초록 ▼

A push-in interbody spinal fusion implant having an expandable height and having an at least in part frusto-conical shape or a shape of cylinder split along a horizontal plane through its mid-longitudinal axis with an upper member and a lower member angled to each other during insertion into the spi

A push-in interbody spinal fusion implant having an expandable height and having an at least in part frusto-conical shape or a shape of cylinder split along a horizontal plane through its mid-longitudinal axis with an upper member and a lower member angled to each other during insertion into the spine.

대표청구항 ▼

A push-in interbody spinal fusion implant having an expandable height and having an at least in part frusto-conical shape or a shape of cylinder split along a horizontal plane through its mid-longitudinal axis with an upper member and a lower member angled to each other during insertion into the spi

A push-in interbody spinal fusion implant having an expandable height and having an at least in part frusto-conical shape or a shape of cylinder split along a horizontal plane through its mid-longitudinal axis with an upper member and a lower member angled to each other during insertion into the spine. 19981100, Preissman et al., 604/082; US-5833705, 19981100, Ken et al., 606/191; US-5853418, 19981200, Ken et al., 606/191; US-5891112, 19990400, Samson, 604/282; US-5891114, 19990400, Chien et al., 604/282; US-5895391, 19990400, Farnholtz, 606/108; US-5899892, 19990500, Mortier et al., 604/280; US-5947940, 19990900, Beisel, 604/282; US-6152909, 20001100, Bagaoisan et al., 604/173; US-6171295, 20010100, Garabedian et al., 604/264 n said brain fluid, using the Goldman equation. 3. The method of claim 1 wherein: the step of sensing a value of a physiological parameter associated with ion concentration of brain fluid indudes measuring the electrical conductivity of said brain fluid. 4. The method of claim 1 wherein the modulated ion-content brain fluid produces a voltage differential between intra-cellular fluid and extra-cellular fluid, which may be modified to such a level that epileptic seizures are controlled. 5. The method of claim 1 wherein the step of sensing a value of a physiological parameter associated with ion concentration of brain fluid includes measuring electrical activity of predetermined most likely epileptic brain cells. 6. The method of claim 1 wherein the step of modifying ion concentrations of said brain fluid to render modulated ion-content brain fluid includes filtering said brain fluid. 7. The method of claim 1 wherein the step of modifying ion concentrations of said brain fluid to render modulated ion-content brain fluid includes chemically treating said brain fluid. 8. Apparatus for treating epilepsy and other neurological disorders of the brain comprising: means for sensing a value of a physiological parameter associated with ion concentration of brain fluid; and means for modifying ion concentrations of said brain fluid based on the value sensed by the means for sensing w render modulated ion-content brain fluid. 9. The apparatus of claim 8 wherein the means for sensing a value of a physiological parameter associated with ion concentration of brain fluid includes means for calculating ion concentration in said brain fluid, using the Goldman equation. 10. The apparatus claim 8 wherein the means for sensing a value of a physiological parameter associated with ion concentration of brain fluid includes means for measuring the electrical conductivity of said brain fluid. 11. The apparatus of claim 8 wherein the means for modifying ion concentrations of said brain fluid modulates the ion-content brain fluid to produces a voltage differential between intra-cellular fluid and extra-cellular fluid to such a level that epileptic seizures are controlled. 12. The apparatus of claim 8 wherein the means for sensing a value of a physiological parameter associated with ion concentration of brain fluid includes means for measuring electrical activity of most likely epileptic brain cells. 13. The apparatus of claim 8 wherein the means for modifying ion concentrations of said brain fluid to render modulated ion-content brain fluid includes a filter for filtering said brain fluid. 14. The apparatus of claim 8 wherein the means for modifying ion concentrations of said brain fluid to render modulated ion-content brain fluid includes means for chemically treating said brain fluid. wherein the tubular body further includes a membrane layer formed of a membrane material, substantially surrounding the graft layer, and having a second average permeability of at most about 100 cc/cm2/min. at 120 mm Hg. and less than the first average permeability. 2. The endoprosthesis of claim 1 wherein: the tubular body is radially reducible to a reduced diameter, and enlargeable to an increased diameter. 