A loading tool to facilitate loading a prosthesis into a delivery system includes a hinged body with first and second body portions and a collar slidingly disposed over the hinged body. First ends of the body portions are attached and second ends of the body portions are not attached. Each body portion includes a resilient clip that includes a radial protrusion. Each resilient clip is configured to displaced radially inwards when a pinching force is applied thereto. The loading tool has an open configuration in which the second ends are radially spaced apart and the collar is disposed over the first ends. The loading tool has a closed configuration in which the second ends are disposed directly adjacent to each other and the collar is disposed over the second ends. The radial protrusions lock the loading tool in the closed configuration when the resilient clips are not displaced radially inwards.
A recapturable external LAA exclusion clip system includes a clip comprising first and second clip struts, at least one of the struts having a connector interface comprising a first portion of a lock, and a delivery device comprising a handle and an end effector. The handle comprises jaw and lock controls. The end effector is connected to the handle and comprises a clevis and first and second jaws. The jaws are connected to the clevis and operatively connected to the jaw control to actively articulate at least one of the jaws with respect to the other. At least one of the jaws has a connector comprising a second portion of the lock operatively connected to the lock control to removably lock with the first portion of the lock. The first and second portions of the lock have a locked state and are configured to unlock the locked state upon actuation of the lock control.
A medical lead includes a lead body, a connector, an electrical conductor, and a sleeve. The lead body includes a distal end and a proximal end defining a longitudinal axis of the lead body. The connector is positioned near the proximal end of the lead body. The electrical conductor extends about the longitudinal axis of the lead body. The sleeve is coupled to an insulative material of the lead body and positioned around the electrical conductor. The electrical conductor is electrically coupled to the connector. The sleeve includes a fixed portion that is fixed to the electrical conductor and an unfixed portion that is not fixed to the electrical conductor. In response to bending of the medical lead, the conductor may move within the unfixed portion to relieve strain created by the bending.
An external LAA exclusion clip comprises a clipping assembly comprising first and second opposing clip struts each of the clip struts having a tissue-contacting surface and first and second bias surfaces, a bias assembly connecting the first clip strut to the second clip strut to align the first and second clip struts in a strut plane passing through the tissue-contacting surface. The bias assembly comprises at least one first bias spring connected to the first bias surface of the first clip strut and to the first bias surface of the second clip strut and at least one second bias spring connected to the second bias surface of the first clip strut and the second bias surface of the second clip strut. The first bias spring and the second bias spring are configured to permit movement of the first and second clip struts in the strut plane.
An example method for controlling delivery of electrical stimulation therapy includes maintaining, by one or more processors of a medical device configured to deliver electrical stimulation to a patient, a counter tied to a clock used by the medical device to deliver the electrical stimulation to the patient; and obtaining, by the one or more processors, one or more representations of sensed electrical signals for the patient that are referenced to counts of the counter. In this example, the method also includes identifying, based on the one or more representations of the sensed electrical signals for the patient, a count of the counter at which stimulation is to be delivered to the patient; and delivering, by the medical device and to the patient, electrical stimulation based on the identified count of the counter.
GUY'S AND ST. THOMAS' NHS FOUNDATION TRUST (United Kingdom)
MEDTRONIC, INC. (USA)
Inventor
Bapat, Vinayak
Ryan, Timothy
Abstract
A heart prosthesis that includes at least one information marker and methods of using the heart prosthesis are disclosed. The at least one information marker can indicate any suitable information associated with the heart prosthesis, e.g., one or more of a manufacturer, type, model, feature, size, and date. And the heart prosthesis can include any suitable prosthesis, e.g., a prosthetic heart valve or an annuloplasty prosthesis.
Configurations are described for assisting execution of a percutaneous procedure while protecting the vascular pathway to the operational theater. One embodiment is directed to a system for deploying a device to a distal location across a diseased vessel, comprising a sheath comprising an expandable distal portion comprising a porous wall defining a lumen therethrough, the distal portion having a collapsed configuration, wherein the sheath has a first cross sectional outer diameter and a first lumen inner diameter, and an expanded configuration, wherein the sheath has a second cross sectional outer diameter and a second lumen inner diameter; wherein in the collapsed configuration, the sheath is configured to be advanced across at least a portion of the diseased vessel to a position adjacent the distal location without substantial size interference between the first cross sectional outer diameter of the sheath and an inner diameter profile of a lumen of the vessel.
