, Inc. Atherectomy devices and methods
US8062316 23 Abr 2008 22 Nov 2011 Avinger, Inc. Catheter system and method for boring through blocked vascular passages
US8070762 * 22 Oct 2008 6 Dic 2011 Atheromed Inc. Atherectomy devices and methods
US8090430 28 Sep 2009 3 Ene 2012 Medtronic Vascular, Inc. Methods and apparatus for acute or chronic delivery or substances or apparatus to extravascular treatment sites
US8097012 27 Jul 2005 17 Ene 2012 The Spectranetics Corporation Endocardial lead removing apparatus
US8100920 26 Jun 2008 24 Ene 2012 C.R. Bard, Inc. Endoscopic tissue apposition device with multiple suction ports
US8126570 13 Abr 2010 28 Feb 2012 Cardiac Pacemakers, Inc. Telescoping guide catheter with peel-away outer sheath
US8133214 7 Oct 2008 13 Mar 2012 Motoya Hayase Material removal catheter and method
US8142446 17 Sep 2008 27 Mar 2012 Sorin Crm S.A.S. Toolkit for implanting an intracorporeal lead such as for cardiac pacing or sensing
US8192430 11 Dic 2007 5 Jun 2012 Cook Medical Technologies Llc Device for extracting an elongated structure implanted in biological tissue
US8235916 29 Sep 2011 7 Ago 2012 Pacesetter, Inc. System and method for manipulating insertion pathways for accessing target sites
US8236016 10 Abr 2009 7 Ago 2012 Atheromed, Inc. Atherectomy devices and methods
US8239039 30 Ago 2005 7 Ago 2012 Cardiac Pacemakers, Inc. Device on lead to prevent perforation and/or fixate lead
US8252015 2 Mar 2010 28 Ago 2012 Medtronic, Inc. Expandable guide sheath and apparatus and methods for making them
US8257312 30 Jul 2008 4 Sep 2012 Medtronic, Inc. Integrated slitter for medical instrument inserter
US8257314 10 Nov 2006 4 Sep 2012 Cook Medical Technologies Llc Spiral shaft catheter
US8273078 5 Mar 2008 25 Sep 2012 Amj Bv Device for creating openings in pressurized vessels with deformable walls
US8303511 21 Abr 2005 6 Nov 2012 Pacesetter, Inc. Implantable pressure transducer system optimized for reduced thrombosis effect
US8303570 15 Ago 2011 6 Nov 2012 Boston Scientific Scimed, Inc. Adjustable stiffness catheter
US8323240 28 Abr 2010 4 Dic 2012 Medrad, Inc. Interventional catheter assemblies and control systems
US8326437 4 Mar 2009 4 Dic 2012 W. L. Gore & Associates, Inc. Atraumatic lead removal sheath
US8333740 1 May 2009 18 Dic 2012 Shippert Ronald D Tissue transfer cannula
US8337516 2 Dic 2011 25 Dic 2012 Atheromed, Inc. Atherectomy devices and methods
US8343167 6 Ago 2008 1 Ene 2013 Reverse Medical Corporation Thrombectomy system and method
US8353899 19 Jun 2012 15 Ene 2013 Lockheed Martin Corporation Multiple-mode device for high-power short-pulse laser ablation and CW cauterization of bodily tissues
US8361094 6 Dic 2006 29 Ene 2013 Atheromed, Inc. Atherectomy devices and methods
US8372098 8 Feb 2007 12 Feb 2013 Merit Medical Systems, Inc. Fluid line removal device for removing a fluid line from a body and related methods
US8424535 * 5 Jul 2012 23 Abr 2013 Covidien Lp Circular surgical stapler with mating anvil and shell assembly
US8568433 10 Jul 2009 29 Oct 2013 Cook Medical Technologies Llc Medical device having one or more active strands
US8622275 * 19 Nov 2009 7 Ene 2014 Ethicon Endo-Surgery, Inc. Circular stapler introducer with rigid distal end portion
US9232945 * 7 Jul 2014 12 Ene 2016 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
US9283040 * 13 Mar 2013 15 Mar 2016 The Spectranetics Corporation Device and method of ablative cutting with helical tip
US20010005789 22 Ene 2001 28 Jun 2001 Embol-X, Inc. Percutaneous catheter and guidewire for filtering during ablation of myocardial or vascular tissue
US20010016717 14 Ene 1999 23 Ago 2001 Boston Scientific Corporation Guidewire compatible port and method for inserting same
US20010025174 10 May 2001 27 Sep 2001 Daniel Steven A. Viewing surgical scope for minimally invasive procedures
US20010039427 * 2 May 2001 8 Nov 2001 Dinger Fred B. Suction rasp and handpiece adapter assembly and powered surgical handpiece assembly including a suction rasp
US20010041899 26 Mar 1999 15 Nov 2001 James B. Hunt Minimally-invasive medical retrieval device
US20020002372 26 Abr 2001 3 Ene 2002 Medtronic, Inc. Suction stabilized epicardial ablation devices
US20020007204 17 May 2001 17 Ene 2002 Cook Vascular Incorporated Apparatus for removing an elongated structure implanted in biological tissue
US20020010475 17 May 2001 24 Ene 2002 Cook Vascular Incorporated Apparatus for removing an elongated structure implanted in biological tissue
US20020010487 30 Mar 2001 24 Ene 2002 Evans Michael A. Expansible shearing catheters for thrombus removal
US20020045811 2 Jun 1995 18 Abr 2002 Carter Kittrell Laser ablation process and apparatus
US20020065543 29 Nov 2000 30 May 2002 Pacesetter, Inc. Double threaded stylet for extraction of leads with a threaded electrode
US20020103459 5 Dic 2001 1 Ago 2002 Sparks Kurt D. Catheter system for vascular re-entry from a sub-intimal space
US20020103477 15 Mar 2002 1 Ago 2002 Michael Grasso Laser lithotripsy device with suction
US20020123785 2 Mar 2001 5 Sep 2002 Cardiac Pacemakers, Inc. Cardiac lead permitting easy extraction
US20020165425 23 Feb 2001 7 Nov 2002 Yoon Gul Joong Implantable left ventricular assist device with cylindrical cam
US20020183735 15 Jul 2002 5 Dic 2002 Edwards Stuart D. Ablation of rectal and other internal body structures
US20020188278 7 Jun 2001 12 Dic 2002 Bruce Tockman Method and apparatus for an adjustable shape guide catheter
US20030009146 5 Ago 2002 9 Ene 2003 Muni Ketan P. Aspiration method
US20030036788 20 Ago 2001 20 Feb 2003 The Spectranetics Corporation Lead locking device and method
US20030050630 2 Ago 2002 13 Mar 2003 Afx, Inc. Tissue ablation apparatus with a sliding ablation instrument and method
US20030050631 2 Ago 2002 13 Mar 2003 Afx, Inc. Tissue ablation apparatus with a sliding ablation instrument and method
US20030055444 31 Oct 2002 20 Mar 2003 Bacchus Vascular, Inc. Expansible shearing catheters for thrombus and occlusive material removal
