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.

This document describes bone matter collection devices and methods for their use. For example, longitudinally extendable/retractable spirally wound, conically-shaped bone matter collection/harvesting devices are described. In some implementations, such bone matter collection devices can be attachable with and detachable from bone drill bits. In some implementations, bone chips generated by bone drilling are collected in such a bone matter collection device while the bone matter collection device is detachably coupled to the bone drill bit, and the collected bone chips can be used for bone grafting and other purposes.

An assembly for retracting soft tissue in a surgical incision is provided, the assembly including a supporting member having first and second ends; a retractor blade having a first distal end and a second proximal end retained at the first end of the support member; a retaining arm which co-operates with the support member and receives and supports a clamping assembly; and an adjusting assembly which engages the support member and allows the clamping assembly to advance and retract relative to the retractor blade.

A minimally invasive system comprises an elongate medical instrument including a flexible body. The flexible body includes a wall including a channel, and the channel includes a groove. The flexible body further includes a lumen defined by an interior surface of the wall and a curved distal tip portion. The elongate medical instrument further includes a shape sensor coupled to the flexible body. The shape sensor is at least partially positioned within the groove, and the shape sensor is configured to detect shape characteristics of at least a portion of the flexible body. The system further includes an actuator for manipulating the elongate medical instrument.

The use of stepped cannulas, wherein a step structure creates a backstop to reduce backflow along the cannula body, is known for convection enhanced delivery of agents to the brain and other structures within an animal. Described herein are novel and improved stepped cannula designs wherein the length of the cannula segment between the step and the dispensing outlet is variable and can be controllably adjusted inside the patient during delivery. This advantageously allows the operator to place the cannula step at the optimal position and deliver agents at one or more positions within the target structure.

There is described an endovascular prosthesis delivery device. The subject endovascular prosthesis delivery device comprises a combination of a delivery frame element and a hub insert element that are secured to one another by a first retention element. At a distal portion of the delivery frame element, there is a prosthesis attachment zone for coupling to an endovascular prosthesis. When it is desired to deploy the endovascular prosthesis, the first retention element is broken in a manner to allow relative movement between the hub insert element and the delivery frame element. A pull wire assembly is secured with respect to the hub insert element and comprises a pull wire which is coupled to the endovascular prosthesis in the prosthesis attachment zone of the delivery frame element. Once the first retention element is broken by the physician (this is done when the endovascular prosthesis is in the correct position for deployment), the physician can then retract the hub insert which has the effect of retracting pull wire from the prosthesis attachment zone of the delivery frame element. The endovascular prosthesis and the endovascular prosthesis delivery device are now detached from one another and the latter may be withdrawn from the patient.

An interventional catheter for treating an artery includes an elongated body sized and shaped to be transcervically introduced into a common carotid artery at an access location in the neck. The elongated body has an overall length such that the distal most section can be positioned in an intracranial artery and at least a portion of the proximal most section is positioned in the common carotid artery during use.

A device sized and shaped for insertion into a body comprising: at least one mechanical limb comprising: a support segment; a first flexible section extending from the support segment and terminating in a coupling section; and a second flexible section extending from the coupling section and terminating in a tool or a connector for a tool; wherein a long axis of one or more of the flexible sections is bendable in a single bending plane; wherein a long axis length of the first flexible section is at least double a maximum extent of the first flexible section perpendicular to a flexible section long axis; wherein a long axis length of the second flexible section is at least double a maximum extent of the second flexible section perpendicular to a flexible section long axis.

A heart valve prosthesis is provided that includes a first member and a second member. The first member comprises a first central portion to be disposed adjacent to a line of coaptation on a first side of two adjacent heart leaflets and peripheral portions to be placed into direct contact with the two adjacent heart leaflets. The second member is separate from or can be separable from the first member, for example during delivery. The second member has a central portion and peripheral portions configured to be placed into direct contact with a second side of the two adjacent heart leaflets.

A surgical method for operating a trocar defining an access port for a surgical instrument, using a holding arm and a number of drives. The method includes: inserting the trocar through an abdominal wall of the patient body; operating at least one drive to move the surgical instrument in the patient body; operating at least one drives to actuate an effector; and moving the holding arm to generate a pivoting movement of the trocar and surgical instrument about a pivot point defined by the abdominal wall of the patient body. The trocar is freely pivotable relative to the holding device, and the pivoting movement is caused by contact between the trocar and the abdominal wall of the patient body or an elastic membrane located on the abdominal wall of the patient body.