3. The endoprosthesis of claim 2 wherein: the tubular body is constrainable to a reduced diameter and self-expandable to an increased diameter. 4. The endoprosthesis of claim 1 wherein: the tubular body is adapted for deployment at a treatment site along body tissue, the membrane layer has a membrane layer surface that forms an outside surface of the tubular body adapted to contact the body tissue upon said deployment, and the membrane layer is biocompatible with said body tissue. 5. The endoprosthesis of claim 1 wherein: said first average permeability of the graft material layer is within a range from about 50 cc/cm2/min. to about 5,000 cc/cm2/min. at 120 mm Hg. 6. The endoprosthesis of claim 1 wherein: said membrane material comprises at least one material from the group consisting of: silicone elastomers, polyurethane polymers, polycarbonate urethanes, polytetrafluoroethylene (PTFE), and ePTFE. 7. The endoprosthesis of claim 6 wherein: said membrane material is a silicone elastomer. 8. The endoprosthesis of claim 1 wherein: said graft material comprises at least one of the materials selected from the group consisting of: polyethylene terepthalate (PET), polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (PTFE), polycarbonate urethane, polyurethane, polypropylene, polyethylene, silicone, and polyolefins. 9. The endoprosthesis of claim 8 wherein: the graft material is polyethylene terepthalate (PET). 10. The endoprosthesis of claim 1 wherein: the membrane layer is configured to substantially isolate the first fluid contained in the fluid passage from a second fluid located outside the tubular body. 11. The endoprosthesis of claim 10 wherein: the first fluid comprises blood, and the second fluid comprises bile. 12. The endoprosthesis of claim 11 wherein: said tubular body is adapted to be deployed at a transjugular intrahepatic portal systemic shunt (TIPS) treatment site. 13. The endoprosthesis of claim 1 wherein: the structural layer is disposed between the membrane layer and the graft layer. 14. The endoprosthesis of claim 1 wherein: said membrane layer is formed by coating the structural layer with the membrane material. 15. The endoprosthesis of claim 1 wherein: the membrane layer consists essentially of a porous layer formed of a graft material and impregnated with the membrane material. 16. An implantable endoprosthesis comprising: a tubular support structure defining a longitudinal passage extending therethrough, and having sufficient structural strength to maintain the longitudinal passage open in opposition to radially inward forces due to surrounding tissue; a membrane made of a membrane material disposed on at least a portion of the outside of the tubular support structure; a graft layer disposed on at least a portion of the inside of the tubular support structure; wherein the graft layer has a first average permeability ranging from about 50 to about 5,000 cc/cm2/min. at 120 mm Hg. and is adapted for containing a first fluid in the passage, and the membrane has a second average permeability less than the first average permeability of at most about 100 cc/cm2/min. at 120 mm. Hg., and is adapted for isolating the first fluid in the passage from a second fluid located outside the passage. 17. The endoprosthesis of claim 16 wherein: the first fluid consists essentially of blood, and the second fluid consists essentially of bile. 18. The endoprosthesis of claim 16 wherein: the membrane consists essentially of a coating of a membrane material applied to the tubular support structure. 19. The endoprosthesis of claim 16 wherein: the membrane consists essentially of a porous layer formed of a graft material and coated with the membrane material. 20. The endoprosthesis of claim 16 wherein: said support structure comprises first and second sets of filaments wound helically in respective and different first and second directions, crossing one another to form multiple crossing points. 21. The endoprosthesis of claim 20 wherein: the support structure is constrainable to a reduced diameter and self-expandable to an increased diameter. 22. A process for making an implantable endoprosthesis, including: providing a tubular support structure defining a longitudinal passage, and having sufficient structural strength to maintain the passage open in opposition to radially inward forces due to surrounding tissue; forming a graft layer of a graft material with a first average permeability, and disposing the graft layer along an inside surface of the tubular support structure; and coating the tubular support structure with a membrane material to form a membrane layer, with a second average permeability of the membrane layer being less than the first average permeability of the graft layer. 