US20030055445 31 Oct 2002 20 Mar 2003 Bacchus Vascular, Inc. Expansible shearing catheters for thrombus and occlusive material removal
US20030069575 21 Jun 2002 10 Abr 2003 Afx, Inc. Tissue ablation system with a sliding ablating device and method
US20030073985 11 May 2001 17 Abr 2003 Mueller Richard L. Intraoperative myocardial device and stimulation procedure
US20030078562 17 Ene 2001 24 Abr 2003 Transvascular, Inc. Methods and apparatus for acute or chronic delivery of substances or apparatus to extravascular treatment sites
US20030105451 4 Dic 2001 5 Jun 2003 Cardiac Pacemakers, Inc. Adjustable length catheter assembly
US20030125619 31 Dic 2001 3 Jul 2003 Cardiac Pacemakers, Inc. Telescoping guide catheter with peel-away outer sheath
US20030167056 27 Feb 2003 4 Sep 2003 Jahns Scott E. Suction stabilized epicardial ablation devices
US20030199916 * 9 Jun 2003 23 Oct 2003 Yee Carl E. Multi-sheath delivery catheter
US20030199921 9 Jun 2003 23 Oct 2003 Olin Palmer Snare
US20030204202 25 Abr 2003 30 Oct 2003 Olin Palmer Embolic basket
US20030229323 17 Jun 2003 11 Dic 2003 Boston Scientific Corporation Guidewire compatible port and method for inserting same
US20030229353 10 Jun 2003 11 Dic 2003 Cragg Andrew H. Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae
US20040006358 20 May 2003 8 Ene 2004 Pathway Medical Technologies, Inc. Intralumenal material removal using a cutting device for differential cutting
US20040010248 3 Jul 2003 15 Ene 2004 Appling William M. Endovascular treatment device having a fiber tip spacer
US20040049208 3 Abr 2003 11 Mar 2004 Thomas Fogarty, M.D. Methods and systems for vein harvesting and fistula creation
US20040054368 5 Ago 2003 18 Mar 2004 Novacept Apparatuses and methods for interstitial tissue removal
US20040054388 18 Jul 2003 18 Mar 2004 Osypka Thomas P. Device and method for delivering cardiac leads
US20040064024 30 Sep 2002 1 Abr 2004 Sommer John L. Cardiac vein lead and guide catheter
US20040068256 22 Sep 2003 8 Abr 2004 Biolase Technology, Inc. Tissue remover and method
US20040068288 6 Oct 2003 8 Abr 2004 Olin Palmer Intravascular device and system
US20040111101 17 Ene 2003 10 Jun 2004 Chin Albert K. Endoscopic subxiphoid surgical procedures
US20040116939 5 Dic 2003 17 Jun 2004 Cook Vascular Incorporated Apparatus for removing an elongated structure implanted in biological tissue
US20040116992 26 Sep 2003 17 Jun 2004 Wardle John L. Cardiovascular anchoring device and method of deploying same
US20040138562 17 Ene 2002 15 Jul 2004 Joshua Makower Devices, systems and methods for acute or chronic delivery of substances or apparatus to extravascular treatment sites
US20040143284 18 Feb 2003 22 Jul 2004 Chin Albert K. Subxiphoid procedures and apparatus for placement of cardiac defibrillator and pacer
US20040147911 13 Ene 2004 29 Jul 2004 Cardiofocus, Inc. Surgical ablation instruments for forming an encircling lesion
US20040147912 13 Ene 2004 29 Jul 2004 Cardiofocus, Inc. Surgical ablation system with sliding ablation device
US20040147913 13 Ene 2004 29 Jul 2004 Cardiofocus, Inc. Surgical ablation instruments with irrigation features
US20040153096 5 Feb 2003 5 Ago 2004 Goode Louis B. Device for removing an elongated structure implanted in biological tissue
US20040172116 31 Ene 2003 2 Sep 2004 Medtronic, Inc. Arrangement for implanting a miniaturized cardiac lead having a fixation helix
US20040181249 20 Ene 2004 16 Sep 2004 Pathway Medical Technologies, Inc. Bearing system to support a rotatable operating head in an intracorporeal device
US20040220519 10 Mar 2004 4 Nov 2004 Pathway Medical Technologies, Inc. Interventional catheter assemblies and control systems
US20040230212 10 Mar 2004 18 Nov 2004 Pathway Medical Technologies, Inc. Medical sealed tubular structures
US20040230213 10 Mar 2004 18 Nov 2004 Pathway Medical Technologies, Inc. Liquid seal assembly for a rotating torque tube
US20040235611 10 Mar 2004 25 Nov 2004 Pathway Medical Technologies, Inc. Tubular torque transmitting system for medical device
US20040236312 10 Mar 2004 25 Nov 2004 Pathway Medical Technologies, Inc. Seal for a connector of a movable catheter system
US20040236397 25 Jun 2004 25 Nov 2004 The Spectranetics Corporation Lead locking device and method
US20040243123 16 Mar 2004 2 Dic 2004 Scimed Life Systems, Inc. Laser lithotripsy device with suction
US20040243162 10 Mar 2004 2 Dic 2004 Pathway Medical Technologies, Inc. Interventional catheter assemblies and control systems
US20040254534 11 Jun 2003 16 Dic 2004 Bjorkman Bradford A. Sliding connection assembly to facilitate lead stabilization
US20040267276 30 Jun 2003 30 Dic 2004 Camino Thomas S. Slide and kit for delivering implants
US20050004644 6 May 2004 6 Ene 2005 Enpath Medical, Inc. Rotatable lead introducer
US20050025798 29 Jul 2003 3 Feb 2005 Harry Moulis Medical liquid delivery device
US20050054948 29 Jul 2004 10 Mar 2005 Goldenberg Alec S. Biopsy needles
US20050065561 3 Nov 2004 24 Mar 2005 Cardiac Pacemakers, Inc. Methods of using a telescoping guide catheter with peel-away outer sheath
US20050090748 10 Jun 2003 28 Abr 2005 Transvascular, Inc. Methods and apparatus for acute or chronic delivery of substances or apparatus to extravascular treatment sites
US20050131399 12 Oct 2004 16 Jun 2005 Loeb Marvin P. Devices and methods for directed, interstitial ablation of tissue
US20050149104 4 Oct 2004 7 Jul 2005 Leeflang Stephen A. Expandable guide sheath and apparatus and methods for making them
US20050149105 4 Oct 2004 7 Jul 2005 Leeflang Stephen A. Expandable guide sheath and apparatus and methods for making them
US20050197623 17 Feb 2005 8 Sep 2005 Leeflang Stephen A. Variable steerable catheters and methods for using them
US20050222607 10 May 2005 6 Oct 2005 Olin Palmer Snare
US20050228402 24 Ene 2003 13 Oct 2005 Lawrence Hofmann Methods and devices for percutaneous and surgical interventions
