Vascular closure devices and methods for closing a blood vessel puncture site disposed at a distal end of a tissue tract are described. A combination of the body's own natural mechanism with chemical and/or biological agents is relied upon to accelerate the hemostatic process. Included are steps of introducing a closure device through the tissue tract and deploying an expansible member at a distal end of the device within the blood vessel to occlude the puncture site. A sealing member disposed proximal the expansible member is then displaced by retracting and tensioning a coil spring so as to expose a chemical and/or biological region or release region of the device. The retraction and tensioning of the coil spring is limited by a coupling member. Exposure of blood and tissue to the chemical and/or biological sealing member promotes the clotting processing to accelerate the occlusion process in the tract.

An endovascular apparatus including a stabilizing element and a rod that may be detachably coupled to the stabilizing element. The rod may be elongated along a longitudinal axis. The rod may have at least one therapeutic agent thereon. The therapeutic agent may be an enzyme, an antibody, a biomarker, or a bioreceptor for neutralizing components of a bodily fluid of a patient. The rod may be inserted into the patient's body to place the therapeutic agent into fluid communication with the patient's bodily fluid. The rod may be formed from silicone and an outer surface of the rod may be etched prior to coating the rod with the therapeutic agent.

Catheter-delivered endovascular medical devices are described. The devices may include a pull wire attached to a distal body. The distal body may be formed of a distal body outer body comprising a basket comprised of a plurality of cells defined by a plurality of basket strips and a distal body inner body located in the interior of the distal body outer body and comprising a plurality of distal braided mesh openings formed by a plurality of woven linear strands. The distal braided mesh openings may be smaller than the cells when the device is in the relaxed state. Methods of using and making the devices are also described.

In various embodiments, a layer of material can comprise a body, a proximal end portion, and a distal end portion. The proximal end portion can be releasably secured to a staple cartridge of a surgical end effector, and the distal end portion can be releasably secured to an anvil of the surgical end effector. The layer of material can comprise a tissue thickness compensator.

Stapling assemblies for use with a surgical stapler and methods for manufacturing the same are provided. Three dimensional adjuncts for use with a surgical stapling assembly and methods for manufacturing the same are also provided.

A surgical pad can comprise a flexible pad portion configured to be positioned over an opening in a target tissue. A plurality of elongate ribs can be distributed across a surface of the flexible pad portion oriented away from the target tissue and can be coupled to the flexible pad portion. A surgical pad can comprise a central opening configured to be aligned with an opening in a target tissue, and a plurality of edge openings distributed around an outer edge portion. A method can comprise positioning a spacer between a target tissue and a surgical pad to adjust the tension of surgical cords secured to surgical pad. A method can comprise positioning a spacer between a surface of a surgical pad oriented away from a target tissue and portions of surgical cords secured over the surface of the surgical pad, to adjust the tension of the surgical cords.

A surgical instrument includes a member connectable with a longitudinal element of a surgical distractor connected with vertebrae. At least one blade is connected with the member adjacent to an axis oriented transverse to the longitudinal element and being movable to space tissue adjacent the vertebrae. The at least one blade being intra-operatively translatable relative to the member along the axis. Surgical systems, constructs, implants and methods are disclosed.

A composite comprising: a barrier, said barrier being configured to selectively pass water, and said barrier being degradable in the presence of water; a matrix material for disposition within said barrier, wherein said matrix material has a flowable state and a set state, and wherein said matrix material is degradable in the presence of water; and at least one reinforcing element for disposition within said barrier and integration with said matrix material, wherein said at least one reinforcing element is degradable in the presence of water, and further wherein, upon the degradation of said at least one reinforcing element in the presence of water, provides an agent for modulating the degradation rate of said matrix material in the presence of water.

Medical devices as wells as methods for making and using medical devices are disclosed. An example medical device may include a left atrial appendage device. The left atrial appendage device may include an expandable frame configured to shift between a first configuration and an expanded configuration. A fabric mesh may be disposed along at least a portion of the expandable frame. An anti-thrombogenic coating may be disposed along the fabric mesh.

Preferred embodiments relate to devices for performing a lymphovenous bypass procedure. A first ring is secured to tissue connected to at least one lymphatic channel of a patient and a second ring is attached to a vein of the patient. An end of the lymphatic channel that extends through the first ring is inserted into an open end of the vein and the rings are connected together to establish fluid flow from the lymphatic channel into the vein.