Configurations are described for assisting execution of a percutaneous procedure while protecting the vascular pathway to the operational theater. One embodiment is directed to a system for deploying a device to a distal location across a diseased vessel, comprising a sheath comprising an expandable distal portion comprising a porous wall defining a lumen therethrough, the distal portion having a collapsed configuration, wherein the sheath has a first cross sectional outer diameter and a first lumen inner diameter, and an expanded configuration, wherein the sheath has a second cross sectional outer diameter and a second lumen inner diameter; wherein in the collapsed configuration, the sheath is configured to be advanced across at least a portion of the diseased vessel to a position adjacent the distal location without substantial size interference between the first cross sectional outer diameter of the sheath and an inner diameter profile of a lumen of the vessel.
Configurations are described for assisting in the execution of a percutaneous procedure while protecting the vascular pathway to the operational theater, which may comprise diseased tissue. A railed sheath may be controllably expandable and collapsible, and may comprise two or more elongate rail structures configured to assist in the distribution of loads to associated diseased tissue structures, while also contributing to the deployment of percutaneous tools by maintaining alignment of such tools with the railed catheter and associated anatomy.
Configurations are described for assisting in the execution of a percutaneous procedure while protecting the vascular pathway to the operational theater, which may comprise diseased tissue. A railed sheath may be controllably expandable and collapsible, and may comprise two or more elongate rail structures configured to assist in the distribution of loads to associated diseased tissue structures, while also contributing to the deployment of percutaneous tools by maintaining alignment of such tools with the railed catheter and associated anatomy.
Configurations are described for assisting in the execution of a percutaneous procedure while protecting the vascular pathway to the operational theater, which may comprise diseased tissue. A railed sheath may be controllably expandable and collapsible, and may comprise two or more elongate rail structures configured to assist in the distribution of loads to associated diseased tissue structures, while also contributing to the deployment of percutaneous tools by maintaining alignment of such tools with the railed catheter and associated anatomy.
In some embodiments, a device (102) may include a mesh having at least one bioresorbable polymer coating. The coating may comprise at least one active agent which is eluted over time. The device (102) may at least partially cover at least a portion of an implanted transdermal medical device (100).
An anchorage device 100 comprising a mesh substrate 124 coupled to an implantable medical device 120 is disclosed, where the mesh substrate has a coating 120 comprising a polymer, and the mesh further comprises at least one active pharmaceutical ingredient. The active pharmaceutical agent is designed to elute from the device over time. The mesh substrate can be configured to reduce the mass of the anchorage device such that tissue in-growth and/or scar tissue formation at the treatment site is reduced. In some embodiments, the mesh substrate can be formed with a mesh having a low areal density. In some embodiments, the mesh substrate can include one or more apertures or pores to reduce the mass of the substrate.
The present invention relates to coatings comprising polyethylene glycol and at least one polyphenolic polymer. In particular, the polyphenolic polymer could be selected from the group consisting of tyrosine-derived polyarylates, linear polyesteramides, dihydroxybenzoate polymers, and resorcinol-derived polymers. The coating of the present invention may also include a drug, such as an antibiotic. The coatings of the present invention are suitable for use as coatings for medical devices, such as orthopedic pins or stents.
The invention generally relates to compositions and methods for preventing sternal wound infections, such as mediastinitis. In certain embodiments, the invention provides an antimicrobial composition including at least one bioresorbable polymer, such as a tyrosine-derived polyesteramide, and at least one antimicrobial agent, in which the composition is adapted to be topically applied to an esophageal perforation in a subject or a median sternotomy incision site in the subject, and in which the at least one antimicrobial agent is present in an amount effective to inhibit development of mediastinitis in the subject.
A61K 47/34 - Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyesters, polyamino acids, polysiloxanes, polyphosphazines, copolymers of polyalkylene glycol or poloxamers
The invention generally relates to compositions and methods for preventing sternal wound infections, such as mediastinitis. In certain embodiments, the invention provides an antimicrobial composition including at least one bioresorbable polymer, such as a tyrosine-derived polyesteramide, and at least one antimicrobial agent, in which the composition is adapted to be topically applied to an esophageal perforation in a subject or a median sternotomy incision site in the subject, and in which the at least one antimicrobial agent is present in an amount effective to inhibit development of mediastinitis in the subject.
A61K 47/34 - Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyesters, polyamino acids, polysiloxanes, polyphosphazines, copolymers of polyalkylene glycol or poloxamers
The present invention is directed to linear, biodegradable polyesteramide (PEA) polymers synthesized with repeating units derived from aminophenol esters and diacids. These PEAs have a monomer repeat represented by the following formula; as well as a variety of uses to coat, form or comprise medical devices, combination medical devices and pharmaceutical compositions, including sustained release formulations.
The present invention is directed to linear, biodegradable polyesteramide (PEA) polymers synthesized with repeating units derived from aminophenol esters and diacids. These PEAs have a monomer repeat represented by the following formula; as well as a variety of uses to coat, form or comprise medical devices, combination medical devices and pharmaceutical compositions, including sustained release formulations.