US20050251116 3 May 2005 10 Nov 2005 Minnow Medical, Llc Imaging and eccentric atherosclerotic material laser remodeling and/or ablation catheter
US20050259942 8 Abr 2005 24 Nov 2005 Burak Temelkuran Photonic crystal fibers and medical systems including photonic crystal fibers
US20050267557 * 1 Jul 2005 1 Dic 2005 Cardiac Pacemakers, Inc. Extendable and retractable lead having a snap-fit terminal connector
US20050273090 6 Jun 2005 8 Dic 2005 Tim Nieman Methods and devices for directionally ablating tissue
US20050283143 10 Ene 2005 22 Dic 2005 Rizoiu Ioana M Tissue remover and method
US20050288596 21 Abr 2005 29 Dic 2005 Eigler Neal L Implantable pressure transducer system optimized for reduced thrombosis effect
US20050288604 27 Abr 2005 29 Dic 2005 Eigler Neal L Implantable pressure transducer system optimized to correct environmental factors
US20050288654 6 Jun 2005 29 Dic 2005 Tim Nieman Methods and devices for delivering ablative energy
US20050288722 27 Abr 2005 29 Dic 2005 Eigler Neal L Implantable pressure transducer system optimized for anchoring and positioning
US20060041250 15 Ago 2005 23 Feb 2006 Poleo Louis A Catherization system and method
US20060084839 8 Nov 2005 20 Abr 2006 Mourlas Nicholas J Apparatus and methods for coronary sinus access
US20060100663 22 Dic 2005 11 May 2006 Olin Palmer Embolic basket
US20060167417 26 Ene 2005 27 Jul 2006 Thomas Medical Products, Inc. Catheter sheath slitter and method of use
US20060173440 14 Abr 2006 3 Ago 2006 Medtronic Vascular, Inc. Microcatheter Devices and Methods for Targeted Substance Delivery
US20060217755 3 Feb 2006 28 Sep 2006 Eversull Christian S Expandable guide sheath with steerable backbone and methods for making and using them
US20060235431 * 14 Abr 2006 19 Oct 2006 Cook Vascular Incorporated Lead extraction device
US20060247751 28 Abr 2005 2 Nov 2006 Seifert Kevin R Guide catheters for accessing cardiac sites
US20060253179 14 Abr 2006 9 Nov 2006 Cook Vascular Incorporated Tip for lead extraction device
US20060265042 22 Dic 2005 23 Nov 2006 Exploramed Nc2, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US20060276871 20 May 2005 7 Dic 2006 Exploramed Nc2, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US20070015964 20 Abr 2006 18 Ene 2007 Eversull Christian S Apparatus and Methods for Coronary Sinus Access
US20070016130 6 May 2006 18 Ene 2007 Leeflang Stephen A Complex Shaped Steerable Catheters and Methods for Making and Using Them
US20070021812 28 Sep 2006 25 Ene 2007 Cardiac Pacemakers, Inc. Telescoping guide catheter with peel-away outer sheath
US20070049929 24 Jul 2006 1 Mar 2007 Catanese Joseph Iii Apparatus and method for manipulating or retracting tissue and anatomical structure
US20070050003 30 Ago 2005 1 Mar 2007 Cardiac Pacemakers, Inc. Device on lead to prevent perforation and/or fixate lead
US20070083217 16 Ago 2006 12 Abr 2007 Eversull Christian S Apparatus and Methods for Placing Leads Using Direct Visualization
US20070100410 31 Oct 2006 3 May 2007 Medtronic Vascular, Inc. Devices and methods for transluminal or transthoracic interstitial electrode placement
US20070106328 5 Dic 2006 10 May 2007 Wardle John L Retrieval devices for anchored cardiovascular sensors
US20070123892 25 Oct 2006 31 May 2007 Joimax Gmbh Facet joint reamer
US20070129710 9 Ene 2007 7 Jun 2007 Rudko Robert I Endovascular tissue removal device
US20070142846 6 Feb 2007 21 Jun 2007 Neotract, Inc. Integrated handle assembly for anchor delivery system
US20070197861 24 Abr 2007 23 Ago 2007 Kyphon Inc. Systems and methods for creating cavities in interior body regions
US20070198020 24 Abr 2007 23 Ago 2007 Kyphon Inc. Apparatus and method for creating cavities in interior body regions
US20070276412 13 Ago 2007 29 Nov 2007 Neotract, Inc. Integrated handle assembly for anchor delivery system
US20070276419 26 May 2006 29 Nov 2007 Fox Hollow Technologies, Inc. Methods and devices for rotating an active element and an energy emitter on a catheter
US20080004643 19 Oct 2006 3 Ene 2008 Atheromed, Inc. Atherectomy devices and methods
US20080004644 19 Oct 2006 3 Ene 2008 Atheromed, Inc. Atherectomy devices and methods
US20080004645 19 Oct 2006 3 Ene 2008 Atheromed, Inc. Atherectomy devices and methods
US20080004646 19 Oct 2006 3 Ene 2008 Atheromed, Inc. Atherectomy devices and methods
US20080004647 6 Dic 2006 3 Ene 2008 Atheromed, Inc. Atherectomy devices and methods
US20080015625 9 May 2007 17 Ene 2008 Acumen Medical, Inc. Shapeable for steerable guide sheaths and methods for making and using them
US20080021484 3 Ago 2007 24 Ene 2008 Neotract, Inc. Apparatus and method for manipulating or retracting tissue and anatomical structure
US20080021485 3 Ago 2007 24 Ene 2008 Neotract, Inc. Apparatus and method for manipulating or retracting tissue and anatomical structure
US20080033232 3 Ago 2007 7 Feb 2008 Neotract, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US20080033456 13 Ago 2007 7 Feb 2008 Neotract, Inc. Integrated handle assembly for anchor delivery system
US20080033458 9 Jul 2007 7 Feb 2008 Neotract, Inc. Multi-actuating trigger anchor delivery system
US20080033488 3 Ago 2007 7 Feb 2008 Neotract, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US20080039833 3 Ago 2007 14 Feb 2008 Neotract, Inc. Apparatus and method for maniuplating or retracting tissue and anatomical structure
US20080039872 3 Ago 2007 14 Feb 2008 Neotract, Inc. Apparatus and method for manipulating or retracting tissue and anatomical structure
US20080039874 3 Ago 2007 14 Feb 2008 Neotract, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US20080039875 3 Ago 2007 14 Feb 2008 Neotract, Inc. Apparatus and method for manipulating or retracting tissue and anatomical structure
US20080039876 3 Ago 2007 14 Feb 2008 Neotract, Inc. Apparatus and method for manipulating or retracting tissue and anatomical structure