23. The process of claim 22 wherein: the forming of the membrane layer further comprises disposing a porous layer of a graft material along an outside surface of the support structure, and coating the support structure and the porous layer with the membrane material. 24. A body insertable prosthesis, including: a tubular body including a structural layer adapted to maintain the tubular body open in opposition to radially inward forces due to surrounding tissue, a graft layer formed of a graft material having a first average permeability ranging from about 50 to about 5,000 cc/cm2/min. at 120 mm Hg., and a membrane layer formed of a membrane material, disposed outwardly of the graft layer and having a second average permeability less than the first average permeability and at most about 100 cc/cm2/min. at 120 mm. Hg. 25. The prosthesis of claim 24 wherein: the tubular body is constrainable to a reduced diameter and self-expandable to an increased diameter. 26. The prosthesis of claim 24 wherein: the structural layer comprises a plurality of wound filaments crossing one another to form multiple crossing points. 27. The prosthesis of claim 26 wherein: the plurality of filaments comprise first and second sets of the filaments wound helically in respective first and second different common directions. 28. The prosthesis of claim 24 wherein: the membrane layer consists essentially of a porous layer formed of a graft material and either impregnated with or coated with the membrane material. 29. The prosthesis of claim 24 wherein: the structural layer is disposed between the membrane layer and the graft layer. , Werp et al.; US-6068638, 20000500, Makower, 606/159; US-6159225, 20001200, Makower, 606/155; US-6190353, 20010200, Makower et al., 600/137; US-6231587, 20010500, Makower, 606/108; US-6443158, 20020900, LaFontaine et al., 128/898 er tubular member is coaxially disposed in the second inflation lumen in the first distal outer tubular member. 9. The catheter of claim 3, wherein the second inner tubular member is coaxially disposed in the third inflation lumen in the second distal outer tubular member. 10. The catheter of claim 2, wherein the coupler tubular sleeve is disposed around a distal section of the second inner tubular member, and at least in part defines the coupling lumen. 11. The catheter of claim 10, wherein the coupling lumen is defined at least in part by an outer surface of the second inner tubular member and an inner surface of the tubular sleeve. 12. The catheter of claim 11, wherein the section of the second inner tubular member disposed in the tubular sleeve has an outer diameter not greater than an outer diameter of a section of the second inner tubular member proximally adjacent to the tubular sleeve. 13. The catheter of claim 10, wherein the tubular sleeve has an inner lumen extending from the distal end to the proximal end of the tubular sleeve and in which the section of the second inner tubular member is disposed, and the coupling lumen is defined in part by a radially enlarged proximal portion of the inner lumen of the tubular sleeve. 14. The catheter of claim 10, wherein the distal end of the first branch is radially aligned with a proximal section of the tubular sleeve, in the coupled configuration. 15. The catheter of claim 10, wherein the distal end of the tubular sleeve is proximal to the distal end of the second branch. 16. The catheter of claim 15, wherein the distal tip member is butt-joined to the distal end of the second inner tubular member. 17. The catheter of claim 15, wherein the tubular sleeve is disposed around a distal section of the second inner tubular member and a proximal section of the distal tip member, and the coupling lumen is defined by an inner surface of the tubular sleeve, an outer surface of the distal section of the second inner tubular member, and an outer surface of the proximal section of the distal tip member. 18. The catheter of claim 10, wherein the coupling lumen is a blind lumen having a closed distal end and an open proximal end. 19. The catheter of claim 1, wherein the second balloon is longer than the first balloon. 20. The catheter of claim 1, wherein the first balloon has a proximal end radially aligned with a proximal section of the second balloon located proximal to a working length of the second balloon, in the coupled configuration. 