|Numéro de publication||US5320605 A|
|Type de publication||Octroi|
|Numéro de demande||US 08/007,767|
|Date de publication||14 juin 1994|
|Date de dépôt||22 janv. 1993|
|Date de priorité||22 janv. 1993|
|État de paiement des frais||Payé|
|Autre référence de publication||WO1994016761A1|
|Numéro de publication||007767, 08007767, US 5320605 A, US 5320605A, US-A-5320605, US5320605 A, US5320605A|
|Cessionnaire d'origine||Harvinder Sahota|
|Exporter la citation||BiBTeX, EndNote, RefMan|
|Citations de brevets (40), Référencé par (248), Classifications (15), Événements juridiques (4)|
|Liens externes: USPTO, Cession USPTO, Espacenet|
The present invention relates generally to the field of catheters. More specifically, the present invention relates to dilatation catheters for use in administering treatments to relieve a stenotic region or to widen a constricted blood flow or tubular passage, such as the coronary artery, as well as other vessels.
Percutaneous transluminal coronary angioplasty (PTCA), a procedure for treating a patient having a stenosis or constricted blood region in a coronary artery, has become a widely accepted therapeutic alternative to coronary arterial bypass surgery for many patients. PTCA increases the lumen by radial expansion. The main advantage of PTCA rests in the avoidance of the immediate post-operative discomforts associated with coronary bypass surgery, and certainly in the reduction of morbidity by use of this procedure.
The benefits of PTCA are restricted to lesions accessible to the balloon dilatation catheter. With standard systems, certain lesions are inaccessible due to variations in the patient's anatomy and vasculature. Further, seducing side branches, tortuous vessels, and the more distal arteries have presented serious difficulties in the PTCA procedure because, due to its cross-sectional area, the balloon could not reach the stenotic region.
Performing a coronary angioplasty involves the difficulty of inserting a balloon catheter into the desired coronary artery. Most balloon catheters are too flexible for direct insertion into the patient's coronary artery. Accordingly, the standard angioplasty process begins with the insertion of a guiding catheter, or sleeve into the obstructed vessel, under local anesthesia. To facilitate the introduction of the guiding catheter, and to avoid damage to the body lumen at the puncture site, a guide wire may be useful in the insertion of the guiding catheter. The guiding catheter is designed to provide a conduit through which a balloon catheter is not tapered so as to permit the unimpeded passage of the balloon catheter therethrough.
When considering angioplasty as a method of treating stenotic regions, the morphology of the lesion is critical in determining whether the balloon catheter can be safely passed beyond the stenosis, and whether the vessel will adequately dilate. If the stenosis is comprised primarily of fatty deposits, for example, it is often times possible to compress the stenosis radially outwardly, against the adjacent vessel wall, so as to increase the cross-sectional area of the vessel, and provide adequate perfusion through the vessel. If, however, the artery is hard, or the stenosis has calcified, a standard balloon might burst when inflated. Further, tortuous hardened arteries may be dissected if inflated with such a dilatation balloon.
The lesion may be approached with a guide wire by advancing the catheter and guide wire as a unit, or by advancing the guide wire first. Steering the tip of the wire is done by the surgeon or by an assistant. If the tip is moving in an undesired direction, then slight withdrawal and rotation of tip will point it in the correct way. Once the wire is positioned, the balloon catheter may be advanced over it until it crosses the lesion while the surgeon pulls back on the guide wire to maintain the tip in a fixed position in the distal coronary. If resistance is encountered at the lesion, gentle pressure on the balloon catheter will often cause it to cross. If, however, the lesion is too tight or hard and the balloon tip still will not cross, a new, low profile catheter must be selected. In this instance, the safety of the movable guide wire system must be sacrificed.
Ordinarily, a cardiologist, administering an angioplasty treatment, does not know how much pressure to apply to the balloon to achieve satisfactory results. Since the balloon is non-distensible, it can be inflated only to the constructed size of the balloon. Further attempts to force fluid into the balloon will result in increased pressure, but no significant increase in diameter. However, excessive pressure in the balloon may dissect the artery, which may cause serious damage to the patient's heart.
Therefore, the cardiologist positions the balloon in the artery, expands the balloon, and then allows the balloon to depressurize to permit measurement of blood flow across the stenosis. If the blood flow rate is not acceptable, the cardiologist must repeat the angioplasty treatment, often times necessitating the insertion of multiple catheters, of progressively larger diameters, to gradually increase the lumen of the artery until the obstruction is either alleviated, or until the cardiologist determines that angioplasty will be unable to restore the blood flow rate to an acceptable value.
When the angioplasty procedure requires the insertion and withdrawal of a great many balloon catheters, the risk of damage to the lining of the blood vessel is substantially increased. All blood vessels have a lining of very flattened cells, known as endothelial cells, the integrity of which is essential to normal blood flow. Damage or injury to the endothelial layer promotes the adherence of blood cells passing through the vessel at the point of injury, and may form further obstructions within the artery or vessel.
The dilatation catheters of the present invention overcome many of the difficulties associated with ordinary prior art dilatation catheters. In one aspect of the invention, a two wire system, of minimal diameter is disclosed. In this embodiment, the dilatation balloon is secured directly to an advance wire and a second movable wire is provided. Advantageously, following inflation and deflation of the dilatation balloon, the catheter is withdrawn across the lesion while the second, movable wire is advanced, so as to keep it far distal to the dilated segment. Significantly, if the results are unsatisfactory, or if dissection or other filling defects obscure the lesion, the same dilatation balloon, or a different size or type of dilatation balloon can be quickly and safely passed across the stenosis over the second wire which has been left in place. In addition to providing distal access to the dilated segment, the movable wire gives strength and support along the length of the catheter during insertion thereof, while maintaining the smallest possible profile at the distal end of the catheter to facilitate the ease of insertion past the stenotic region. The added strength and support of the catheter is helpful in manipulating the catheter through the desired vessels.