US20080039889 13 Ago 2007 14 Feb 2008 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US20080039893 9 Jul 2007 14 Feb 2008 Neotract, Inc. Multi-actuating trigger anchor delivery system
US20080039894 3 Ago 2007 14 Feb 2008 Neotract, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US20080045986 29 Jun 2007 21 Feb 2008 Atheromed, Inc. Atherectomy devices and methods
US20080051756 30 Oct 2007 28 Feb 2008 Medtronic Vascular, Inc. Devices, Systems and Methods for Acute or Chronic Delivery of Substances or Apparatus to Extravascular Treatment Sites
US20080058759 30 Oct 2007 6 Mar 2008 Medtronic Vascular, Inc. Devices, Systems and Methods for Acute or Chronic Delivery of Substances or Apparatus to Extravascular Treatment Sites
US20080071341 5 Oct 2007 20 Mar 2008 Cook Vascular Incorporated Tip for lead extraction device
US20080071342 5 Oct 2007 20 Mar 2008 Cook Vascular Incorporated Vessel entry device
US20080097398 31 Jul 2006 24 Abr 2008 Vladimir Mitelberg Interventional medical device component having an interrupted spiral section and method of making the same
US20080097426 13 Dic 2007 24 Abr 2008 Boston Scientific Scimed, Inc. Percutaneous catheter and guidewire for filtering during ablation of myocardial or vascular tissue
US20080103439 3 Oct 2007 1 May 2008 Pathway Medical Technologies, Inc. Interventional catheters incorporating an active aspiration system
US20080103446 3 Oct 2007 1 May 2008 Pathway Medical Technologies, Inc. Interventional catheters incorporating aspiration and/or infusion systems
US20080103516 3 Oct 2007 1 May 2008 Pathway Medical Technologies, Inc. Interventional catheters having cutter assemblies and differential cutting surfaces for use in such assemblies
US20080125748 25 Sep 2006 29 May 2008 Medtronic Vascular, Inc. High Torque, Low Profile Catheters and Methods for Transluminal Interventions
US20080147061 11 Dic 2007 19 Jun 2008 Cook Vascular Incorporated Device for extracting an elongated structure implanted in biological tissue
US20080183163 30 Ene 2007 31 Jul 2008 Lampropoulos Fred P Introducer sheath and hub assembly
US20080208105 12 Dic 2007 28 Ago 2008 Zelickson Brian D Laser energy device for soft tissue removal
US20080221560 6 May 2004 11 Sep 2008 Keio University Intravascular Diagnostic or Therapeutic Apparatus Using High-Intensity Pulsed Light
US20080228208 18 Mar 2008 18 Sep 2008 Pathway Medical Technologies, Inc. Intralumenal material removal using a cutting device for differential cutting
US20080234602 18 Mar 2008 25 Sep 2008 Oostman Clifford A Biological unit removal tools with retention mechanism
US20080234698 18 Mar 2008 25 Sep 2008 Oostman Clifford A Harvesting tools for biological units
US20080234716 29 Sep 2006 25 Sep 2008 Kiester Douglas P Apparatus And Method For A High Speed Rotation-To-Rotation Oscillation Converter For Surgical Use
US20080249516 5 Mar 2008 9 Oct 2008 Amj Bv Device for creating openings in pressurized vessels with deformable walls
US20080262516 26 Jun 2008 23 Oct 2008 C.R. Bard, Inc. Endoscopic tissue apposition device with multiple suction ports
US20080275497 29 Abr 2008 6 Nov 2008 Endosvascular Technologies, Inc. Snare
US20080275498 29 Abr 2008 6 Nov 2008 Endosvascular Technologies, Inc. Embolic basket
US20080277445 7 May 2007 13 Nov 2008 Zergiebel Earl M Single fire tacker instrument
US20080281308 7 May 2007 13 Nov 2008 Ceramoptec Industries, Inc. Device and method for improved vascular laser treatment
US20080287888 29 Jul 2008 20 Nov 2008 Ravenscroft Adrian C Catheter device
US20090012510 14 Jul 2008 8 Ene 2009 Endoscopic Technologies, Inc. Cardiac ablation devices and methods
US20090018523 13 Ago 2007 15 Ene 2009 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US20090018553 9 Jul 2007 15 Ene 2009 Neotract, Inc. Multi-actuating trigger anchor delivery system
US20090034927 2 Oct 2008 5 Feb 2009 Burak Temelkuran Photonic crystal fibers and medical systems including photonic crystal fibers
US20090036871 7 Oct 2008 5 Feb 2009 Motoya Hayase Material removal catheter and method
US20090054918 6 Ago 2008 26 Feb 2009 Henson Michael R Thrombectomy System and Method
US20090060977 17 Oct 2008 5 Mar 2009 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US20090071012 18 Sep 2008 19 Mar 2009 Ela Medical S.A.S., 98, Rue Maurice-Arnoux, F-9212 Slitter tool for cutting a tubular sheath of a guide catheter
US20090076522 17 Sep 2008 19 Mar 2009 Ela Medical S.A.S. Toolkit for implanting an intracorporeal lead such as for cardiac pacing or sensing
US20090131907 31 Dic 2008 21 May 2009 Maquet Cardiovascular Llc Endoscopic Cardiac Surgery
US20090157045 17 Feb 2009 18 Jun 2009 Brett Haarala Guidewire Compatible Port and Method for Inserting the Same
US20090192439 13 Ago 2007 30 Jul 2009 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US20090204128 13 Ago 2007 13 Ago 2009 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US20090221994 8 May 2007 3 Sep 2009 Wolfgang Neuberger Device and Method for Improved Vascular Laser Treatment
US20090222025 6 Mar 2009 3 Sep 2009 Neotract, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US20090227999 14 May 2009 10 Sep 2009 Voyage Medical, Inc. Visual electrode ablation systems
US20090234378 22 Oct 2008 17 Sep 2009 Atheromed, Inc. Atherectomy devices and methods
US20090270862 25 Abr 2008 29 Oct 2009 Greg Arcenio Medical device with one-way rotary drive mechanism
US20100004606 2 Jul 2009 7 Ene 2010 William Cook Europe Aps Deployment assembly and introducer
US20100016836 28 Sep 2009 21 Ene 2010 Medtronic Vascular, Inc. Methods and Apparatus for Acute or Chronic Delivery or Substances or Apparatus to Extravascular Treatment Sites
US20100030154 30 Jul 2008 4 Feb 2010 Niall Duffy Medical instrument inserter
US20100030161 30 Jul 2008 4 Feb 2010 Niall Duffy Integrated slitter for medical instrument inserter
US20100030262 30 Jul 2009 4 Feb 2010 Neotract, Inc. Anchor delivery system with replaceable cartridge
US20100030263 30 Jul 2009 4 Feb 2010 Neotracrt, Inc. Slotted anchor device
