A bone marrow access apparatus includes a bone penetrating member and a cap. The bone penetrating member includes a tubular insertion portion, and a head portion provided at a proximal end of the tubular insertion portion. A cross-sectional shape of the head portion is wider than a cross-sectional shape of the tubular insertion portion. A recess is provided in the head portion, and an internal channel is provided through the head portion and the tubular insertion portion. The cap accommodates the head portion of the bone penetrating member therein. The cap includes a lower wall which covers at least a part of a distal side of the head portion, and a projection which projects into the recess of the head portion.

A system for treating a patient having thrombus including an aspiration catheter having an aspiration lumen configured to be coupled to a vacuum source and configured for aspirating thrombus therethrough, an elongate member having a straight distal portion configured to extend from the aspiration lumen into a thrombus within the blood vessel, and a manipulation device selectively coupled to the elongate member, the manipulation device being configured to apply motive force to the elongate member, wherein the motive force comprises a combination of motive force components comprising an alternating clockwise motion and counter-clockwise motion.

Telescoping, self-driving, and laterally-pushing atherectomy devices are provided, each having a flexible sheath, a cutter with helical flutes, and a drive assembly. The drive assembly can have a flexible driveshaft rotatably translational with the lumen of the flexible sheath, a positive displacement pump to transport cut tissue, and a flexible drive shaft that can be longer than the flexible sheath for a reversible telescoping of the drive assembly from the lumen of the flexible sheath. The positive displacement pump can be a screw pump having a drive screw portion exposed for contact with a vascular lumen for a self-driving of the device through the vascular lumen. A reversibly-expandable, lateral pushing member can be included at the distal end of the flexible sheath for a lateral pushing of the cutter. Improved cutting heads, and methods of making them, are provided for cutting a combination of soft and hard plaque.

An orthopedic surgical instrument for use in knee surgeries includes an elongated body, a pair of output shafts, and a user control. A first output shaft extends out from a first side of the body along a first output axis substantially perpendicular to a longitudinal axis of the elongated body. A second output shaft also extends out from the first side of the elongated body along a second output axis substantially perpendicular to the longitudinal axis of the elongated body. The user control is coupled to the elongated body near a first end and the first and second output shafts are situated near the second end of the elongated body. Each of the first output shaft and the second output shaft are configured to turn independent of one another in response to operation of the user control. Various joint distractors for use with the orthopaedic surgical instrument are also disclosed.

The disclosure provides plaque treatment catheter assemblies for the treatment of arterial plaques and removal of clots. One assembly includes a second catheter tube movable within a first catheter tube, and an expansion member movable within the second tube. The second catheter tube has one or more distally-disposed and outwardly-expandable plaque treatment portion(s). Another assembly includes a catheter tube and at least one channel(s) within the catheter. The channel includes an elongate member with a distally-disposed plaque scoring or clot retrieval member. Optionally, the assembly includes an expandable member that can cause movement of the scoring member.

An improved plaque extractor for shaving, scooping, cutting, and emulsifying accumulated plaque from blood vessels into fine particles, and removing the particles from blood vessel walls without cutting or permanently stretching the walls, and without substantially blocking the blood flow through the vessel during plaque removal operation. The plaque extractor includes an extractor guide and an internal auger, in which both are rotating and moving axially inside the vessel to engage the occlusive material. The operation of the device does not substantially disrupt blood pressure within the blood vessel.

A medical device for removing a material from a hollow anatomical structure is provided. The device may include a shaft member. The device may include an expandable centering element near the distal end of the device. The device may include a macerator element either attached to the shaft or independent and freely moveable from the shaft. Alternatively, the device may include a rotating wire attached to the macerator element. The device may include an aspiration lumen in for removal of material. The device may include a drive shaft attached to a motor and used to rotate the macerator element. The device may be used in combination with a distal occlusion element, which may be either a radially expandable filter or balloon member.

A surgical instrument that includes a shaft assembly that defines a shaft axis and includes a proximal articulation joint that defines a first articulation axis that is transverse to the shaft axis and a distal articulation joint that defines a second articulation axis that is transverse to the shaft axis and the first articulation axis. The instrument further includes an anvil that is non-removably attached to the shaft assembly and a channel that is removably attachable to the shaft assembly and configured to operably support a surgical staple cartridge.

A platform device for material excision or removal from vascular structures for either handheld or stereotactic table use may comprise a work element or elements configured to selectively open and close at least one articulable beak or scoopula configured to penetrate and remove intra-vascular materials or obstructions, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks or scoopulas and provisions for simultaneous beak or scoopula closing under rotation may be incorporated.

A discectomy tool comprising: a) a cannula having an outer surface having a longitudinal bore therein, a proximal end and a distal end; b) a steering wire disposed in the longitudinal bore; c) a flexible, hollow transmission shaft disposed in the cannula, the shaft having a throughbore, a proximal end portion, a distal end portion and an outer surface having a thread extending therefrom; d) an irrigation source fluidly connected to the throughbore; e) a cutting tip attached to the distal end portion of the transmission shaft.