21. A bifurcated catheter, comprising: a) an elongated shaft, comprising: i) a proximal outer tubular member defining a first inflation lumen; ii) a first distal outer tubular member defining a second inflation lumen, and a second distal outer tubular member defining a third inflation lumen; iii) an intermediate outer tubular member defining a fourth inflation lumen, and joining the proximal outer tubular member and the first and second distal outer tubular members together so that the first inflation lumen is in fluid communication with the second and third inflation lumens; and iv) a first inner tubular member extending within the proximal, intermediate, and first distal outer tubular members, and a second inner tubular member extending within the intermediate and second distal outer tubular members and having a proximal end in the intermediate section, and a distal tip member secured to a distal end of the second inner tubular member to form a junction with the second inner tubular member, so that the shaft has a multifurcated distal shaft section with a first branch formed at least in part by the first distal outer tubular member and the first inner tubular member, and a second branch formed at least in part by the second distal outer tubular member and the second inner tubular member; and b) a first balloon on the first branch having an interior in fluid communication with the second inflation lumen, and a second balloon on the second bran ch having an interior in fluid communication with the third inflation lumen; and c) a coupler on the second branch, located distal to the second balloon, comprising a sleeve which has the second inner tubular member and the distal tip member disposed in a lumen of the sleeve so that the sleeve surrounds the junction between the second inner tubular member and the distal tip member, with the distal tip member extending distally beyond a distal end of the sleeve to define the distal-most end of the catheter, and which at least in part defines a coupling lumen configured to slidably receive a distal end of a joining wire therein so that the sleeve is configured for releasably coupling the first and second branches together to form a coupled configuration. 22. The catheter of claim 21, wherein the coupling lumen defined by the sleeve is a blind coupling lumen with a closed distal end and an open proximal end configured to slidably receive a joining wire to thereby releasably couple the first and second branches together. 23. The catheter of claim 21, wherein the coupling lumen is defined by an inner surface of the tubular sleeve, an outer surface of the distal section of the second inner tubular member, and an outer surface of the proximal section of the distal tip member secured thereto. 24. The catheter of claim 21, wherein the distal end of the first branch is radially aligned with a proximal section of the sleeve, in the coupled configuration. 25. A bifurcated catheter, comprising: a) an elongated shaft, comprising: i) a proximal outer tubular member defining at least a first inflation lumen; ii) a first distal outer tubular member defining a second inflation lumen, and a second distal outer tubular member defining a third inflation lumen; iii) an intermediate outer tubular member defining a fourth inflation lumen, and joining the proximal outer tubular member and the first and second distal outer tubular members together so that the first inflation lumen is in fluid communication with at least one of the second and third inflation lumens; and iv) a first inner tubular member extending within the proximal, intermediate, and first distal outer tubular members, and a second inner tubular member extending within the intermediate and second distal outer tubular members and having a proximal end in the intermediate section, so that the shaft has a multifurcated distal shaft section with a first branch formed at least in part by the first distal outer tubular member and the first inner tubular member, and a second branch formed at least in part by the second distal outer tubular member and the second inner tubular member; and b) first balloon on the first branch having an interior in fluid communication with the second inflation lumen, and a second balloon on the second branch having an interior in fluid communication with the third inflation lumen; and c) a coupler comprising a tubular sleeve disposed around a distal section of the second inner tubular member so that the second inner tubular member is located within a lumen of the tubular sleeve, at least in part defining a blind coupling lumen with a closed distal end and an open proximal end configured to slidably receive a joining wire to thereby form a coupled configuration releasably coupling the first and second branches together, with a distal end of the second branch extending out of a distal end of the lumen of the tubular sleeve and distally beyond a distal end of the tubular sleeve to define a distal-most end of the catheter. 26. The catheter of claim 25, wherein the coupling lumen is defined at least in part by an outer surface of the second inner tubular member and an inner surface of the tubular sleeve. 