WO1991001773A1 - Percutaneous mechanical dilating catheter for cardiac valves and blood vessels - Google Patents

Percutaneous mechanical dilating catheter for cardiac valves and blood vessels

Info

Publication number
WO1991001773A1
WO1991001773A1 PCT/IT1990/000072 IT9000072W WO1991001773A1 WO 1991001773 A1 WO1991001773 A1 WO 1991001773A1 IT 9000072 W IT9000072 W IT 9000072W WO 1991001773 A1 WO1991001773 A1 WO 1991001773A1
Authority
WO
Grant status
Application
Patent type
Prior art keywords
dilating
catheter
blood
body
valves
Prior art date
Application number
PCT/IT1990/000072
Other languages
French (fr)
Inventor
Enrico Mangieri
Claudio D'orazi
Original Assignee
Enrico Mangieri
Orazi Claudio D
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00Dilators with or without means for introducing media, e.g. remedies
    • A61M29/02Dilators made of swellable material
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00778Operations on blood vessels
    • A61B2017/00783Valvuloplasty

Abstract

This invention is a mechanical dilating catheter that serves to dilate stenotic cardiac valves and blood vessels. It is composed of four parts: 1) the handle (1); 2) the sheath (4); 3) the wire (5); 4) the dilating body. This has a concave area (12) in the central section of the expansion blades (8) which firmly anchors the body to the edges of stenotic cardiac valves and to stenotic segments of blood vessels.

Description

Percutaneous mechanical dilating catheter for cardiac valves and blood vessels.

Great progress has been made in interventional cardiology over the last decade. The therapeutic use of balloon catheters has been extended to stenotic cardiac valves with the aim of increasing the flow of blood by dilating the valve. However, balloon catheters have certain limitations. This is due partly to their structure and conformation and partly to the fact that they cεn have a dilating effect on the valve only at the moment of maximum inflation of the balloon. Below, we outline some of the most common drawbacks associated with this type of catheter.

The first of these is serioι_s hypotension with cerebral ischemia which occurs when the balloon is fully inflated and temporarily obstructs the flow of blood inside the valve undergoing dilation.

The second is the onset of cardiac valve insufficiency, which agσravates the original illness and necessitates valve transplantation within a fairly short timescale. This is due to the fact that the balloon must be inflated to its maximum capacity relatively quickly, in addition to the fact that it can only assume one shape regardless of the type of valve involved. A third drciwback is the damage that can be caused by a balloon larger in diameter that the valve ring or the stenotic blood vessel being treated. Yet another drawback is the instability of the balloon within stenotic valves. It can slip on the surface of such structures, producing little or no dilation. The aim of the percutaneous mechanical dilating catheter is to eliminate the serious drawbacks mentioned above. This new catheter solves the problem of how to d::late stenotic cardiac valves and blood vessels.

This catheter is undoubtedly an improvement on the existing balloon catheter for the following reasons; a) unlike the balloon catheter, it allows an improved flew of blood during the process of dilation itself,thus avoiding the risk of serious systemic hypotension and ischemia. b) the new catheter allows the dilating body to be positioned in the most anatomically favourable way inside the stenotic valve or vessel. c) the cardiologist can regulate the dimensions of the body as required during the procedure. d) the dilation prccedure can be carried cut in a much less traumatic manner without limitations of time and with maximuir accuracy of pressure on the stenotic valve cusps and blood vessels. e) the body of the new catheter can be firmly anchored to the edges of stenotic valves and to the stenotic segments of blood vessels.