US20100049225 10 Abr 2009 25 Feb 2010 Atheromed, Inc. Atherectomy devices and methods
US20100063488 9 Sep 2008 11 Mar 2010 Fischer Jr Frank J Wire guided thrombectomy device
US20100125253 17 Nov 2008 20 May 2010 Avinger Dual-tip Catheter System for Boring through Blocked Vascular Passages
US20100137873 5 Feb 2010 3 Jun 2010 Grady Jr Mark P Aiming Arm for Bone Plates
US20100160952 2 Mar 2010 24 Jun 2010 Medtronic, Inc. Expandable Guide Sheath and Apparatus and Methods for Making Them
US20100191165 28 Dic 2009 29 Jul 2010 Angiodynamics, Inc. Multilumen Catheters and Method of Manufacturing
US20100198194 13 Abr 2010 5 Ago 2010 Manning Frank E Telescoping Guide Catheter with Peel-Away Outer Sheath
US20100198229 13 Ene 2010 5 Ago 2010 Leadex Cardiac Ltd. Lead extraction methods and apparatus
US20100217081 18 Mar 2010 26 Ago 2010 Linvatec Corporation Endoscope and related system
US20100217277 25 Feb 2009 26 Ago 2010 Pacesetter, Inc. Device and method for the implantation of active fixation medical leads
US20100222737 16 Abr 2010 2 Sep 2010 Arizant Healthcare Inc. High flow rate infusion unit and heat exchanger
US20100222787 25 Feb 2010 2 Sep 2010 Cook Vascular Incorporated Tension control device
US20100240951 1 Jun 2010 23 Sep 2010 Neotract, Inc. Integrated Handle Assembly for Anchor Delivery System
US20100256616 2 Abr 2010 7 Oct 2010 Retrovascular, Inc. Recanalizing occluded vessels using radiofrequency energy
US20100280496 1 May 2009 4 Nov 2010 Shippert Ronald D Tissue transfer cannula
US20100305594 24 Ene 2010 2 Dic 2010 Scottsdale Medical Devices, Inc. Percutaneous vein harvester with shielded blade
US20100324472 14 Nov 2008 23 Dic 2010 Pathway Medical Technologies, Inc. Delivery and administration of compositions using interventional catheters
US20100331793 21 Feb 2008 30 Dic 2010 Amj B.V. Laser catheter for bypass surgery and assembly comprising said catheter
US20110004238 23 Ago 2010 6 Ene 2011 Abbott Laboratories Intravascular device and system
US20110009957 15 Sep 2010 13 Ene 2011 Edwards Lifesciences Ag Percutaneous mitral annulplasty with cardiac rhythm management
US20110022057 23 Jul 2010 27 Ene 2011 Pacesetter, Inc. Apparatus and methods for transferring an implanted elongate body to a remote site
US20110028959 30 Jul 2009 3 Feb 2011 Paul Chasan Surgical Apparatus and Method for Performing Minimally Invasive Surgery
US20110034790 18 Oct 2010 10 Feb 2011 The Board Of Trustees Of The Leland Stanford Jr. University Apparatus and methods for coronary sinus access
US20110040238 11 Ago 2010 17 Feb 2011 Pathway Medical Technologies, Inc. Interventional catheter assemblies incorporating guide wire brake and management systems
US20110040312 9 Ago 2010 17 Feb 2011 Neotract, Inc. Deforming anchor device
US20110040315 22 Oct 2010 17 Feb 2011 Atheromed, Inc. Devices, systems, and methods for cutting and removing occlusive material from a body lumen
US20110040326 9 Ago 2010 17 Feb 2011 Neotract, Inc. Coiled anchor device
US20110046648 9 Ago 2010 24 Feb 2011 Neotract, Inc. Latching anchor device
US20110054493 9 Nov 2010 3 Mar 2011 Neotract, Inc. Multi-Actuating Trigger Anchor Delivery System
US20110060349 6 Ago 2010 10 Mar 2011 Neotract, Inc. Anchor delivery system
US20110071440 30 Nov 2010 24 Mar 2011 Pathway Medical Technologies, Inc. Interventional catheters incorporating aspiration and/or infusion systems
US20110105947 28 Oct 2010 5 May 2011 Wilson-Cook Medical Inc. System and method for performing a full thickness tissue biopsy
US20110106004 11 Ago 2010 5 May 2011 Pathway Medical Technologies, Inc. Systems and methods for operating interventional catheters using a common operating console and adaptive interface components
US20110106099 29 Oct 2009 5 May 2011 Medtronic, Inc. Lead extraction device
US20110112548 8 Nov 2010 12 May 2011 Daniel Fifer Methods and systems for removal of implantable intravascular devices
US20110112562 28 Abr 2010 12 May 2011 Pathway Medical Technologies, Inc. Interventional catheter assemblies and control systems
US20110112563 27 Dic 2010 12 May 2011 Atheromed, Inc. Atherectomy devices and methods
US20110112564 21 May 2009 12 May 2011 Wolf Yehuda G Device And Method For Crossing Occlusions
US20110118660 7 May 2010 19 May 2011 Pathway Medical Technologies, Inc. Interventional catheters incorporating an active aspiration system
US20110144423 27 Dic 2010 16 Jun 2011 Neotract, Inc. Median Lobe Retraction Apparatus and Method
US20110144425 28 Feb 2011 16 Jun 2011 Neotract, Inc. Apparatus and Method for Manipulating or Retracting Tissue and Anatomical Structure
US20110151463 14 Nov 2008 23 Jun 2011 Pathway Medical Technologies, Inc. Methods and systems for biological sample collection and analysis
US20110152607 7 Ene 2011 23 Jun 2011 Neotract, Inc. Apparatus and Method for Manipulating or Retracting Tissue and Anatomical Structure
US20110152906 24 Feb 2011 23 Jun 2011 Atheromed, Inc. Devices, systems, and methods for debulking restenosis of a blood vessel
US20110152907 24 Feb 2011 23 Jun 2011 Atheromed, Inc. Devices, systems, and methods for performing atherectomy including delivery of a bioactive material
US20110160747 27 Dic 2010 30 Jun 2011 Neotract, Inc. Continuous Indentation Lateral Lobe Apparatus and Method
US20110160748 27 Dic 2010 30 Jun 2011 Neotract, Inc. Median Lobe Band Implant Apparatus and Method
US20110166564 27 Dic 2010 7 Jul 2011 Neotract, Inc. Median Lobe Destruction Apparatus and Method
US20110178543 20 Ene 2011 21 Jul 2011 Pavilion Medical Innovations Systems and methods for removal of intravascular leads
US20110190758 28 Mar 2011 4 Ago 2011 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US20110196298 30 Oct 2009 11 Ago 2011 Cathrx Ltd Catheter Assembly
US20110196355 22 Abr 2011 11 Ago 2011 Precise Light Surgical, Inc. Flash vaporization surgical systems
US20110208207 27 Jul 2005 25 Ago 2011 Bowe Wade A Endocardial lead removing apparatus