27. The catheter of claim 26, wherein the distal section of the second inner tubular member disposed in the tubular sleeve has an outer diameter not greater than an outer diameter of a section of the second inner tubular member proximally adjacent to th e coupler. 28. The catheter of claim 25, wherein the distal end of the tubular sleeve is proximal to the distal end of the second branch. 29. The catheter of claim 28, including a distal tip member forming the distal end of the second branch, the lumen of the tubular sleeve having the distal section of the second inner tubular member therein further having a proximal end of the distal tip member therein. 30. The catheter of claim 29, wherein the tubular sleeve is disposed around a distal portion of the second inner tubular member and a proximal section of the distal tip member, and the coupling lumen is defined by an inner surface of the tubular sleeve, an outer surface of the distal section of the second inner tubular member and an outer surface of the proximal section of the distal tip member. 31. A bifurcated catheter, comprising: a) an elongated shaft, comprising: i) a proximal section having a first inflation lumen; ii) a multifurcated distal section having a first branch with a second inflation lumen within at least a portion thereof, and having at least a second branch with a third inflation lumen within at least a portion thereof, the second and third inflation lumens each being in fluid communication with the first inflation lumen; iii) an intermediate section joining the proximal and distal sections together, and having a fourth inflation lumen in fluid communication with the first, second, and third inflation lumens; and iv) a joining wire lumen defined by a first inner tubular member configured to slidably receive a joining wire therein and extending within the proximal section, the intermediate section, and the first branch, and a guide wire lumen defined by a second inner tubular member extending within the intermediate section and the second branch; and b) a first balloon on the first branch having an interior in fluid communication with the second inflation lumen, and a second balloon on the second branch having an interior in fluid communication with the third inflation lumen; and c) a coupler on the second branch, located distal to the second balloon, comprising a tubular sleeve at least in part disposed around a section of the second inner tubular member, the tubular sleeve at least in part defining a coupling lumen configured to slidably receive a distal end of the joining wire so that the coupler is configured for releasably coupling the first and second branches together to form a coupled configuration, and wherein the tubular sleeve has an inner lumen extending from the distal end to the proximal end of the tubular sleeve and in which the section of the second inner tubular member is disposed, and the coupling lumen is defined in part by a radially enlarged proximal portion of the inner lumen of the tubular sleeve. he conduit. The needles in the second set are removed from the needle passer and are placed through the conduit and sealing element and into the collar. The shaft is then moved through the collar to move the vascular conduit along the suture into contact with the aorta. The delivery device is then removed and the respective ends of each suture length secured to fix the end of the vascular conduit to the aorta. et al.; US-5021044, 19910600, Sharkawy; US-5037432, 19910800, Molinari; US-5042984, 19910800, Kensey et al.; US-5087244, 19920200, Wolinsky et al.; US-5112305, 19920500, Barath et al.; US-5199951, 19930400, Spears; US-5244460, 19930900, Unger et al.; US-5279565, 19940100, Klein et al.; US-5288502, 19940200, McGinity et al.; US-5415636, 19950500, Forman, 604/101.03; US-5415637, 19950500, Khosravi; US-5456667, 19951000, Ham et al.; US-5496267, 19960300, Drasler et al.; US-5498238, 19960300, Shapland et al.; US-5527292, 19960600, Adams et al.; US-5591159, 19970100, Taheri; US-5607421, 19970300, Jeevanandam et al.; US-5655548, 19970800, Nelson et al.; US-5674197, 19971000, van Muiden et al.; US-5704911, 19980100, Parsons; US-5718921, 19980200, Mathiowitz et al.; US-5755682, 19980500, Knudson et al.; US-5810836, 19980900, Hussein et al.; US-5836905, 19981100, Lemelson et al., 604/101.05; US-5840059, 19981100, March et al., 604/053; US-5871469, 19990200, Eggers et al.; US-5878751, 19990300, Hussein et al., 128/898; US-5879713, 19990300, Roth et al., 424/489; US-5893840, 19990400, Hull et al., 604/096; US-5904670, 19990500, Schreiner, 604/280; US-5912017, 19990600, Mathiowitz et al.; US-5925016, 19990700, Chornenky et al.; US-5935119, 19990800, Guy et al., 604/500; US-5941868, 19990800, Kaplan et al.; US-5997525, 19991200, March et al., 604/508; US-6080170, 20000600, Nash et al., 606/159; US-6261585, 20010700, Sefton et al., 424/423 lication Ser. 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