In accordance with a further aspect of the present invention, there is disclosed a multiple wire multiple balloon catheter for treating a site within a body lumen. The catheter comprises a first elongate flexible wire, and a first dilatation balloon on the first wire. The first dilatation balloon has at least one lumen extending at least part way through the balloon from the proximal edge thereof towards the distal edge thereof.
A second elongate flexible wire is also provided on the catheter, together with a second dilatation balloon on the second wire. The second wire has a distally extending advance wire on the distal side of the second balloon, and at least a portion of the advance wire extends within the proximal opening of the lumen on the first balloon.
Preferably, a lumen extends at least part way into the second balloon from the proximal end thereof towards the distal end thereof, to accommodate the distal advance wire on the distal end of a third balloon catheter.
In one variation of the present invention, the lumen extends all the way through the first dilatation balloon, so that the second elongate flexible wire and second dilatation balloon can be distally axially advanced through the first balloon.
In accordance with a further aspect of the present invention, there is provided a method of exchanging two or more balloons within a site in a body lumen. The method comprises the steps of providing a multiple wire multiple balloon catheter of the type having a first balloon secured to a first flexible wire and a second balloon secured to a second flexible wire, said first balloon having an axially extending lumen therethrough. The first balloon is positioned within a preselected body site, and inflated to dilate or otherwise treat that site. Thereafter, the second balloon is advanced axially in the distal direction through the lumen in the first balloon, and the second balloon is thereafter dilated to treat a site within the body lumen.
Preferably, the first balloon is deflated prior to the step of advancing the second balloon axially therethrough. Thereafter, the first balloon may be withdrawn in a proximal direction to a site within the body lumen, or entirely away from the patient's body. Alternatively, as desired, the two or more balloons can be inflated simultaneously, either in a side by side or an end to end configuration.
In accordance with a further aspect of the present invention, there is provided a balloon catheter for releasably engaging at least one other balloon catheter for insertion into a body lumen as a single unit, but which single unit is capable of sequential dilatation of a preselected site by two or more distinct balloons. The catheter comprises an elongate flexible catheter comprising a wire, and an inflatable balloon on the wire. The inflatable balloon is in fluid communication with at least one inflation lumen extending axially along the wire.
An engagement structure is provided on the catheter, for engaging the distal tip of a second balloon catheter of the type having an elongate flexible wire and at least one inflatable balloon thereon. The engagement structure is optionally on the elongate flexible catheter shaft, or on the first inflatable balloon.
In a preferred embodiment, the engagement structure comprises an opening on the proximal end of the first dilatation balloon. Preferably, the opening is in communication with a lumen extending axially throughout the length of the first balloon.
Further objects, features and other advantages of the present invention will become apparent from the ensuing detailed description, when considered together with the appended drawings and claims.
FIG. 1 is a perspective view of a dilatation catheter;
FIG. 2 is a cross-sectional view, taken along line 2--2 of FIG. 1, showing the positioning of a second wire with respect to the dilatation balloon, prior to insertion into a body lumen;
FIG. 3 is a cross-sectional view, taken along line 3--3 of FIG. 1, illustrating one possible arrangement of the second movable wire;
FIG. 3a is a cross-sectional view of an alternative method of securing the second wire to the balloon dilatation catheter of FIG. 1;
FIG. 3b is a cross-sectional view of a second alternative method of securing the second wire to the balloon dilatation catheter of FIG. 1;
FIG. 4 is a perspective view of a multi-lobed dilatation balloon;
FIG. 5 is a cross-sectional view of the multi-lobed dilatation balloon of FIG. 4, illustrating separate inflation lumen and ports for each lobe of the balloon;
FIG. 6 is a cross-sectional view of a variation of the multi-lobed balloon of FIG. 4, illustrating the combination of two lobes inflated by a single inflation lumen and port;
FIG. 7 is a partial cross-sectional view illustrating the dilatation balloon of FIG. 4 positioned within a patient's artery with the lobes inflated;
FIG. 8 is a partial cross-sectional view of a dilatation catheter within a patient's artery, having a plurality of perfusion ports for allowing the continuous passage of blood flow through the artery while the balloon is inflated;
FIG. 9 is a cross-sectional view, taken along line 9--9 of FIG. 8, illustrating the several lumen within the catheter;
FIG. 10 is a cross-sectional view, taken along line 10--10 of FIG. 8, illustrating, by way of arrows, the perfusion of blood through the inner lumen of the catheter;
FIG. 11 is a cross-sectional view of a multi-layered dilatation balloon in an inflated state;
FIG. 12 is a perspective view of a dilatation catheter having a one-sided dilatation balloon, secured to a catheter wire;
FIG. 13 is a cross-sectional view, taken along line 13--13 of FIG. 12, illustrating the attachment of the one-sided balloon to the catheter wire and the provision of a second, movable wire;
FIG. 13a is a cross-sectional view of an alternative method of securing the second wire to the balloon dilatation catheter of FIG. 12; and
FIG. 14 is a cross-sectional view, taken along line 14--14 of FIG. 12, illustrating the attachment of the dilatation balloon to the catheter wire and, in dotted lines, the positioning of the second wire with respect to the dilatation catheter when advanced.
FIG. 15 is a partial perspective view of a multi-wire multi-balloon embodiment of the present invention.
FIG. 16 is a cross-sectional view along the lines 16, 16 in FIG. 15.
FIG. 17 is a side elevational view of a second embodiment of a multi-wire multi-balloon catheter in accordance with the present invention.