US20110213398 20 Ene 2011 1 Sep 2011 Pavilion Medical Innovations Systems and Methods for Removal of Intravascular Leads
US20110218528 7 Mar 2011 8 Sep 2011 Retro Vascular, Inc. Anatomical structure access and penetration
US20110238078 25 Mar 2011 29 Sep 2011 Cook Medical Technologies Llc Device and method for positioning an implanted structure to facilitate removal
US20110238102 3 Jun 2011 29 Sep 2011 Pacesetter, Inc. Transseptal delivery instrument
US20110245751 3 Mar 2011 6 Oct 2011 The John Hopkins University Methods and devices for percutaneous and surgical interventions
US20110257592 23 Jun 2011 20 Oct 2011 Medtronic, Inc. Shapeable or Steerable Guide Sheaths and Methods for Making and Using Them
US20110270169 30 Abr 2010 3 Nov 2011 Medtronic, Inc. Steerable Stylet with Guidewire Tip
US20110270170 30 Abr 2010 3 Nov 2011 Medtronic, Inc. Steerable Medical Device Having Means For Imparting Multiple Curves in the Device
US20110270289 14 Jul 2011 3 Nov 2011 Atheromed, Inc. Atherectomy devices and methods
US20110301417 15 Ago 2011 8 Dic 2011 The Board Of Trustees Of The Leland Stanford Jr. University Apparatus and methods for coronary sinus access
US20110301626 19 Ago 2011 8 Dic 2011 Atheromed, Inc. Atherectomy devices and methods
US20120029278 * 25 May 2011 2 Feb 2012 Olympus Medical Systems Corp. Implant placement device, coupling support, and endoscopic treatment tool
US20120035590 29 Sep 2011 9 Feb 2012 Pacesetter, Inc. System and method for manipulating insertion pathways for accessing target sites
US20120041422 29 Sep 2011 16 Feb 2012 Pacesetter, Inc. System and method for manipulating insertion pathways for accessing target sites
US20120053564 25 Ago 2011 1 Mar 2012 Ravenscroft Adrian C Catheter device
US20120065659 9 Ago 2011 15 Mar 2012 To John T Helical groove dilating device and related methods
US20120083810 2 Dic 2011 5 Abr 2012 Atheromed, Inc. Atherectomy devices and methods
US20120083826 2 Oct 2011 5 Abr 2012 The Board Of Trustees Of The Leland Stanford Junior University Surgical device and methods
US20120095447 19 Oct 2010 19 Abr 2012 Occam Scientific, Llc Apparatus for rotating medical devices, systems including the apparatus, and associated methods
US20120095479 21 Dic 2011 19 Abr 2012 Bowe Wade A Endocardial Lead Removing Apparatus
US20120097174 7 Jul 2010 26 Abr 2012 The Trustees Of Columbia University In The City Of Coronary Sinus Cannula With Left Ventricle Lead And Pressure Tent
US20120123411 14 Nov 2011 17 May 2012 Estech, Inc. (Endoscopic Technologies, Inc.) Stabilized ablation systems and methods
US20120136341 8 Feb 2012 31 May 2012 Appling William M Multilumen Catheters and Method of Manufacturing
US20120158117 6 Dic 2011 21 Jun 2012 Cook Medical Technologies Llc Handle Control System for a Stent Delivery System
US20120165861 2 Mar 2012 28 Jun 2012 Abbott Laboratories Snare
US20120172907 30 Dic 2010 5 Jul 2012 Kimberly-Clark, Inc. Tissue Removal Apparatus
US20120191015 23 Mar 2012 26 Jul 2012 Depuy Products, Inc. Coordinate instrument set
US20120203240 27 Ene 2012 9 Ago 2012 Jacque Delahoussaye Cuffed-catheter remover
US20120209173 9 Feb 2012 16 Ago 2012 Motoya Hayase Material removal catheter and method
US20120215305 16 Feb 2012 23 Ago 2012 Micardia Corporation Adjustable annuloplasty ring and activation system
US20120239008 3 Mar 2011 20 Sep 2012 Distal Access, Llc Apparatus for rotating medical devices, systems including the apparatus, and associated methods
US20120245600 6 Jun 2012 27 Sep 2012 Neotract, Inc. Anchor delivery system with replaceable cartridge
US20120253229 6 Feb 2012 4 Oct 2012 Cook Medical Technologies Llc Tissue Sampling Device And Method
US20120265183 11 Sep 2009 18 Oct 2012 Amj Bv Catheter system for bypass surgery and a method for preparing a catheter system for bypass surgery
US20120323252 * 16 Jun 2011 20 Dic 2012 Cook Medical Technologies Llc Tip for lead extraction device
US20120323253 29 Ago 2011 20 Dic 2012 Ellis Garai Device and method for positioning an electrode in tissue
US20130006167 9 Sep 2011 3 Ene 2013 Alvarez Jeffery B Reentry Catheter and Method Thereof
US20130006228 11 Sep 2012 3 Ene 2013 Johnson Theododre C Methods and apparatuses for tissue treatment
US20130035676 22 Abr 2011 7 Feb 2013 Precise Light Surgical, Inc. Flash vaporization surgical systems
US20130090681 13 May 2011 11 Abr 2013 Cook Medical Technologies Llc Dilating device
US20130096582 3 Dic 2012 18 Abr 2013 Neotract, Inc. Anchor delivery system
US20130131548 18 Ene 2013 23 May 2013 Cook Medical Technologies Llc Coaxial incisional full-core biopsy needle
US20130253259 7 May 2013 26 Sep 2013 Boston Scientific Scimed, Inc. Insertion device and method for delivery of a mesh carrier
US20140277037 * 15 Mar 2013 18 Sep 2014 The Spectranetics Corporation Retractable blade for lead removal device
US20150105796 * 19 Dic 2014 16 Abr 2015 The Spectranetics Corporation Surgical instrument including an inwardly deflecting cutting tip for removing an implanted object
US20150305744 30 Jun 2015 29 Oct 2015 Ethicon Endo-Surgery, Inc. Detachable motor powered surgical instrument
US20160015963 13 Mar 2014 21 Ene 2016 The Spectranetics Corporation Surgical instrument for removing an implanted object
US20160120562 15 Ene 2016 5 May 2016 The Spectranetics Corporation Retractable separating systems and methods
USD267145 28 Mar 1980 7 Dic 1982 Strap tightener and cutter
USD309350 1 Jun 1987 17 Jul 1990 Pfizer Hospital Products Group, Inc. Surgical sternotomy band tightening instrument
USD430781 1 Nov 1999 12 Sep 2000 Panduit Corp. Cable tie application tool
USD600792 12 Feb 2009 22 Sep 2009 Pathway Medical Technologies, Inc. Tubing cassette
USD679010 27 Abr 2012 26 Mar 2013 Olympus Medical Systems Corp. Handle of surgical instrument
USD697618 20 May 2013 14 Ene 2014 Entrigue Surgical, Inc. Insertion device
USD706928 5 Mar 2013 10 Jun 2014 Anchor Orthopedics Xt Inc. Handle for suturing instrument
