A coated implantable medical device 10 includes a structure 12 adapted for introduction into the vascular system, esophagus, trachea, colon, biliary tract, or urinary tract; at least one layer 18 of a bioactive material positioned over the structure 12; and at least one porous layer 20 positioned over the bioactive material layer 18. Preferably, the structure 12 is a coronary stent, and the bioactive material is at least one of heparin, dexamethasone or a dexamethasone derivative. The device 10 includes layers 18 and 22 of heparin and dexamethasone, the layer 22 of dexamethasone being positioned above the layer 18 of heparin. The layers of bioactive material also can be individual materials or a combination of different materials. Unexpectedly, the more soluble heparin markedly promotes the release of the less soluble dexamethasone above it. The porous layer 20 is composed of a polymer applied by vapor or plasma deposition and provides a controlled release of the bioactive material. It is particularly preferred that the polymer is a polyimide, parylene or a parylene derivative, which is deposited without solvents, heat or catalysts, merely by condensation of a monomer vapor.

Coated implantable medical device

An acoustic imaging system for use within a heart has a catheter, an ultrasound device incorporated into the catheter, and an electrode mounted on the catheter. The ultrasound device directs ultrasonic signals toward an internal structure in the heart to create an ultrasonic image, and the electrode is arranged for electrical contact with the internal structure. A chemical ablation device mounted on the catheter ablates at least a portion of the internal structure by delivery of fluid to the internal structure. The ablation device includes a material that vibrates in response to electrical excitation, the ablation being at least assisted by vibration of the material. The ablation device may alternatively be a transducer incorporated into the catheter, arranged to convert electrical signals into radiation and to direct the radiation toward the internal structure. The electrode may be a sonolucent structure incorporated into the catheter, through which the ultrasound device is arranged to direct signals. An acoustic marker mounted on the catheter emits a sonic wave when electrically excited. A central processing unit creates a graphical representation of the internal structure, and super-imposes items of data onto the graphical representation at locations that represent the respective plurality of locations within the internal structure corresponding to the plurality of items of data. A display system displays the graphical representation onto which the plurality of items of data are super-imposed.

Catheters for imaging, sensing electrical potentials and ablating tissue

Newness and distinctiveness is claimed in the features of ornamentation as shown inside the broken line circle in the accompanying representation.

Display screen or portion thereof with graphical user interface

A surgical instrument can comprise a channel configured to support a staple cartridge and, in addition, an anvil pivotable between open and closed positions relative to the channel. The surgical instrument can further comprise a cutting member configured to incise tissue positioned captured between the staple cartridge and the anvil and, in addition, means for stopping the cutting member prior to a distal end datum, wherein the distal end datum can be defined by the distal-most staple cavity in the staple cartridge. In such embodiments, the incision within the tissue may not extend beyond the portion of the tissue that has been stapled.

Surgical stapling instrument with an articulatable end effector

A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. An E-beam firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. The E-beam firing bar affirmatively spaces the anvil from the elongate channel to assure properly formed closed staples, especially when an amount of tissue is clamped that is inadequate to space the end effector. In particular, an upper pin of the firing bar longitudinally moves through an anvil slot and a channel slot is captured between a lower cap and a middle pin of the firing bar to assure a minimum spacing. Forming the E-beam from a thickened distal portion and a thinned proximal strip enhances manufacturability and facilitates use in such articulating surgical instruments.

Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism

Acoustic imaging balloon catheters formed by a disposable liquid-confining sheath supporting a high fidelity, flexible drive shaft which carries on its end an ultrasound transducer and includes an inflatable dilatation balloon. The shaft and transducer rotate with sufficient speed and fidelity to produce real time images on a T.V. screen. In preferred embodiments, special features that contribute to the high fidelity of the drive shaft include the particular multi-filar construction of concentric, oppositely wound, interfering coils, a pre-loaded torque condition on the coils enhancing their interfering contact, and dynamic loading of the distal end of the probe, preferably with viscous drag. The coil rotating in the presence of liquid in the sheath is used to produce a desirable pressure in the region of the transducer. Numerous selectable catheter sheaths are shown including a sheath with an integral acoustically-transparent window, sheaths with end extensions that aid in positioning, a liquid injection-producing sheath, a sheath having its window section under tension employing an axially loaded bearing, a sheath carrying a dilatation or positioning balloon over the transducer, a sheath carrying a distal rotating surgical tool and a sheath used in conjunction with a side-viewing trocar.

Acoustic imaging catheter and the like

A medical device and system capable of providing on-demand delivery of biologically active material to a body lumen patient, and a method of making such medical device. A first coating layer comprising a biologically active material and optionally a polymeric material is disposed on the surface of the medical device. A second coating layer comprising magnetic particles and a polymeric material is disposed on the first coating layer. The second coating layer, which is substantially free of a biologically active material, protects the biologically active material prior to delivery. The system includes the medical device and a source of energy, such as an electromagnetic or mechanical vibrational energy. When the patient is exposed to the energy source, the magnetic particles move out of the second coating layer and create channels therein through which the biologically active material can be released.

Energetically-controlled delivery of biologically active material from an implanted medical device

A medical guidewire (28) has a substantially uniform small diameter (d) throughout its length and incorporates means for lateral acoustic scanning, and the guidewire comprises a proximal connector (27), an extended main guidewire body portion (144), an axially elongated transition section (34), and a floppy tip portion (26), the main body portion comprises a stationary outer wall including means capable of transmitting torque and within the outer wall, an elongated rotable shaft (1) with a distally positioned acoustic imaging transducer (22) mounted thereon, the proximal connector is constructed to be attached to and detached from a device (20) to enable a therapeutic device to be introduced over the guidewire, the connector has a stationary portion secured to the outer wall and an inner drive portion secured to the shaft, the floppy tip portion comprises an outer wire coil (7) and a core rod (8) which tapers from a relatively large diameter at a proximal joint with the outer wire coil to a floppy distal tip, and the elongated transition section (34) serves to join the main body portion to the floppy tip section.

Robert J. Crowley

Papers

Catheters for imaging, sensing electrical potentials and ablating tissue

Acoustic imaging catheter and the like

Energetically-controlled delivery of biologically active material from an implanted medical device

Ultrasound imaging guidewire

Acousting imaging catheters and the like