FIG. 18 is a cross-sectional view taken along the lines 18, 18 in FIG. 17.
FIG. 19 is a cross-sectional view of an alternate embodiment of the catheter of FIG. 17, including an outer tubular sheath.
FIG. 20 is a cross-sectional view taken along the lines 20, 20 in FIG. 17.
FIG. 21 is a side elevational view of the catheter of FIG. 17, with the distal balloon deflated and the proximal balloon advanced part-way through the distal balloon.
FIG. 22 is a cross-sectional view taken along the lines 22, 22 in FIG. 21.
FIG. 23 is a side elevational view of the catheter of FIGS. 17 and 21, illustrating the previously proximal balloon now fully distally advanced and inflated.
Referring now to the drawings in detail, wherein like reference numerals designate like elements throughout the several views thereof, there is shown generally at 10, in FIGS. 1 and 2, a dilatation catheter embodying the present invention in a preferred form. The catheter 10 comprises a dilatation balloon 12, having a distal end 20 which is fastened around an axially elongate wire 16. By attaching the dilatation balloon 12 directly on the wire 16, the catheter 10 has an exceedingly small cross-sectional area, especially designed for insertion into the most distal arteries which are much narrower than the main coronary artery. Preferably, the dilatation balloon 12 is attached to the wire 16 only at the distal end 20, leaving the wire 16 free to move within the shaft 14. Preferably, the wire 16 extends the length of the catheter 10, and exhibits a small segment, referred to as an advance wire 22, which extends beyond the distal end 20 of the dilatation balloon 12. Advantageously, the advance wire 22 may be of any suitable length, and may be preformed to any desired configuration to facilitate insertion of the catheter 10 and passage through the body lumen.
The proximal end 18 of the dilatation balloon 12 tapers to a diameter which approaches that of the wire 16 to form the shaft 14 of the catheter 10. Thus, the catheter shaft 14 is an extension of the dilatation balloon 12. The catheter shaft 14 provides a path for conducting pressurized fluids into and out of the balloon 12 for selective expansion and deflation thereof. Preferably, the balloon 12 and shaft 14 of the catheter 10 are made of a non-distensible material so that it can only be inflated to expand to the constructed size. Further attempts to inflate such structures result in an increase in pressure, but no significant increase in diameter.
A second wire 24 is movably secured to the catheter shaft 14. As illustrated in FIGS. 1 and 3, the second wire 24 may be external to the catheter shaft 14 and held in place by a thin membrane (not shown). The membrane can cover the entire second wire, or can be disposed at intervals along the length thereof. If the second wire 24 is external to the catheter shaft 14, as illustrated in FIGS. 1-3, the dilatation balloon 12 may exhibit a groove 26 on an outer surface thereof, closed off by a thin membrane 28. The membrane covered groove 26 provides a path through which the second wire 24 may slide. Alternatively, the second wire 24 may be movably retained within the catheter shaft 14 in side by side fashion with the first wire 16, as illustrated in FIG. 3a, or within the catheter shaft 14 but separated from the first wire 16 by a partition 30, as illustrated in FIG. 3b. Preferably, the second wire 24 trails the proximal shoulder 18 of the balloon 12 during insertion of the dilatation catheter 10.
The dilatation catheter 10 illustrated in FIGS. 1-3b is particularly suited for use in distal arteries or severe stenosis. In use, the catheter 10 is inserted into the body lumen until the dilatation balloon 12 is proximate the stenotic area. Preferably, the second wire 24 remains behind the balloon portion of the catheter during the initial insertion across the stenotic region so as to maintain the smallest diameter possible when crossing the lesion. Following several inflations and deflations, the balloon 12 is withdrawn across the lesion while the second wire 24 is advanced beyond the dilated segment. The second wire 24 is left in place in the body lumen for a short period of time, referred to as the post-dilatation observation period, which is usually on the order of 15 minutes to ensure that the lumen will not collapse. If occlusion occurs with the wire 24 still in place across the lesion, then there is access to the distal artery, and the same balloon catheter 10, or a different balloon catheter (not shown), can easily be passed across the lesion and the vessel redilated. Thus, once the wire 24 is in place, the surgeon may pass a larger or smaller balloon catheter over the wire to redilate the body lumen. Likewise, this invention offers the surgeon the option of withdrawing the original balloon catheter and directing over the guide wire 24 a catheter having a different balloon configuration or other medical appliance without the difficulty and time require to once again insert the catheter through the body lumen. In this way, if the result is unsatisfactory, or if dissection or other filling defects obscure the lesion, a balloon catheter can be quickly and safely passed across the lesion over the second wire 24 which has been left in place. This is particularly significant in dealing with the more distal arteries, to which access is often times difficult, in that reinsertion of a fresh catheter may not only prove difficult, but also damaging to the endothelial layer and, in emergency situations, too time consuming, dictating the need for emergency bypass surgery, rather than a second attempt at dilatation.
FIGS. 12-14 illustrate yet an even lower profile dilatation catheter 90. As illustrated, the dilatation balloon 92 of the catheter 90 is a one-sided balloon. The one-sided, or half-circle configuration of the dilatation balloon 92 yields a smaller distal diameter than a balloon which completely encircles the wire 94. Like the catheter 10 illustrated in FIGS. 1-3, the distal end 96 of the one-sided dilatation balloon 82 is secured directly to the wire 94. The proximal end 98 of the balloon 92 tapers and extends longitudinally along the length of the wire 94 to form an inflation lumen 100. A second, movable wire 102 is retained proximate the catheter 90 by a thin hollow membrane 104, secured to the wire 94 which terminates proximate to the proximal end 98 of the dilatation balloon 92. This catheter 90 is particularly useful in dilating severe stenotic regions, where the passage through the artery is very small. In such an instance, the low profile catheter 90 is inserted into the stenosis and inflated to widen the passageway. The dilatation balloon 92 is the deflated, and the movable wire 102 advanced beyond the stenosis so that a second, larger dilatation may be inserted over the wire 92 to adequately dilate the vessel.