USD708742 11 Dic 2012 8 Jul 2014 Karl Storz Gmbh & Co. Kg Handle for medical device
EP1040843B1 29 Mar 1999 28 Sep 2005 Cook Incorporated A guidewire
EP1120088B1 28 Ene 2000 29 Abr 2009 William Cook Europe ApS An embolization device introducer
EP1120094B1 28 Ene 2000 21 Jun 2006 William Cook Europe ApS A delivery catheter for a self-expandable prosthesis
EP1120127B1 28 Ene 2000 11 Ago 2004 Cook Incorporated Catheter made of a multifilar row of wires
EP1120128B1 28 Ene 2000 9 Nov 2005 Cook Incorporated A catheter system
EP1903957B1 14 Abr 2006 28 Dic 2011 Cook Medical Technologies LLC Lead extraction device
EP2451336B1 1 Jul 2010 21 Ago 2013 Cook Medical Technologies LLC Medical device having one or more active strands
JP2004516073A Título no disponible
JPH05506382A Título no disponible
WO1991017711A1 20 May 1991 28 Nov 1991 Cardiovascular Imaging Systems, Inc. Intravascular catheter having combined imaging abrasion head
WO1995033513A1 5 Jun 1995 14 Dic 1995 Cook Pacemaker Corporation Locally flexible dilator sheath
WO1999049937A1 26 Mar 1999 7 Oct 1999 The General Hospital Corporation Method and apparatus for the selective targeting of lipid-rich tissues
WO1999058066A1 12 May 1999 18 Nov 1999 Med-En Ltd. Device and method for evacuating refuse from tissues of the body
WO2001076680A1 4 Abr 2001 18 Oct 2001 Stx Medical, Inc. Intralumenal material removal systems and methods
WO2002049690A2 19 Dic 2001 27 Jun 2002 Fox Hollow Technologies, Inc. Debulking catheter
WO2002049690A9 19 Dic 2001 1 May 2003 Fox Hollow Technologies Inc Debulking catheter
WO2004080345A2 10 Mar 2004 23 Sep 2004 Pathway Medical Technologies Inc. Interventional catheters having differential cutting surfaces
WO2004080507A2 10 Mar 2004 23 Sep 2004 Pathway Medical Technologies, Inc. Interventional catheters assemblies and control systems
WO2006007410A2 16 Jun 2005 19 Ene 2006 Medtronic, Inc. Minimally invasive coring vein harvester
WO2008005888A2 29 Jun 2007 10 Ene 2008 Atheromed, Inc. Atherectomy devices and methods
WO2008005891A2 29 Jun 2007 10 Ene 2008 Atheromed, Inc. Atherectomy devices and methods
WO2008042987A2 3 Oct 2007 10 Abr 2008 Pathway Medical Technologies, Inc. Interventional catheters
WO2009005779A1 30 Jun 2008 8 Ene 2009 Atheromed, Inc. Atherectomy devices, systems, and methods
WO2009046002A1 30 Sep 2008 9 Abr 2009 Cook Vascular Incorporated Tip for lead extraction device
WO2009054968A1 22 Oct 2008 30 Abr 2009 Atheromed, Inc. Atherectomy devices and methods
WO2009065082A1 14 Nov 2008 22 May 2009 Pathway Medical Technologies, Inc. Methods and systems for biological sample collection and analysis
WO2009126309A2 10 Abr 2009 15 Oct 2009 Atheromed, Inc. Atherectomy devices and methods
WO2011003113A1 5 Jul 2010 6 Ene 2011 Tactus Technology User interface enhancement system
WO2011084863A2 30 Dic 2010 14 Jul 2011 Cheetah Omni, Llc Fiber lasers and mid-infrared light sources in methods and systems for selective biological tissue processing and spectroscopy
WO2011133941A2 22 Abr 2011 27 Oct 2011 Precise Light Surgical, Inc. Flash vaporization surgical systems
WO2011162595A1 24 Jun 2010 29 Dic 2011 Vascular Connect B.V. Laser catheter for bypass surgery
WO2012009697A1 15 Jul 2011 19 Ene 2012 Pathway Medical Technologies, Inc. Peristaltic pump assemblies and systems incorporating such pump assemblies
WO2012040239A1 20 Sep 2011 29 Mar 2012 Spine View, Inc. Cannulotome
WO2012098335A1 19 Ene 2012 26 Jul 2012 A Raymond Et Cie Device for introducing elements into a body
WO2012114333A1 23 Feb 2012 30 Ago 2012 Oren Ilan Ben Hybrid catheter for vascular intervention
WO2012177117A1 21 Jun 2011 27 Dic 2012 Amj B.V. Laser catheter for bypass surgery, as well as assembly comprising such a catheter
WO2013036588A1 6 Sep 2012 14 Mar 2013 Circulite, Inc. Cannula tips, tissue attachment rings, and methods of delivering and using the same
WO2014151814A1 13 Mar 2014 25 Sep 2014 The Spectranetics Corporation Surgical instrument for removing an implanted object
1 "Horizon Scanning Technology Prioritising Summary: Laser lead extraction systems," Australia and New Zealand Horizon Scanning Network, Aug. 2010, 15 pages.
2 Decision to Grant for European Patent Application No. 07255018.9, dated Aug. 8, 2013 , 2 pages.
3 Decision to Grant for European Patent Application No. 07255018.9, dated Aug. 8, 2013 2 pages.
4 Department of Health and Ageing in Australian Government, "Horizon Scanning Technology Prioritising: Laser Extraction Systems." 2010. 15 pages.
5 Design U.S. Appl. No. 29/519,239 entitled Medical Device Handle, filed Mar. 3, 2015.
6 Design U.S. Appl. No. 29/519,258 entitled Medical Device Handle, filed Mar. 3, 2015.
7 EP extented Search Report mailed Oct. 21, 2009; Application No. 07255019.7, 8 pages.
8 Extended European Search for European Application No. 07255018.9, dated Nov. 12, 2010.
9 Extended European Search Report for European Application No. 07255018.9, dated Nov. 12, 2010, 8 pages.
10 Extended European Search Report for European Patent Application No. 07255019.7, dated Oct. 21, 2009, 8 pages.
11 Extended European Search Report issued in EP Application No. 14770860.6, mailed Jan. 10, 2017, 14 pages.
12 Final Action for U.S. Appl. No. 11/615,005, mailed Nov. 21, 2013, 20 pages.
13 Final Action for U.S. Appl. No. 11/615,005, mailed Nov. 9, 2009, 10 pages.
14 Final Action for U.S. Appl. No. 11/615,006, mailed Jul. 20, 2010, 9 pages.
15 Final Action for U.S. Appl. No. 11/615,006, mailed Nov. 22, 2013, 16 pages.
16 Final Action for U.S. Appl. No. 11/615,006, mailed Oct. 26, 2009, 9 pages.
17 Intent to Grant for European Patent Application No. 07255018.9, dated Nov. 29, 2012, 7 pages.
18 International Preliminary Report on Patentability issued in PCT/US2015/016899, mailed Sep. 15, 2016, 7 pages.
19 International Search Report and Written Opinion for International Patent Application No. PCT/US2013/059434, dated Dec. 13, 2013, 14 pages.