From observation obtained during experiments on dead sub-- jects, the inventors deduced that only the concavity on the central section of the expansion blades allows to firmly anchor the dilating body tc the edges of stenotic valves and to the tracts of blood vessels. Used in vivo without a firm anchorage, the dilating body would frequently lose contact with the stenotic structure, possibly providing little or no dilatinc effect. DESCRIPTION

Fig. 1 shows the percutaneous mechanical dilating catheter. It comprises four parts; the handle, the sheath, the wire, and the dilating body. The diagram shows the catheter in the act of dilation. The handle 1 is pistol-shaped and is furπi- shed with a lever 2. This transmits ccminands via a wire 5 to open and close the dilating body. At the bottom (lower extremity) of the handle there is a screw to regulate expansion 3. The flexible sheath 4 has a lenght and diameter which can be adjusted to suit the age and the surface area of the patient. The wire runs through the sheath and is attached at one end to the handle and at the other to a head 7 of the body. One end of the sheath is connected to the handle and the other to a head 6 of the body. The body, which is shown in the act of dilation, is made up as follows The two heads 6, 7 are located at each extremity of the body. Each, head has three sites for the expansion blades 8, The proximal head 6 has a hole for the wire 5; the distal head 7 has an anchor point for the wire 5. Each of the heads is fitted with a tube 9, 10 which fit into each other and serve to regulate the movement of the heads. The wire runs through these tubes. At the end of the body there is a flexible guide 11 attached to the heεd 7. There is a concave area 12 located in the central section of the expansion blades 8. - A -

MODE OF EMPLOYMENT

Pressure applied on the lever 2 modifies the position of the wire. This brings the two heads closer together, thus opening (flexing) the three blades. During this expansion, the blades come into contact with stenotic valves or blood vessels, which they then dilate as required. After dilation, the pressure on the heads is released allowing the body to return to its initial closed position.

Claims

1. the "Percutaneous mechanical dilating catheter for cardiac valves and blood vessels" characterized by being composed of four parts; a handle, a sheath, a wire, a dilating bod .
2. the "Percutaneous mechanical dilating catheter for cardiac valves and blood vessels", as preceding, having a dilating body.
3. the "Percutaneous mechanical dilating catheter for cardiac valves and blood vessels", as preceding, having a dilating body preferably made of stainless steel, but not excluding any other suitable material.
4. the "Percutaneous mechanical dilating catheter for cardiac valves and blood vessels", as preceding, having a dilating body comprising three flexible, elastic blades 8 preferably made of stainless steel, but not excluding any other suitable material.
5. the "Percutaneous mechanical dilating catheter for cardiac valves and blood vessels", as preceding, of which the blades 8 have a convave area 12.
6. the "Percutaneous mechanical dilating catheter for cardiac valves and blocd vessels", as preceding, of which the concave area 12 is located in the central section of the blades 8.
PCT/IT1990/000072 1989-08-01 1990-07-26 Percutaneous mechanical dilating catheter for cardiac valves and blood vessels WO1991001773A1 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
IT3591589 1989-08-01
IT35915B/89 1989-08-01
IT4782490 1990-04-03
IT47824A/90 1990-04-03

Publications (1)

Publication Number Publication Date
WO1991001773A1 true true WO1991001773A1 (en) 1991-02-21

Family

ID=26329021

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IT1990/000072 WO1991001773A1 (en) 1989-08-01 1990-07-26 Percutaneous mechanical dilating catheter for cardiac valves and blood vessels

Country Status (1)

Country Link
WO (1) WO1991001773A1 (en)