As illustrated in FIG. 13, both the hollow membrane 104 and the inflation lumen 100 will form complete circles around the exterior of the movable wire 102 and the catheter wire 94, respectively. The membrane 104 inflation lumen 100 are then secured together so as to share a common outer wall 106. Alternatively, as illustrated in FIG. 13a, the inflation lumen 100 may be wrapped half way around the catheter wire 94 and secured on opposing sides 108, 110 thereof so that the catheter wire 94 forms a portion of the inflation lumen 100. Likewise, the hollow membrane 104 may be wrapped half way around the catheter wire 94 to provide a path through which the movable wire may travel. In the embodiment illustrated in FIG. 13a, the catheter wire 94 provides a common wall for both the inflation lumen 100 and the hollow membrane 104, and thereby yields a smaller diameter catheter shaft.
FIGS. 4-7 are illustrative of a multi-lobed dilatation balloon 32. The multi-lobed balloon 32 is useful in negotiating tortuous vessels and is particularly useful when dilating arteries having acute bends. Preferably, the multi-lobed balloon 32 is a continuous balloon having alternating regions of thick 34 and thin 36 balloon material. The thick portions 34 do not expand as readily as the thin portions 36, and thus the dilatation balloon 32 exhibits multiple lobes, having areas corresponding to the thin portions 36 which readily expand to dilate stenotic areas, and areas corresponding to the thick portions 34 which are resistant to expansion, so as not to straighten arterial bends while the lumen is being dilated. The catheter shaft 14 may be straight, as shown in FIGS. 5 and 6, or it may be preformed with different shapes and configurations to facilitate insertion through the body lumen.
Alternatively, the multi-lobed dilatation balloon 32 may be comprised of a plurality of balloons 38, having overlapping shoulders 40, secured to the exterior of the catheter shaft 14. In such a case, each lobe 38 is advantageously provided with a separate inflation port 42, as illustrated in FIG. 5. As illustrated in FIG. 5, each inflation port may be connected to a separate inflation lumen 44, so that each lobe 38 of the multi-lobed balloon 32 may be separately inflated. Conversely, as illustrated in FIG. 6, a single inflation lumen 46 having a plurality of inflation ports 48 disposed proximate to a lobe of the multi-lobed balloon, or a combination of lobes, may be utilized to inflate each of the lobes simultaneously.
FIG. 7 illustrates a multi-lobed balloon 32 in an inflated state, within a bending body lumen 50. Significantly, as illustrated, the multi-lobed balloon 32 does not force the artery 50 to straighten as the balloon is inflated, but rather, conforms to the arterial bends, so as to reduce the risk of dissection of the artery. Further, the multi-lobed construction of the balloon 32 significantly increases the ease of insertion through tortuous vessels over a straight, single-lobed balloon, in that the multi-lobed balloon is more flexible.
FIGS. 8-10 are illustrative of a dilatation balloon catheter 52 having a plurality of perfusion ports 54, 56 on opposite ends 58, 60 of a dilatation balloon 62. As illustrated in FIG. 8, when the balloon 62 is in an inflated state within the artery 64, it completely occludes blood flow past the arterial wall. A bypass lumen 68 which is independent from the lumen through which the guide wire 66 passes, allows blood to perfuse through and bypass the dilation balloon so as to maintain blood flow to the distal side of the occluding balloon. Note that the guide wire need not be withdrawn in order to provide the passage of this blood flow. This is significant in that withdrawal and reinsertion of the guide wire 66 can sometimes result in damage to the arterial walls. Thus, by providing a bypass lumen 68, the dilatation catheter 52 is made safer for the patient.
Not infrequently, it is determined that angioplasty will be unable to restore the blood flow rate to an acceptable level. In such a case, the patient is prepared for emergency bypass surgery. If the catheter is fully withdrawn from the affected vessel and the vessel becomes totally obstructed, infarction of the area distal to the obstruction will begin to occur. A guide wire left in place across the lesion, will provide a small opening through which a small amount of blood may flow beyond the stenosis, however, this blood flow is not usually sufficient to prevent infarction. Advantageously, however, if the dilatation balloon 52 is left across the stenosis in a deflated state, blood will perfuse through the perfusion ports 54, 56 and the bypass lumen 68 to maintain a steady flow of blood distal to the obstruction. Thus, the catheter 52 can effectively serve as a shunt while preparing the patient for emergency bypass surgery.
In many instances, the body lumen, such as the arteries, veins, and other vessels, tubes, and heart valves are hard, or have calcified fibrous lesions which are resistant to dilatation. Standard angioplasty balloons are often not strong enough to dilate the hardened lesions, and are prone to bursting within the artery necessitating the withdrawal of the catheter and insertion of a new one. Thus, as illustrated in FIG. 11, a dilatation balloon 70, having a plurality of concentric balloon layers 72, 74, 76 is provided. Each balloon layer 72, 74, 76 is provided with a separate inflation port 78, 80, 82 and inflation lumen 84, 86, 88 for selectively inflating the balloon 70. In use, the innermost balloon 72 is inflated first to partially dilate the body lumen. The outer layers 74, 76 of the balloon 70 give additional strength and support to the inner balloon 72 to prevent the inner balloon 72 from bursting. The outer balloons 74, 76 are progressively inflated so as to compress the stenosis radially outwardly, against the adjacent arterial wall. Significantly, the multi-layered balloon 70 of FIG. 11 is also useful in those instances where progressively larger balloons must be used in order to properly dilate the artery or other body lumen or wall of the heart valve.
