Remote access, soft tissue tunneling dilators are used for the placement of central venous catheters of varying sizes into one or more jugular veins, for forming pathways of varying sizes through subcutaneous soft tissue, or for enlarging internal renal access pathways of varying sizes to accommodate access by urological instruments. Dilators comprise a tapered body extending from a proximal end to a distal tip, where both an outer diameter and a material hardness of the tapered body gradually increase distally-to-proximally from the distal tip toward the proximal end of the tapered body. The tapered body may include a plurality of visual indicators disposed upon the body at one or both of a plurality of distally-to-proximally increasing length increments and a plurality of distally-to-proximally increasing diameter increments. Other embodiments are also disclosed.

Apparatus for delivering therapeutic agents to the central nervous system of a subject is described. The apparatus includes at least one intracranial catheter and a percutaneous access device. The percutaneous access device includes a body having at least one extracorporeal surface and at least one subcutaneous surface, the body defining at least one port for connection to an implanted intracranial catheter. The port is accessible from the extracorporeal surface of the device, but is provided with a seal such as a rubber bung between the lumen of the port and the extracorporeal surface. The percutaneous access device may have more than two ports and/or a flange. A method of implanting the percutaneous access device is also described.

A surgical access assembly and method of use is disclosed. The surgical access assembly comprises an outer sheath and an obturator. The outer sheath and obturator are configured to be delivered to an area of interest within the brain. Either the outer sheath or the obturator may be configured to operate with a navigational system to track the location of either within the brain. Once positioned at a desired location, the obturator is removed, leaving a distal end of the outer sheath adjacent an area of interest, and creating a working corridor. Interrogation of the area of interest may be performed to evaluate a disorder and/or abnormality, as well as evaluate treatment regimes. Interventional devices may also be introduced to the area of interest, as well as a variety of treatments.

Adapters for a connector assembly for percutaneous tubing are provided. A male adapter (FIG. 22a, 1000) includes a connector fitting (1002) proximate a first end, the connector fitting configured to join to a connector for a tubing system or device, and a male connector (656) proximate a second end. The male connector includes a plug end with a fluid lumen defined therethrough, the plug end having a circumferential groove defined therein to receive a locking extension of a female connector sized to be received within the circumferential groove of the plug end to allow the female connector to rotate relative to and maintain axial engagement with the male connector when the locking extension is received within the groove. An adapter having a female connector (FIG. 24, 1300) is also provided.

Devices and methods for retrieving percutaneously implanted catheter systems such as a heart valve repair system. The devices include at least one locking connector at the distal end of a flexible elongated extension for coupling to an implanted tubular member. The locking connector may be a tubular anchor having a pair of distal prongs which are biased outward and face in a proximal direction, as well as an expandable auxetic midsection. Inserting the tubular anchor into the implanted tubular member flexes the distal prongs inward such that they prevent proximal movement of the tubular anchor. A user pulls on the proximal end of the tubular anchor to expand the auxetic midsection and lock the two pieces together. The devices and methods are particularly useful to attach extensions to implanted concentric tubes to enable relative axial force application.

A drug delivery device configured to simultaneously interface with a scala tympani and a scala vestibuli of a cochlea, wherein the device can be configured to deliver drug to the cochlea at least in part via a post introduction non-diffusion based delivery, and wherein the device can be configured to induce complete circuit circulation from the scala tympani to the scala vestibuli and/or vice versa, thereby distributing drug within the cochlea.

A method of treating a patient using a power-injectable access port, including implanting the power-injectable access port in the patient, imaging the power-injectable access port following implanting, and power injecting a fluid into the patient through the power-injectable access port. The power-injectable access port includes a septum covering a reservoir, the septum including a radiopaque material forming at least one letter, the at least one letter indicating that the power-injectable access port is suitable for power injection. The power-injectable access port is designed to accommodate a pressure developed within the reservoir of at least 35 psi, and a fluid flow rate of at least 1 milliliter per second. Imaging the power-injectable access port produces an image, and the method includes identifying the at least one letter on the image to confirm that the power-injectable access port is suitable for power injecting a fluid.

Luer activated valves are disclosed herein that are capable of being integrated into different types of medical devices, such as, IV catheters, sheath introducers, tear-away sheaths, etc. for the purpose of regulating the passage of fluids and/or devices into and out of such devices.

Embodiments provide apparatus and methods for delivering liquid form medication within the body wherein the medication is stored in solid form and then mixed with a liquid in an apparatus implanted within the body. One embodiment provides an implantable apparatus for in vivo delivery of medication comprising a housing including a reservoir, a store of solid form medication (SSM) and a pump. An SSM element is added to the reservoir along with fluid to form a medication solution comprising at least one drug. The medication solution is then delivered to a delivery site using a pumping means to pump solution from the reservoir through a delivery member such as catheter to a delivery site. Embodiments of the invention are particularly useful for delivering medication to a patient to treat a medical condition over an extended period of time without requiring the patient to take external medication.

Apparatus for delivering therapeutic agents to the central nervous system of a subject is described. The apparatus includes at least one intracranial catheter and a percutaneous access device. The percutaneous access device includes a body having at least one extracorporeal surface and at least one subcutaneous surface, the body defining at least one port for connection to an implanted intracranial catheter. The port is accessible from the extracorporeal surface of the device, but is provided with a seal such as a rubber bung between the lumen of the port and the extracorporeal surface. The percutaneous access device may have more than two ports and/or a flange. A method of implanting the percutaneous access device is also described.