A medical device has an artificial contractile structure including at least one contractile element adapted to contract a hollow body organ in such a way that said contractile element is adapted to be in a resting position or in an activated position, the activated position being defined with the contractile element constricting the hollow body organ and the resting position being defined with the contractile element not constricting the hollow body organ. The medical device further includes a tensioning device adapted to apply a force so as to tighten the contractile element around the hollow body organ, the tensioning device having a flexible transmission with a tensioning element arranged in a sheath. The sheath has an inner coiled wire coiled in a first direction, and an outer coiled wire surrounding the inner coiled wire and coiled in a second direction opposite to said first direction.

The invention relates to restricting flow through a vascular access site such as an arteriovenous (AV) fistula or a graft using intravascular measurements to guide the procedure. The invention provides systems and methods for using intravascular detection to guide the restriction of flow through an AV fistula or graft. An intravascular instrument such as an imaging catheter or guidewire with measuring capabilities is inserted into a vessel proximal to an access site and used to evaluate the access site, which is banded to obtain healthy flow as indicated by the intravascular instrument. In certain aspects, the invention provides a method for improving a hemodialysis fistula or graft by inserting an intravascular instrument into a vessel proximal to the fistula or graft, making a measurement with the intravascular instrument, and restricting flow through the fistula or graft until the measurement obtains a predetermined value.

Body lumen occlusion apparatus and methods are described.

The invention relates to a perivascular ring having an inner diameter adjustable by inflation/deflation and adapted to be implanted and closed about a vessel for controlling the inner diameter of said vessel and thus the flow and/or pressure of a fluid flowing in said vessel. The ring of the invention is capable of regulating blood flow to the liver, in particular after an hepatectomy or hepatic transplant, and to substantially improve the survival chances of the patient. The ring according the invention has an adjustable inner diameter (Ø.sub.i) for implantation and locking about a vessel.

In a method, system and device a member is provided around an aneurysm enabling treatment and monitoring of the aneurysm. In accordance with one embodiment the device is adapted to be adjusted postoperatively. Hereby the treatment can be efficiently carried out without having to perform surgery when adjusting the member.

Cartridges and methods for ligation or dissection and ligation of tubular tissue structures are described. The cartridges and methods provide a means for efficient dissection and application of one or more ligatures by a single user using a single cartridge resulting in effective closure of a vessel or other tubular tissue structure by placement of a ligature at the desired location resulting in the desired tissue margin or stump.

A system for coupling a first space within a body of a patient with a second space within the body of the patient including a flow connector insertable into the first and second spaces within the body and having a conduit having a wall forming a lumen therein and first and second orifices. A first retention member is engageable with a first portion of the first space within the body and has a first opening, and the flow connector is positioned within the first opening. A second retention member is engageable with the second space within the body, the second retention member has a second opening and the flow connector is positioned within the second opening. The second retention member interlocks with the first retention member.

Ring comprising: an outer belt (3) equipped with closing means (7) for closing the ring (1) around a duct (2); an inner chamber (4) that can be inflated and deflated; a flexible inflation/deflation tube (5);
wherein the lips have contact surfaces facing each other, the closing means comprising at least one perforation arranged on the contact surface of a first of the two lips and at least one protrusion protruding from the contact surface of a second of the two lips, the protrusion and the perforation being configured so that the protrusion is retained in the perforation by fitting, the fitting being selected to be released in the event of overpressure in the ring.

A novel catheter-based system which ligates the left atrial appendage (LAA) on the outside of the heart, preferably using a combination of catheters and/or instruments, e.g., a guide catheter positioned inside the left atrial appendage which may assist in locating the left atrial appendage and/or assist in the optimal placement of a ligature on the outside of the appendage, and a ligating catheter and/or instrument outside the heart in the pericardial space to set a ligating element at the neck of the left atrial appendage.

Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture therethrough.