Referring to FIG. 15, there is disclosed one embodiment of a multi-wire multi-balloon catheter in accordance with the present invention. In general, the multi-wire multi-balloon catheter permits the transluminal placement of more than one balloon on a wire, as a single unit. The balloons can be positioned and inflated sequentially, to accomplish a variety of objectives previously discussed. Alternatively, the two or more balloons can be inflated simultaneously, such as end to end to treat a long lesion or side by side to produce a wider opening. Advantageously, the multi-wire multi-balloon catheters of the present invention exhibit a particularly low profile, and permit the rapid exchange of balloons with minimal trauma to the vascular intima.
Referring to FIG. 15, a multi-wire multi-balloon catheter 120 is illustrated. The catheter comprises generally an elongate flexible tubular housing 122, having at least one axially extending central lumen extending therethrough. A first balloon 124 is secured to a shaft 125 placing the balloon 124 in fluid communication with a proximal source of inflation media. The balloon 124 is further provided with a distal advance wire 128, as has been previously discussed. In FIG. 15, the first balloon 124 is illustrated in an inflated configuration.
A second balloon 126 is illustrated in a deflated configuration. Balloon 126 is secured to an elongate flexible shaft 127 which places the balloon 126 in fluid communication with a proximal source of inflation media. Balloon 126 is similarly provided with an advance wire 130, as has been previously discussed. The second advance wire is preferably provided with an atraumatic tip, such as a rounded end, polymeric bead or other structure known in the art.
The catheter 120 is illustrated in FIG. 15 as it would appear part-way through a multiple balloon dilatation procedure. The first balloon 124 is extended distally of the second balloon 126, and dilated within a preselected site in the body lumen. Following a dilatation in accordance with conventional techniques, the balloon 124 is evacuated. The second balloon 126 is thereafter advanced distally and positioned within the preselected site. Second balloon 126 is thereafter dilated.
The sequential dilatation of two or more balloons can accomplish any of a variety of objectives, as will be understood by one of skill in the art. For example, the balloons can be progressively sized, so that a series of balloons ranging from relatively small to relatively large inflated diameter may be inflated seriatim. Alternatively, the balloons could be of approximately equal size, but utilized to dilate successive axial lengths of a particularly long lesion. Other applications such as treatment of bifurcation lesions and simultaneous dilatations as discussed herein will be apparent to one of skill in the art in view of the present disclosure.
Some additional structural details of the multi-wire multi-balloon catheter of FIG. 15 are revealed in FIG. 16. Referring to FIG. 16, there is disclosed a cross-sectional view of the catheter 120 illustrating the outer tubular housing 122. In this embodiment, two discreet central lumen 134 and 136 are separated by an interior wall 132. The first balloon shaft 125 extends axially through lumen 134. Shaft 125 is spaced radially apart from a central core wire 129, to permit passage of inflation media. Similarly, shaft 127 is radially spaced apart from a central core wire 131 to permit passage of inflation media.
The first balloon shaft 125 and second balloon shaft 127 may be movably associated with one another such as by a tubular sheath 122, as illustrated in FIG. 15, or in any of a variety of other ways previously disclosed for securing the two-wire catheter system. In addition, additional balloons can be readily added to the multi-wire multi-balloon catheters disclosed herein.
Referring to FIGS. 17, 18 and 20, there is disclosed an alternative embodiment of a multi-wire multi-balloon catheter in accordance with the present invention. Catheter 138 generally comprises a first balloon 140 illustrated in an inflated state, and secured to an elongate core wire 142. Wire 142 preferably extends all the way from the first balloon 140 throughout the length of the catheter body to the proximal end thereof.
A second wire 144 is provided with a second balloon 145, illustrated in the deflated condition. As shown in FIG. 17, the second balloon trails the first inflated balloon during insertion and during the initial part of a dilatation procedure.
The first balloon 140 is in fluid communication with an elongate sleeve 146, which is spaced radially outwardly from the core 142 to provide an annular flow path for inflation media, as has been described. Similarly, the second core wire 144 extends axially through an outer sheath 148, which provides fluid communication between the second balloon 145 and a proximal source of inflation media.
The first balloon 140 is provided with a lumen 150 extending axially therethrough. As illustrated in FIG. 17, the distal tip 152 of the second core 144 and balloon 145 extends a small distance into the proximal end of lumen 150. Due to the pressure contained in the inflated balloon 140, the distal portion of the lumen 150 is normally collapsed while the first balloon 140 is in an inflated condition.
Optionally, the second core wire 144 is provided with a slight bowing, as illustrated, or other means to provide a lateral bias in the direction of core wire 142 to help urge the distal tip 152 into the lumen 150.
Referring to FIG. 19, there is disclosed an alternate embodiment of the shaft of the catheter 138, in which each of the elongate tubular bodies 146 and 148 are disposed within an outer tubular sheath 149, similar to sheath 122 in the embodiment illustrated in FIG. 15.
Following evacuation of balloon 140, the collapsing pressure on lumen 150 is relieved and lumen 150 becomes traversable by the second balloon 145. See FIG. 21. After first balloon 140 has been fully evacuated, second balloon 145 is advanced distally with respect to first balloon 140. Relative axial motion of the two balloons can be accomplished manually, by pulling on the proximal end of shaft 146 or pushing on the proximal end of shaft 148. Alternatively, a proximal control having a sliding lever, pistol grip or other convenient structure can be utilized to precisely control an exchange of the positions of the two balloons.