Body tissue and struc-tures may be protected using a fluid containing a mixture of partially crosslinked polysaccharide and a fur-ther crosslinker. The mixture desir-ably is sprayable, forms a fluid pro-tective layer via in situ crosslinking, desirably does not drip or run from a treatment site, and may avoid the use of more rapidly curing but potentially less bioacceptable crosslinkers at the treatment site.
Tissue and other body structures may be protected using a hydrated composition made from free-flowing substantially collagen-free rehydratable polysaccharide particles and rehydratable polysaccharide sponges. Rehydration of the particles without clumping may be carried out be dispersing the particles in a biocompatible water-miscible polar dispersant such as ethanol and combining the dispersion with sufficient aqueous solvent for the particles to convert them to a cohesive hydrogel. The hydrated composition may assist in returning an injured, inflamed or surgically repaired surface to a normal state, e.g., through one or more healing mechanisms such as modulation of an inflammatory response, phagocytosis, mucosal remodeling, reciliation or other full or partial restoration of normal function.
A61K 9/00 - Medicinal preparations characterised by special physical form
A61K 31/045 - Hydroxy compounds, e.g. alcohols; Salts thereof, e.g. alcoholates
A61L 15/22 - Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
A hydratable gel-forming polymer may be sterilized by chilling the polymer below ambient temperature and steril-izing the chilled polymer using ionizing radiation (e.g., E-Beam radiation). Doing so may reduce the degradation in physical prop-erties caused by ionizing radiation sterilization of the polymer while at ambient temperature, and may preserve or retain desired hydration or gel-forming characteristics. The polymer might be a chitosan and/or further polysaccharides.
A stent frame (10) including an annular portion (12) having first and second ends, a central longitudinal axis, and a wire portion with at least two extending posts (18) the wire portion having a generally sinusoidal series of peaks and valleys be-tween each of the at least two extending posts; an atrial portion (14) extending from the first end of the annular portion, wherein the atrial portion includes a plurality of flares (20) that extend radially outward relative to the longitudinal axis of the annular por-tion; and a ventricular portion (16) extending from the second end of the annular portion, wherein the ventricular portion includes at least one flare (24) that extends radially outward relative to the longitudinal axis of the annular portion.
Bodily tissue and structures may be protected using a fluid layer containing a mixture of chitosan and oxidized polysaccha-ride. The mixture forms a protective gel layer via in situ crosslinking. Compared to crosslinking using a low molecular weight aldehyde such as glutaraldehyde or genipin, oxi-dized polysaccharides appear to pro-vide faster gelation while avoiding the use of potentially less bioaccept-able low molecular weight aldehydes.
Bodily tissue and structures may be coated with a protective gel layer made from a two-part composition whose first part contains thiolated chitosan and whose second part contains sufficient oxidizing agent or external crosslinking agent so that when the two parts are mixed and coated onto the tissue or structure the mixture will form a protective gel layer in less than 30 minutes.
Effective treatments of pain for extended periods of time are pro-vided. Through the administration of an effective amount of clonidine at or near a target site, one can relieve pain caused by diverse sources, including but not limit-ed, to spinal disc herniation (i.e. sciatica), spondilothesis, stenosis, discogenic back pain and joint pain, as well as pain that is incidental to surgery. When appro-priate formulations are provided within biodegradable polymers, this relief can be continued for at least three days. In some embodiments, the relief can be for at least twenty-five days, at least fifty days, at least one hundred days, at least one hundred and thirty-five days or at least one hundred and eighty days.
The present invention relates to polymers modified to increase their resorbability. In particular, the polymers of the invention have phenyl ester side chains which are good leaving groups and which thereby increase the resorption rate of the polymer relative to the same polymer, for example, bearing a comparable amount of an alkyl ester side chain. Such polymers are generally water insoluble, but when modified are able to solublize drugs and upon degradation and resorption, release those in a physiological environment in a controlled and/or sustained manner.
