An endoluminal punch and introducer sheath are described wherein the endoluminal punch comprises a guidewire lumen through which a user is capable of placing a guidewire. The endoluminal punch system further comprises a mechanism affixed to the hub which is capable of controlling the axial positioning of the guidewire relative to the endoluminal punch distal end. The control mechanism can be released so that the endoluminal punch can be removed from a patient while retaining the guidewire in place within the patient. The endoluminal punch introducer, including a sheath and dilator, can comprise energy emitting electrodes or transducers for cutting larger size holes in stubborn (friable, scarred, or fibrotic) tissue. In other embodiments, the endoluminal punch can comprise a guidewire or stylet, wherein the guidewire or stylet is capable of emitting energy to cut through tissue.

A Veress needle assembly for a peritoneal dialysis catheter guide wire has (i) a hollow needle with a pointed end, (ii) an inner tube received within the hollow needle so as to be slidable relative to the hollow needle in the longitudinal direction between a first position in which the first end of the inner tube protrudes longitudinally beyond the pointed end of the hollow needle and a second position in which the first end of the inner tube is retracted so that the pointed end is unobstructed by the inner tube, and (iii) a biasing mechanism to bias the inner tube towards the first position. The inner tube includes a fluid passage having an outlet opening at the first end of the inner tube that is oriented to allow the peritoneal dialysis catheter guide wire to readily the outlet opening when inserted through the fluid passage of the inner tube.

A method and device are provided for simultaneously or near-simultaneously diagnosing and treating tension pneumothorax and/or hemothoraxA Veress-type needle portion includes a hollow needle for puncturing the chest wall over a blunt hollow probe biased by one or more springs to extend distally into the pleural cavity. Openings in the blunt hollow probe connect via a pathway to an automatic check valve, which permits the flow of air and/or fluid only in a proximal direction. Pressure from within the pleural cavity is transmitted to the interior surface of a pressure documenter. If pressure greater than atmospheric pressure is present in the pleural cavity, the pressure documenter will be automatically urged proximally to simultaneously allow air and/or fluid to escape from the pleural space through the device, thus treating the tension pneumothorax and/or hemothorax, as well as providing a stable indicator to positively document the diagnosis of increased pressure.

A method and device are provided for simultaneously or near-simultaneously diagnosing and treating tension pneumothorax and/or hemothoraxA Veress-type needle portion includes a hollow needle for puncturing the chest wall over a blunt hollow probe biased by one or more springs to extend distally into the pleural cavity. Openings in the blunt hollow probe connect via a pathway to an automatic check valve, which permits the flow of air and/or fluid only in a proximal direction. Pressure from within the pleural cavity is transmitted to the interior surface of a pressure documenter. If pressure greater than atmospheric pressure is present in the pleural cavity, the pressure documenter will be automatically urged proximally to simultaneously allow air and/or fluid to escape from the pleural space through the device, thus treating the tension pneumothorax and/or hemothorax, as well as providing a stable indicator to positively document the diagnosis of increased pressure.

A seal member and outer cylinder needle (OCN) tip part for blocking, in a fluid-tight state, both external peripheral space (EPS) end parts formed between the external-peripheral-surface of an inner needle (IN) and internal peripheral surface of an OCN, for slidably holding the IN in close contact; an opening part formed on the OCN external-peripheral-surface and for intravascular communication with the EPS; an OCN connection part for communicating between the EPS and blood circuit end; an IN connection part for communicating between the IN internal space and other blood circuit end. The movable IN positioned between the projecting position where the tip part protrudes from the OCN tip and the housed position housing the tip inside the OCN. The IN punctures the blood vessel interior while holding the projecting position, and moved to the housed position after puncture allowing blood to extracorporeally circulate via the OCN and IN connection part.

A device for depositing a solid medicament, having: a cannula (12) having a tip (18) provided at the distal end; and an attachment (20) which receives a proximal region of the cannula and has ridges (24, 26, 28) extending perpendicularly to the longitudinal axis of the cannula; and a plunger (16) which is movable progressively inside the cannula and has a handle (38). The handle (38) has rib-like retaining elements which extend in the longitudinal direction of the plunger (16), are spaced apart therefrom and are connected to the plunger in each case using a connecting element which can be severed at least in one of its end regions by interacting with the attachment (20).

Improved medical guide elements for use with dilators to be inserted into an organ or body structure of a patient, such as the kidney. The guide element includes a proximal segment and a distal segment. The diameter of the distal segment is greater than the diameter of the proximal segment. The change in diameter is abrupt, providing a discrete step transition at a point along the filament which presents a proximally-facing surface on the distal segment. When the proximal segment of the guide element is fully inserted into a dilator having a distal tip adapted for insertion into a patient, the dilator distal tip firmly abuts the proximally-facing end surface of the distal segment. The relative dimensions of the dilator tip and the discrete stepped transition of the guide element provides full shielding or over shielding of the dilator tip, thereby facilitating passage of the dilator tip along the tissue track, through the puncture hole and into the orifice.

The present invention relates a puncture needle includes: a sheath having a longitudinal axis; a needle tube that is arranged inside the sheath to be moved along the longitudinal axis and that has a needle tip; and a protective tube that is arranged inside the needle tube to be moved along the longitudinal axis and that has a lumen into which a guide wire is inserted. The needle tube has a step portion formed at a position midway along the needle tube. The protective tube has a protrusion, which protrudes radially outward, on an outer peripheral surface thereof at a position midway nearer a proximal end side of the protective tube than the step portion is. A distal end of the protective tube is positioned at a position to protrude from the distal end of the needle tube when the protrusion abuts the step portion.

Improved methods for percutaneously creating, entering and/or dilating an opening in the wall of a blood vessel or other anatomic structure. The improvement comprises deploying a guide element having a proximal segment and a distal segment, the diameter of said distal segment being greater than the diameter of said proximal segment at their juncture, and which at said juncture forms an abrupt circumferential step comprising a proximally-facing surface. Said proximally-facing surface abuts the catheter's tip and shields said tip, thereby facilitating passage of said catheter as it enters and passes through said opening in said wall of a blood vessel or other anatomic structure.

A method and device are provided for simultaneously or near-simultaneously diagnosing and treating tension pneumothorax and/or hemothorax. A Veress-type needle portion includes a hollow needle for puncturing the chest wall over a blunt hollow probe biased by one or more springs to extend distally into the pleural cavity. Openings in the blunt hollow probe connect via a pathway to an automatic check valve, which permits the flow of air and/or fluid only in a proximal direction. Pressure from within the pleural cavity is transmitted to the interior surface of a pressure documenter. If pressure greater than atmospheric pressure is present in the pleural cavity, the pressure documenter will be automatically urged proximally to simultaneously allow air and/or fluid to escape from the pleural space through the device, thus treating the tension pneumothorax and/or hemothorax, as well as providing a stable indicator to positively document the diagnosis of increased pressure.