Cited By (41)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2257631A (en) * 1991-05-23 1993-01-20 Christopher John Newman Artery expander
EP0643980A1 (en) * 1993-09-21 1995-03-22 United States Surgical Corporation Surgical instrument for expanding body tissue
DE19610461A1 (en) * 1996-03-16 1997-09-18 Osypka Peter Catheter with spreader section
WO1999023961A1 (en) * 1997-11-12 1999-05-20 Vnus Medical Technologies, Inc. Catheter having expandable electrodes and adjustable stent
WO1999042044A1 (en) * 1998-02-19 1999-08-26 Conway-Stuart Medical, Inc. Electrosurgical sphincter treatment apparatus
WO1999044522A1 (en) * 1998-03-06 1999-09-10 Conway-Stuart Medical, Inc. Apparatus to electrosurgically treat esophageal sphincters
WO1999055245A1 (en) * 1998-04-30 1999-11-04 Edwards Stuart D Electrosurgical sphincter treatment apparatus
WO2008005405A2 (en) * 2006-06-28 2008-01-10 Lemaitre Vascular, Inc. Non-occluding dilation device
WO2008156468A1 (en) * 2007-06-19 2008-12-24 Lemaitre Vascular, Inc. Non-occluding dilation device
US7618432B2 (en) 2003-07-18 2009-11-17 Intervalve, Inc. Valvuloplasty devices and methods
US7951111B2 (en) 2008-10-10 2011-05-31 Intervalve, Inc. Valvuloplasty catheter and methods
US8177781B2 (en) 2000-10-02 2012-05-15 Novasys Medical, Inc. Apparatus and methods for treating female urinary incontinence
US8377055B2 (en) 1999-11-16 2013-02-19 Covidien Lp Methods and systems for determining physiologic characteristics for treatment of the esophagus
US8403927B1 (en) 2012-04-05 2013-03-26 William Bruce Shingleton Vasectomy devices and methods
WO2013126779A1 (en) * 2012-02-23 2013-08-29 Boston Scientific Scimed, Inc. Valvuloplasty device
US8740846B2 (en) 1996-09-20 2014-06-03 Verathon, Inc. Treatment of tissue in sphincters, sinuses, and orifices
US8784467B2 (en) 2009-05-15 2014-07-22 Lemaitre Vascular, Inc. Non-occlusive dilation devices
US8845632B2 (en) 2000-05-18 2014-09-30 Mederi Therapeutics, Inc. Graphical user interface for monitoring and controlling use of medical devices
CN104470414A (en) * 2012-06-22 2015-03-25 迈克罗普拉塔公司 Multi-lumen-catheter retractor system for a minimally-invasive, operative gastrointestinal treatment
US9023031B2 (en) 1997-08-13 2015-05-05 Verathon Inc. Noninvasive devices, methods, and systems for modifying tissues
US9039699B2 (en) 1999-11-16 2015-05-26 Covidien Lp Methods and systems for treatment of tissue in a body lumen
US9155583B2 (en) 1994-06-24 2015-10-13 Mederi Therapeutics, Inc. Systems and methods for monitoring and controlling use of medical devices
US9179970B2 (en) 2005-11-23 2015-11-10 Covidien Lp Precision ablating method
US9186223B2 (en) 1999-09-08 2015-11-17 Mederi Therapeutics, Inc. Systems and methods for monitoring and controlling use of medical devices
US9198713B2 (en) 2007-06-22 2015-12-01 Covidien Lp Electrical means to normalize ablational energy transmission to a luminal tissue surface of varying size
US9198705B2 (en) 1999-05-04 2015-12-01 Mederi Therapeutics, Inc. Unified systems and methods for controlling use and operation of a family of different treatment devices
US9242081B2 (en) 2010-09-13 2016-01-26 Intervalve, Inc. Positionable valvuloplasty catheter
US9292152B2 (en) 2009-09-22 2016-03-22 Mederi Therapeutics, Inc. Systems and methods for controlling use and operation of a family of different treatment devices
US9314289B2 (en) 2007-07-30 2016-04-19 Covidien Lp Cleaning device and methods
US9364283B2 (en) 2007-07-06 2016-06-14 Covidien Lp Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight loss operation
US9393069B2 (en) 2004-01-09 2016-07-19 Covidien Lp Devices and methods for treatment of luminal tissue
US9474565B2 (en) 2009-09-22 2016-10-25 Mederi Therapeutics, Inc. Systems and methods for treating tissue with radiofrequency energy
US9554690B2 (en) 2009-12-16 2017-01-31 Boston Scientific Scimed, Inc. Endoluminal device with retractor system
US9565998B2 (en) 2009-12-16 2017-02-14 Boston Scientific Scimed, Inc. Multi-lumen-catheter retractor system for a minimally-invasive, operative gastrointestinal treatment
WO2017060851A1 (en) * 2015-10-07 2017-04-13 Pi-Cardia Ltd. Impactor for fracturing calcifications in heart valves
US9661984B2 (en) 2004-03-16 2017-05-30 Macroplata, Inc. Endoluminal treatment method and associated surgical assembly
US9737194B2 (en) 2009-12-16 2017-08-22 Boston Scientific Scimed, Inc. Endoluminal system for gastrointestinal treatment
US9750563B2 (en) 2009-09-22 2017-09-05 Mederi Therapeutics, Inc. Systems and methods for treating tissue with radiofrequency energy
US9775664B2 (en) 2009-09-22 2017-10-03 Mederi Therapeutics, Inc. Systems and methods for treating tissue with radiofrequency energy
US9918794B2 (en) 2005-11-23 2018-03-20 Covidien Lp Auto-aligning ablating device and method of use
US9993281B2 (en) 2007-05-04 2018-06-12 Covidien Lp Method and apparatus for gastrointestinal tract ablation for treatment of obesity