20 International Search Report and Written Opinion issued in PCT/US2014/021167 mailed Jun. 26, 2014, 19 pages.
21 International Search Report and Written Opinion issued in PCT/US2014/026496 mailed Jul. 30, 2014, 16 pages.
22 International Search Report and Written Opinion issued in PCT/US2015/016899, mailed May 1, 2015.
23 International Search Report and Written Opinion issued in PCT/US2015/018305, mailed May 28, 2015, 14 pages.
24 International Search Report and Written Opinion issued in PCT/US2015/058227, mailed Feb. 3, 2016, 18 pages.
25 International Search Report and Written Opinion issued in PCT/US2016/049108, mailed Dec. 5, 2016, 9 pages.
26 Notice of Allowance for European Patent Application No. 07255018.9, dated Jul. 26, 2012 47 pages.
27 Notice of Allowance for European Patent Application No. 07255018.9, dated Jul. 26, 2012, 47 pages.
28 Notice of Allowance for Japan Patent Application No. 2007-333273, mailed Jan. 16, 2014 3 pages.
29 Notice of Allowance for Japan Patent Application No. 2007-333273, mailed Jan. 16, 2014, 3 pages.
30 Official Action for European Patent Application No. 07255018.9, dated Jul. 19, 2011, 3 pages.
31 Official Action for European Patent Application No. 07255019.7, dated Jul. 21, 2010, 4 pages.
32 Official Action for U.S. Appl. No. 11/615,005, mailed Apr. 16, 2009, 13 pages.
33 Official Action for U.S. Appl. No. 11/615,005, mailed Feb. 11, 2011, 12 pages.
34 Official Action for U.S. Appl. No. 11/615,005, mailed Jul. 21, 2010, 10 pages.
35 Official Action for U.S. Appl. No. 11/615,005, mailed Mar. 14, 2013, 16 pages.
36 Official Action for U.S. Appl. No. 11/615,006, mailed Apr. 24, 2009, 11 pages.
37 Official Action for U.S. Appl. No. 11/615,006, mailed Feb. 17, 2010, 8 pages.
38 Official Action for U.S. Appl. No. 11/615,006, mailed Mar. 14, 2013, 16 pages.
39 Official Action for U.S. Appl. No. 13/800,728, mailed Jan. 16, 2014, 14 pages.
40 Official Action with English translation for Japan Patent Application No. 2007-333173, mailed Apr. 30, 2013 5 pages.
41 Official Action with English translation for Japan Patent Application No. 2007-333173, mailed Apr. 30, 2013, 5 pages.
42 Official Action with English translation for Japan Patent Application No. 2007-333173, mailed Aug. 13, 2012 7 pages.
43 Official Action with English translation for Japan Patent Application No. 2007-333173, mailed Aug. 13, 2012, 7 pages.
44 Official Action with English translation for Japan Patent Application No. 2007-333273, mailed Jul. 30, 2012, 7 pages.
45 Official Action with English translation for Japan Patent Application No. 2007-333273, mailed Jul. 30, 3012 7 pages.
46 Official Action with English translation for Japan Patent Application No. 2007-333273, mailed Jun. 6, 2013 10 pages.
47 Official Action with English translation for Japan Patent Application No. 2007-333273, mailed Jun. 6, 2013, 10 pages.
48 PCT App. PCT/US2015/016899 entitled Medical Device for Removing an Implanted Object filed Feb. 20, 2015.
49 PCT App. PCT/US2015/018305 entitled Multiple Configuration Surgical Cutting Device filed Mar. 2, 2015.
50 PCT Application No. PCT/US2014026496, filed Mar. 13, 2014.
51 Supplemental European Search Report issued in EP Application 14770355 mailed Sep. 15, 2016, 7 pages.
52 Supplemental Partial European Search Report issued in EP Application No. EP14770860 mailed Sep. 15, 2016, 7 pages.
53 U.S. Appl. No. 13/800,651 entitled System and Method of Ablative Cutting and Pulsed Vacuum Aspiration, filed Mar. 13, 2013.
54 U.S. Appl. No. 13/800,651, filed Mar. 13, 2013, Hendrick et al.
55 U.S. Appl. No. 13/800,675 entitled Laser Catheter With Helical Internal Lumen, filed Mar. 13, 2013.
56 U.S. Appl. No. 13/800,675, filed Mar. 13, 2013, Hendrick et al.
57 U.S. Appl. No. 13/800,700 entitled Device and Method of Ablative Cutting With Helical Tip, filed Mar. 13, 2013.
58 U.S. Appl. No. 13/800,700, filed Mar. 13, 2013, Hendrick et al.
59 U.S. Appl. No. 13/800,728 entitled Laser Ablation Catheter, filed Mar. 13, 2013.
60 U.S. Appl. No. 13/800,728, filed Mar. 13, 2013, Hendrick et al.
61 U.S. Appl. No. 13/828,231 entitled Tissue Slitting Methods and Systems, filed Mar. 14, 2013.
62 U.S. Appl. No. 13/828,231, filed Mar. 14, 2013, Bowe et al.
63 U.S. Appl. No. 13/828,310 entitled Tissue Slitting Methods and Systems, filed Mar. 14, 2013.
64 U.S. Appl. No. 13/828,310, filed Mar. 14, 2013, Bowe et al.
65 U.S. Appl. No. 13/828,383 entitled Tissue Slitting Methods and Systems, filed Mar. 14, 2013.
66 U.S. Appl. No. 13/828,383, filed Mar. 14, 2013, Bowe et al.
67 U.S. Appl. No. 13/828,441 entitled Tissue Slitting Methods and Systems, filed Mar. 14, 2013.
68 U.S. Appl. No. 13/828,441, filed Mar. 14, 2013, Bowe et al.
69 U.S. Appl. No. 13/828,536 entitled Expandable Lead Jacket, filed Mar. 14, 2013.
70 U.S. Appl. No. 13/828,536, filed Mar. 14, 2013, Hendrick et al.
71 U.S. Appl. No. 13/828,638 entitled Lead Removal Sleeve, filed Mar. 14, 2013.
72 U.S. Appl. No. 13/828,638, filed Mar. 14, 2013, Fiser.
73 U.S. Appl. No. 13/834,405 entitled Retractable Blade for Lead Removal Device, filed Mar. 15, 2013.
74 U.S. Appl. No. 14/577,976 entitled Surgical Instrument Including an Inwardly Deflecting Cutting Tip for Removing an Implanted Object filed Dec. 19, 2014.
75 U.S. Appl. No. 14/589,688 entitled Retractable Separating Systems and Methods filed Jan. 5, 2015.
76 U.S. Appl. No. 14/627,851 entitled Medical Device for Removing an Implanted Object filed Feb. 20, 2015.
77 U.S. Appl. No. 14/627,950 entitled Medical Device for Removing an Implanted Object filed Feb. 20, 2015.
78 U.S. Appl. No. 14/635,742 entitled Multiple Configuration Surgical Cutting Device filed Mar. 2, 2015.
79 U.S. Appl. No. 14/725,781 entitled Surgical Instrument for Removing an Implanted Object, filed May 29, 2015.
80 U.S. Appl. No. 61/793,597 entitled Surgical Instrument for Removing an Implanted Object filed Mar. 15, 2013.
81 U.S. Appl. No. 61/947,377, filed Mar. 3, 2014.
82 U.S. Appl. No. 61/987,993 entitled Dual Mode Mechanical Catheter Cutting System filed May 2, 2014.
83 U.S. Appl. No. 62/005,315 entitled Surgical Instrument for Removing an Implanted Object filed May 30, 2014.
84 U.S. Appl. No. 62/058,790 entitled Medical Device for Removing an Implanted Object filed Oct. 2, 2014.
85 U.S. Appl. No. 62/094,808 entitled Multiple Configuration Surgical Cutting Device filed Dec. 19, 2014.
86 U.S. Appl. No. 62/113,865 entitled Medical Device for Removing an Implanted Object filed Feb. 9, 2015.
Clasificación internacional A61B17/3205, A61N1/05, A61B17/32
Clasificación cooperativa A61B17/320016, A61B17/32053, A61N2001/0578
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:GRACE, DUSTIN L.;GRACE, KENNETH P.;REEL/FRAME:030013/0120