Second balloon 145 is eventually extended distally all the way through lumen 150 and beyond first balloon 140, as illustrated in FIG. 23. At that time, second balloon 145 can be inflated within the same or a different treatment site in the body lumen. First balloon 140 and the associated wire 142 and shaft 146 can thereafter be proximally withdrawn, as illustrated in FIG. 23, by proximally sliding along shaft 148. Balloon 140 can be withdrawn part way or all the way out of the patient, to leave only second balloon 145 therein.
In this manner, multiple balloons of exceeding low profile can be rapidly sequentially exchanged without the necessity of removing a balloon proximally along a conventional guide wire and thereafter reinserting and positioning a second or sequential balloon at the treatment site. A third balloon on a wire could be positioned proximally of the first two, and advanced through a second lumen extending through the first balloon 140. Where more than two balloons are desired, the embodiment of the invention illustrated in FIG. 15, without the central wall 132 may be desirable.
Alternatively, third, fourth and further balloons can be sequentially stacked, as in the embodiment of FIG. 17. In this embodiment, the distal advance wire of the third balloon extends into a lumen on the second balloon 145 and the distal advance wire on a fourth balloon extending into a lumen on the third balloon, and so on.
Depending upon the dimensions desired for a particular application, at some point, too many balloons may be sequentially aligned to fit within a lumen extending through the distal most balloon 140. In this event, the wire 142 extending through distal balloon 140 can be given a distal push following deflation of balloon 140. This distal axial travel would free the distal tip 152 of the second balloon 145, and first balloon 140 can thereafter be independently proximally withdrawn from the patient leaving second balloon 145 in the distal-most position. In this embodiment, lumen 150 need not extend throughout the axial length of the balloon. Rather, it need extend only deep enough to capture the distal tip 152 of the next balloon in line. Structures other than a pocket, such as a strap or any of a variety of complementary surface structures, can readily be devised by one of skill in the art.
This design thus permits the use of sequential balloons, while at the same time permitting insertion of the sequential balloons as a single unit, by pre-bending advance wire 142 to steer the catheter in a conventional manner. The overlap of distal tip 152 of the second balloon 145 into the first balloon 140 permits the second balloon and sequential balloons thereafter to track the path of travel which has been created by the first balloon 140.
Thus, there is provided in accordance with the method of the present invention, a method of positioning each of a plurality of balloon on a wire structures, which have been introduced into the body lumen as a single unit. There is also provided a method of sequentially dilating a plurality of balloons within a body lumen, comprising the steps of positioning a first balloon at a preselected site, and dilating the site, thereafter deflating and withdrawing the first balloon. A second balloon is thereafter advanced through the first balloon and dilated at the same or different site. Optionally, a third balloon is advanced distally through the second balloon, and dilated at the same or a different site in the body lumen.
It will be appreciated that certain structural variations may suggest themselves to those skilled in the art. The foregoing detailed description is to be clearly understood as given by way of illustration, the spirit and scope of this invention being limited solely by the appended claims.
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|US20070250149 *||20 avr. 2007||25 oct. 2007||Abbott Laboratories||Stiffening Support Catheters and Methods for Using the Same|
|US20070270779 *||20 avr. 2007||22 nov. 2007||Abbott Laboratories||Support Catheter|
|US20070293821 *||20 avr. 2007||20 déc. 2007||Abbott Laboratories||Systems, Methods, and Devices for Injecting Media Contrast|
|US20070293846 *||20 avr. 2007||20 déc. 2007||Abbott Laboratories||Dual Lumen Guidewire Support Catheter|
|US20080046063 *||22 mars 2005||21 févr. 2008||Boatman Scott E||Stent Deployment Device|
|US20080065014 *||20 avr. 2007||13 mars 2008||Abbott Laboratories||Systems, Methods, and Devices to Facilitate Wire and Device Crossings of Obstructions in Body Lumens|
|US20080082046 *||14 sept. 2007||3 avr. 2008||Asahi Intecc Co., Ltd.||Balloon catheter, an assembly of the balloon catheter and a method of inserting the assembly into a guiding catheter|
|US20080082050 *||10 mai 2007||3 avr. 2008||Solar Ronald J||Systems and methods for treating a vessel using focused force|
|US20080200944 *||12 févr. 2008||21 août 2008||Cook Incorporated||Balloon catheter with dilating elements|
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|US20080300610 *||31 mai 2007||4 déc. 2008||Cook Incorporated||Device for treating hardened lesions and method of use thereof|
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|US20090132028 *||26 janv. 2009||21 mai 2009||Advanced Stent Technologies, Inc.||Extendible Stent Apparatus and Method for Deploying the Same|
|US20090143854 *||27 oct. 2008||4 juin 2009||One Scimed Place||Dilation and Stent Delivery System for Bifurcation Lesions|
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|US20090171284 *||27 déc. 2007||2 juil. 2009||Cook Incorporated||Dilation system|
|US20090182406 *||12 janv. 2009||16 juil. 2009||Boston Scientific Scimed, Inc.||Bifurcated stent delivery system|
|US20090275889 *||1 mai 2008||5 nov. 2009||Sundaram Ravikumar||Intravascular Catheter Device for Selective Occlusion of Iliac Vasculature|
|US20090275920 *||15 juil. 2009||5 nov. 2009||Solar Ronald J||Systems and methods for treating a vessel using focused force|
|US20100010521 *||10 juil. 2008||14 janv. 2010||Cook Incorporated||Cutting balloon with movable member|
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|US20110034948 *||10 août 2010||10 févr. 2011||Sundaram Ravikumar||Catheter Device and Method for Selective Occlusion of Arteries of the Descending Aorta|
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|CN104394922A *||1 juil. 2013||4 mars 2015||有限会社Ptmc研究所||Catheter-type therapeutic or diagnostic instrument provided with shaped wire members and catheter tube to be used together with shaped wire members|