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1677671A (en) * 1926-07-02 1928-07-17 Wilford A Councill Ureteral stone extractor and dilator
US3517128A (en) * 1968-02-08 1970-06-23 James R Hines Surgical expanding arm dilator
DE1963316A1 (en) * 1969-12-17 1971-06-24 Inst Serdetschno Sosudistoi Ch Dilator for mitral and praecardialen Trikuspidalkommissurotomie
US4648402A (en) * 1985-10-03 1987-03-10 Santos Manuel V Blood vessel dilating surgical instrument

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1677671A (en) * 1926-07-02 1928-07-17 Wilford A Councill Ureteral stone extractor and dilator
US3517128A (en) * 1968-02-08 1970-06-23 James R Hines Surgical expanding arm dilator
DE1963316A1 (en) * 1969-12-17 1971-06-24 Inst Serdetschno Sosudistoi Ch Dilator for mitral and praecardialen Trikuspidalkommissurotomie
US4648402A (en) * 1985-10-03 1987-03-10 Santos Manuel V Blood vessel dilating surgical instrument

Cited By (72)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2257631A (en) * 1991-05-23 1993-01-20 Christopher John Newman Artery expander
EP0643980A1 (en) * 1993-09-21 1995-03-22 United States Surgical Corporation Surgical instrument for expanding body tissue
US5522835A (en) * 1993-09-21 1996-06-04 United States Surgical Corporation Surgical instrument for expanding body tissue
US5720763A (en) * 1993-09-21 1998-02-24 United States Surgical Corporation Surgical instrument for expanding body tissue
US5928259A (en) * 1993-09-21 1999-07-27 United States Surgical Corporation Surgical instrument for expanding body tissue
US9155583B2 (en) 1994-06-24 2015-10-13 Mederi Therapeutics, Inc. Systems and methods for monitoring and controlling use of medical devices
DE19610461C2 (en) * 1996-03-16 1999-02-11 Osypka Peter Catheter having an insertion tube
DE19610461A1 (en) * 1996-03-16 1997-09-18 Osypka Peter Catheter with spreader section
US5954742A (en) * 1996-03-16 1999-09-21 Osypka; Peter Dilatation catheter
US8740846B2 (en) 1996-09-20 2014-06-03 Verathon, Inc. Treatment of tissue in sphincters, sinuses, and orifices
US9023031B2 (en) 1997-08-13 2015-05-05 Verathon Inc. Noninvasive devices, methods, and systems for modifying tissues
WO1999023961A1 (en) * 1997-11-12 1999-05-20 Vnus Medical Technologies, Inc. Catheter having expandable electrodes and adjustable stent
US6263248B1 (en) 1997-11-12 2001-07-17 Vnus Medical Technologies, Inc. Catheter having expandable electrodes and adjustable stent
WO1999042044A1 (en) * 1998-02-19 1999-08-26 Conway-Stuart Medical, Inc. Electrosurgical sphincter treatment apparatus
US9351787B2 (en) 1998-02-19 2016-05-31 Mederi Therapeutics, Inc. Sphincter treatment apparatus
US8894646B2 (en) 1998-02-19 2014-11-25 Mederi Therapeutics, Inc. Sphincter treatment apparatus
US9539052B2 (en) 1998-02-19 2017-01-10 Mederi Therapeutics, Inc. Sphincter treatment apparatus
WO1999044522A1 (en) * 1998-03-06 1999-09-10 Conway-Stuart Medical, Inc. Apparatus to electrosurgically treat esophageal sphincters
WO1999055245A1 (en) * 1998-04-30 1999-11-04 Edwards Stuart D Electrosurgical sphincter treatment apparatus