C07C 235/34 - Carboxylic acid amides, the carbon skeleton of the acid part being further substituted by oxygen atoms having carbon atoms of carboxamide groups bound to acyclic carbon atoms and singly-bound oxygen atoms bound to the same carbon skeleton the carbon skeleton containing six-membered aromatic rings having the nitrogen atoms of the carboxamide groups bound to hydrogen atoms or to acyclic carbon atoms
A61M 31/00 - Devices for introducing or retaining media, e.g. remedies, in cavities of the body
C08G 63/00 - Macromolecular compounds obtained by reactions forming a carboxylic ester link in the main chain of the macromolecule
C08G 64/00 - Macromolecular compounds obtained by reactions forming a carbonic ester link in the main chain of the macromolecule
C08L 67/00 - Compositions of polyesters obtained by reactions forming a carboxylic ester link in the main chain; Compositions of derivatives of such polymers
C08L 69/00 - Compositions of polycarbonates; Compositions of derivatives of polycarbonates
Biodegradable and resorbable polymer pouches are described for use with cardiac rhythm mamagent devices (CRMs) and other implantable medical devices (IMDs), i.e., a pouch, covering, or other receptacle capable of encasing, surrounding and/or holding the CRM or other IMD for the purpose of securing it in position, inhibiting or reducing bacterial growth, providing pain relief and/or inhibiting scarring or fibrosis on or around the CRM or other IMD. Optionally, the biodegradable and resorbable pouches of the invention include one or more drugs in the polymer matrix to provide prophylactic effects and alleviate side effects or complications associated with the surgery or implantation of the CRM or other IMD.
The present invention is directed to polyphenolic polymers formed from the dihydroxybenzoic acid (DHB) derivatives or from resorcinol derivatives, monomers which form such polymers, blends of the polymers with drugs and/or additional polymers, as well as medical devices formed from, coated with, impregnated by or coverings made with any of the foregoing polymers (with or without drugs) or blends (with or without drugs).
The present invention is directed to polyphenolic polymers formed from dihydroxybenzoic acid (DHB) derivatives or from resorcinol derivatives, monomers which form such polymers, blends of the polymers with drugs and/or additional polymers, as well as medical devices formed from, coated with, impregnated by or coverings made with any of the foregoing polymers (with or without drugs) or blends (with or without drugs).
A biodegradable, flexible covering for a breast implant is provided which comprises one or more biodegradable polymer layers dimensioned and shaped to cover at least a portion of the breast implant. The implant can be inserted into an opening of the covering immediately prior to surgery, but alternate configurations and times of insertion are contemplated as well as open or sheet type devices. The coverings can optionally contain one or more drugs for delivery at the surgical site, particularly for treating or preventing infection, pain, inflammation, capsular contracture, scarring or other complications associated with breast augmentation or breast reconstruction.
The present invention relates to medical prostheses and methods of manufacturing those devices. In particular, the prostheses are temporarily stiffened meshes with particular coatings to provide initial stiffness and thereby permit easier surgical handling for treatment or reconstruction of soft tissue defects. Preferred embodiments include surgical meshes coated with one or more biodegradable polymers that can act as a stiffening agent by coating the filaments or fibers of the mesh to temporarily immobilize the contact points of those filaments or fibers and/or by increasing the stiffness of the mesh by at least 1.1 times its original stiffness. The devices of the invention can also provide relief from various post--operative complications associated with their implantation, insertion or surgical use. By including biologically active agents and/or drugs in the coating, the devices provide prophylaxis for and can alleviate side effects or complications associated with the surgery or use of prostheses in general.
A61F 2/00 - Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
The invention provides biocompatible resorbable polymers, comprising monomer units having formula (I), formula (II), formula (III) or formula (IV). The polymers degrade over time when implanted in the body, and are useful as components of implantable medical devices.
C07C 237/22 - Carboxylic acid amides, the carbon skeleton of the acid part being further substituted by amino groups having the carbon atoms of the carboxamide groups bound to acyclic carbon atoms of the carbon skeleton having nitrogen atoms of amino groups bound to the carbon skeleton of the acid part, further acylated
C07C 235/34 - Carboxylic acid amides, the carbon skeleton of the acid part being further substituted by oxygen atoms having carbon atoms of carboxamide groups bound to acyclic carbon atoms and singly-bound oxygen atoms bound to the same carbon skeleton the carbon skeleton containing six-membered aromatic rings having the nitrogen atoms of the carboxamide groups bound to hydrogen atoms or to acyclic carbon atoms
C08G 63/685 - Polyesters containing atoms other than carbon, hydrogen, and oxygen containing nitrogen
Electrical tissue stimulator and method for limiting the programmability of stimulation pulse parameters. The tissue stimulator includes a plurality of electrodes and a memory for holding a stimulation pulse parameter limit value and a programmed parameter value of a stimulation pulse. A pulse generator applies electrical stimulation pulses to the electrodes in accordance with the programmed parameter value. Programming means is included for receiving remotely generated programming signals and altering the contents of the memory in accordance with the signals. Means is included for comparing the stimulation pulse parameter limit value and the programmed parameter value and for preventing and alteration of the programmed parameter value, unless it is within stimulation pulse parameter limits. The stimulation pulse parameters may include pulse amplitude, pulse width, and pulse rate and the programmed parameter limit values may be upper and lower limits.
patents