|DE19530440A1 *||18 août 1995||20 févr. 1997||Dieter Dr Echtle||Rectal catheter for measurement of abdominal pressure|
|EP0841963A1 *||21 nov. 1995||20 mai 1998||Heartport, Inc.||Cardioplegia catheter system|
|EP0841963A4 *||21 nov. 1995||19 août 1998||Heartport Inc||Cardioplegia catheter system|
|EP0965311A2 *||17 juin 1999||22 déc. 1999||Medtronic Ave, Inc.||Method and apparatus for treating stenoses at bifurcated regions|
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|Classification aux États-Unis||604/101.01, 604/919, 604/913, 604/101.04, 604/101.02, 604/101.05, 606/194|
|Classification internationale||A61F2/958, A61M29/02|
|Classification coopérative||A61M2025/1013, A61M25/09, A61M25/1011, A61M25/104|
|Classification européenne||A61M25/10P, A61M25/10D|
|7 juil. 1997||FPAY||Fee payment|
Year of fee payment: 4
|6 juin 2000||CC||Certificate of correction|
|20 juin 2001||FPAY||Fee payment|
Year of fee payment: 8
|12 déc. 2005||FPAY||Fee payment|
Year of fee payment: 12


July 20, 2018 – The City of Albuquerque announced it will receive $14 million dollars in federal grant money as reimbursement for expenses related to the Albuquerque Rapid Transit, or ART, project along the Central Avenue corridor. But whether the “promised” $75 million more in grant money will come through remains to be seen. Mayor Tim Keller says the city should learn in the fall if it can count on the money. If not, the city will have to cut back on future infrastructure projects. Gene Grant and the Line opinion panelists discuss the city’s progress in moving the ART project forward.
Jeffrey Candelaria, Konnection Now & host on KKOB
Dede Feldman, Former NM State Senator
Diane Snyder, former state senator
Harry Van Buren, professor in UNM Anderson School of Management


text:
Even when we have the worst days and we don't know if we can recover from them. When we look at ourselves and find our reflection disgusting. When all we want to do is feed the fat beast because you've already messed up. Or when we don't want to talk, see, listen to anyone who loves us.
I have been blogging for over three years. I have been high and low weights. All the games of an ED I have played. I have gone through treatment. I still struggle with things, especially when I hit low points in life. I am who I am. I try to avoid the unhealthy choices of what an eating disorder contains. They can't understand why I do what I do. No one understands unless they have gone through it themselves.

domain: sociology


text:
Create a Website Account - Manage notification subscriptions, save form progress and more.
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Posted on June 6, 2022 at 7:23 AM by John Guccione
Charing Cross: Pavement removal will be completed on Monday, June 6. Grading of subbase will continue in preparation for paving, which is planned for Wednesday, June 8.
Gordon Terrace & Plum Tree: Grading of subbase will continue in preparation for paving, which is planned for Wednesday and Thursday, June 8 and June 9.
Longfellow, Hermitage, Byron, Whittier and Kipling: Underground work begins Monday, June 6 and will continue through the week.
Montgomery Rd: Removal of curb and sidewalk along the north side begins Monday, June 8. Placement of new curb is planned Wednesday, June 8. Impacted residents were notified last Friday of this upcoming operation.
Price Lane: Underground operations were completed last week on Price Lane. Pavement removal will take place towards the middle of this week. Additional notification will be provided prior to this operation.

domain: news


text:
my name is Adi. I was one of the lecturers at one of the colleges in the town of balikpapan.
my friend and I are creating a project that focuses on early childhood education. The name of our team is Sawah Padi (Rice Paddy).The location of our project in the area Simpang Pasir, Mangkujenang, Palaran Samarinda. Samarinda is the capital region of east borneo Indonesia.
We concern about educational, spesially for how to created our chlidren to love their country Indonesia (Wawasan Kebangsaan), softskill, of course learned foreign language. Mangkujenang is a village around samarinda city. Especially the area that is right at the exit toll behind samarinda which is currently under construction. The majority of the people are farmers. Formerly this area is a region dominated by rice fields, but since the construction of toll roads, the size of rice fields of citizens is reduced, even tends to damage the surrounding environment. In addition to rice fields, other dominating plants are vegetables. Because most of its citizens farm, so many of the parents are less attention to the development of their children's education.
After school, the children's activities are almost all time spent playing. therefore, we intend to create activities with the aim of giving them the opportunity to make the most of their time to learn and gain insight.
Our teaching system focuses on good manners, attitudes and behavior. That we do, because at this time, the lessons of character, attitude and behavior of children have not been emphasized more in their lessons in formal education. We focus on educating children to love reading, learning by not leaving the characteristic behavior of Indonesian children. We also teach them English, teaching them to play music and sports.

domain: geography


text:
WASHINGTON, D.C. -- John Masson knew something was up Thursday when he and his wheelchair were summoned to the lobby of the Walter Reed Army Medical Center. He just never imagined how such a rainy afternoon could become an instant classic, just by turning a corner.
"Oh, man, is this unbelievable or not?" Masson crowed to nobody in particular. "The Blackhawks. This is why we fight. Because in the United States of America, people give back."
John McDonough, the team president, said much the same thing. The defending Stanley Cup champions have not ever had, nor will they ever have, a more important off-day in their hockey careers. Friday, the Blackhawks will be at the White House, and Sunday, they will be on national TV against the Washington Capitals. But what the Blackhawks did Thursday, with their jerseys on and skates still on the bus, was no touristy sidetrip or made-for-TV drive through.
Click here for the full story.