US9198705B2 (en) 1999-05-04 2015-12-01 Mederi Therapeutics, Inc. Unified systems and methods for controlling use and operation of a family of different treatment devices
US9750559B2 (en) 1999-09-08 2017-09-05 Mederi Therapeutics Inc System and methods for monitoring and controlling use of medical devices
US9925000B2 (en) 1999-09-08 2018-03-27 Mederi Therapeutics, Inc. Systems and methods for monitoring and controlling use of medical devices
US9186223B2 (en) 1999-09-08 2015-11-17 Mederi Therapeutics, Inc. Systems and methods for monitoring and controlling use of medical devices
US9039699B2 (en) 1999-11-16 2015-05-26 Covidien Lp Methods and systems for treatment of tissue in a body lumen
US9555222B2 (en) 1999-11-16 2017-01-31 Covidien Lp Methods and systems for determining physiologic characteristics for treatment of the esophagus
US9597147B2 (en) 1999-11-16 2017-03-21 Covidien Lp Methods and systems for treatment of tissue in a body lumen
US8377055B2 (en) 1999-11-16 2013-02-19 Covidien Lp Methods and systems for determining physiologic characteristics for treatment of the esophagus
US8876818B2 (en) 1999-11-16 2014-11-04 Covidien Lp Methods and systems for determining physiologic characteristics for treatment of the esophagus
US9675403B2 (en) 2000-05-18 2017-06-13 Mederi Therapeutics, Inc. Graphical user interface for monitoring and controlling use of medical devices
US8845632B2 (en) 2000-05-18 2014-09-30 Mederi Therapeutics, Inc. Graphical user interface for monitoring and controlling use of medical devices
US8177781B2 (en) 2000-10-02 2012-05-15 Novasys Medical, Inc. Apparatus and methods for treating female urinary incontinence
US8968284B2 (en) 2000-10-02 2015-03-03 Verathon Inc. Apparatus and methods for treating female urinary incontinence
US8465482B2 (en) 2000-10-02 2013-06-18 Verathon, Inc. Apparatus and methods for treating female urinary incontinence
US7618432B2 (en) 2003-07-18 2009-11-17 Intervalve, Inc. Valvuloplasty devices and methods
US8486102B2 (en) 2003-07-18 2013-07-16 Intervalve, Inc. Valvuloplasty catheter
US9375555B2 (en) 2003-07-18 2016-06-28 Intervalve, Inc. Valvuloplasty catheter
US9393069B2 (en) 2004-01-09 2016-07-19 Covidien Lp Devices and methods for treatment of luminal tissue
US9661984B2 (en) 2004-03-16 2017-05-30 Macroplata, Inc. Endoluminal treatment method and associated surgical assembly
US9918793B2 (en) 2005-11-23 2018-03-20 Covidien Lp Auto-aligning ablating device and method of use
US9918794B2 (en) 2005-11-23 2018-03-20 Covidien Lp Auto-aligning ablating device and method of use
US9179970B2 (en) 2005-11-23 2015-11-10 Covidien Lp Precision ablating method
WO2008005405A2 (en) * 2006-06-28 2008-01-10 Lemaitre Vascular, Inc. Non-occluding dilation device
WO2008005405A3 (en) * 2006-06-28 2008-06-26 Lemaitre Vascular Inc Non-occluding dilation device
US9993281B2 (en) 2007-05-04 2018-06-12 Covidien Lp Method and apparatus for gastrointestinal tract ablation for treatment of obesity
WO2008156468A1 (en) * 2007-06-19 2008-12-24 Lemaitre Vascular, Inc. Non-occluding dilation device
US9198713B2 (en) 2007-06-22 2015-12-01 Covidien Lp Electrical means to normalize ablational energy transmission to a luminal tissue surface of varying size
US9364283B2 (en) 2007-07-06 2016-06-14 Covidien Lp Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight loss operation
US9839466B2 (en) 2007-07-06 2017-12-12 Covidien Lp Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight loss operation
US9314289B2 (en) 2007-07-30 2016-04-19 Covidien Lp Cleaning device and methods
US9504807B2 (en) 2008-10-10 2016-11-29 Intervalve, Inc. Valvuloplasty catheter and methods
US8900264B2 (en) 2008-10-10 2014-12-02 Intervalve, Inc. Valvuloplasty catheter and methods
US7951111B2 (en) 2008-10-10 2011-05-31 Intervalve, Inc. Valvuloplasty catheter and methods
US8784467B2 (en) 2009-05-15 2014-07-22 Lemaitre Vascular, Inc. Non-occlusive dilation devices
US9495059B2 (en) 2009-09-22 2016-11-15 Mederi Therapeutics, Inc. Systems and methods for controlling use and operation of a family of different treatment devices
US9474565B2 (en) 2009-09-22 2016-10-25 Mederi Therapeutics, Inc. Systems and methods for treating tissue with radiofrequency energy
US9310956B2 (en) 2009-09-22 2016-04-12 Mederi Therapeutics, Inc. Systems and methods for controlling use and operation of a family of different treatment devices
US9448681B2 (en) 2009-09-22 2016-09-20 Mederi Therapeutics, Inc. Systems and methods for controlling use and operation of a family of different treatment devices
US9292152B2 (en) 2009-09-22 2016-03-22 Mederi Therapeutics, Inc. Systems and methods for controlling use and operation of a family of different treatment devices
US9675404B2 (en) 2009-09-22 2017-06-13 Mederi Therapeutics, Inc. Systems and methods for treating tissue with radiofrequency energy
US9750563B2 (en) 2009-09-22 2017-09-05 Mederi Therapeutics, Inc. Systems and methods for treating tissue with radiofrequency energy
US9513761B2 (en) 2009-09-22 2016-12-06 Mederi Therapeutics, Inc. Systems and methods for controlling use of treatment devices
US9775664B2 (en) 2009-09-22 2017-10-03 Mederi Therapeutics, Inc. Systems and methods for treating tissue with radiofrequency energy
US9655506B2 (en) 2009-12-16 2017-05-23 Boston Scientific Scimed, Inc. Endoluminal device with retractor system
US9565998B2 (en) 2009-12-16 2017-02-14 Boston Scientific Scimed, Inc. Multi-lumen-catheter retractor system for a minimally-invasive, operative gastrointestinal treatment
US9554690B2 (en) 2009-12-16 2017-01-31 Boston Scientific Scimed, Inc. Endoluminal device with retractor system
US9737194B2 (en) 2009-12-16 2017-08-22 Boston Scientific Scimed, Inc. Endoluminal system for gastrointestinal treatment
US9242081B2 (en) 2010-09-13 2016-01-26 Intervalve, Inc. Positionable valvuloplasty catheter
US9827096B2 (en) 2012-02-23 2017-11-28 Boston Scientific Scimed, Inc. Valvuloplasty device
WO2013126779A1 (en) * 2012-02-23 2013-08-29 Boston Scientific Scimed, Inc. Valvuloplasty device
US8403927B1 (en) 2012-04-05 2013-03-26 William Bruce Shingleton Vasectomy devices and methods
CN104470414A (en) * 2012-06-22 2015-03-25 迈克罗普拉塔公司 Multi-lumen-catheter retractor system for a minimally-invasive, operative gastrointestinal treatment
WO2017060851A1 (en) * 2015-10-07 2017-04-13 Pi-Cardia Ltd. Impactor for fracturing calcifications in heart valves

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