“1961 Jeep Willys CJ-3B in excellent condition with only 13,600 actual miles. Original flat fender with Koenig factory wench. Original Hurricane 4 cyl engine, starts and runs great. There are only a couple of rust spots on the Jeep, no rust in floor or in toolbox. Comes with a Army trailer painted to match, also includes the original tires and wheels. I only used in parades and has not been off road. You will not find a better Jeep Willys in the country.”
I suspect this is a 1948 CJ-2A with a 3B fiberglass body. It appears to be a Bobcat body based on the wide rim around the edge. Could be a good price.
“Willys high hood. Fiberglass tub and hood. Steel fenders, grille, and windshield frame. New gunmetal pearl paint. Buick 231 v6 with edelbrock carb and intake manifold. 3 speed transmission. Warn overdrive. Front disc brakes. Aluminum radiator. New seats. Soft with 1 small tear in back. 33’s with a lot of tread. Overall pretty nice rig.”
UPDATE: Still Available.
(09/17/2016) Has drivetrain updates.
“1953 Willys CJ3B. Freshly rebuilt 2.8L V6. Power steering, power brakes. Brakes have been upgraded with 11″ drums.
Also included: extra front and rear differentials, transfer case, and misc. extra parts.”
Hard to tell how much value is here.
“Willys jeep project motor turns but dos not run but most allcomplet 1000 obo”
No pics provided.
“1954 Willys Jeep CJ3b Project. Body sandblasted and painted, all body holes filled, very slick, interior rhino lined. 2 good engines , V6 Dauntless with new aluminum radiator, and original f134 professionally rebuilt but never installed. No transmission. 2 sets of front and rear ends.Too much other stuff to list. I quit on the project and moved on to another. just need it all gone. $2,500 firm for all,”
Seller plans to add additional pics.
“Selling my 1964 Jeep CJ3B, this jeep is in remarkable condition for being 52 years old! with only 56,000 miles, a lot of which were put on towing it. 4 cylinder Hurricane engine with a manual 3 speed. More pictures coming soon, out of town at the moment. No BS scammer crap!”
Runs and drives. The dash must have been replaced or it’s a new body.
“This was passed down from grandfather, an avid hunter who was a lifelong member of the NRA. He kept it running like a clock and took it out of the garage a few times a year for his hunting trips. Was kept in the garage when not hunting.
Cleaned her up and made some restorations and upgrades. Runs like a clock and is fun to drive.
Great little jeep. Built like a tank and simple. You can fix everything with a few wrenches and a screwdriver. Light, and will not be able to get it stuck. It can almost climb the side of a wall in first.
Thanks for looking, specs below.
1961 Jeep Willy CJ3B High Hood, 4×4
* 4 cylinder F4-134 Hurricane 14 F Head Engine with T-90 Transmission, and Dana 18 Transfer Case that was all rebuilt in 2014.
* New Tires, September 2016
* New Fuel Tank with new sender and fuel gauge October 2016
* Rewired entire jeep, new wiring harness October 2016
* Heavy Duty Tow Bar with tow light harness October 2016
* Hidden Gun Compartment with Built in Safe.
* New Radiator September 2016
* New Brakes with new pads and master cylinder October 2016
* New Seats, (Original Frames) Marine Outdoor Weather Proof Seats. Will last forever. October 2016
* New Seatbelts October 2016”
Appears to have a bed extender and a half top. There could be value here.
“All original except charging system and seats. I have original wheels (not pictured).”
UPDATE: Still Available.
(05/13/2016) It’s got some mods.
“1953 Willys CJ3B. Includes Chassis, Tub, Fenders, Grille, Hood, Windshield frame, seat frames, fuel tank (pretty good condition, very solid but will need some body work and new shackles and mounts in the front. The axles are set up for SOA. It appears the rear axle is a DANA 44 and the front axle is a DANA 30. (Pink in hand and on non-op) asking $900.
Jeep is pre-smog and you can install any drive train you want and never need to smog it. I have a F134 four cylinder motor and some rebuildable transmissions and transfer cases that can be purchased for a reasonable cost if the buyer is interested in having an original type drive train.”
UPDATE: Price dropped to $7900
(12/11/2015) Looks in good shape.
“1953 CJ3B Willys Jeep. 351 Ford V-8 professionally rebuilt by Britco prior to installation, headers, Ford 4 speed transmission, overdrive, 10 X 31.5 Les Schwab tires 90% tread (not pictured), 11 inch front drum brakes, roll bar, Tiger Top, stock heater, upgraded bucket seats, stock vacuum wipers, stock steering system, stock suspension, original gauges. No winch.”
UPDATE: Still Available
(08/27/2016) Has a few updates. Those seats look comfortable.
“EXTREMELY CLEAN WILLYS CJ3-B. NEW TOP AND DOORS, OVER SIZED BRAKES, FORD 2000 CC ENGINE, NEW TIRES AND WHEELS.
EVERYTHING WORKS AND DRIVES GREAT. YOU WON’T FIND A CLEANER CJ3-B”
Looks like the gas tank has been moved to the rear.
“After much consideration, I am selling my 1953 Willys jeep high hood. This is a full resto-mod. It has a 1963 327 Small block Chevy with a four speed. Power steering, tilt column, custom bumpers, relocated boxed fuel cell and a rancho suspension. It has a dual exhaust, new best top, warn hubs, wiring harness and the interior is rhino lined. The paint is fresh and is the factory color, Lozun red. You will be hard pressed to find one this nice and tow ready. The tow yoke is fully wired to operate all lights.
The tires are new Mickey Thompson Baja claws with pro comp powder coated steel wheels including the spare. I am the second owner. It was built to tow behind my father’s rv. I have been told this motor is out of a 63 corvette. The intake manifold matches corvette motors issued at that time, but the motor is a common 63 327 Sbc. I do not need help selling it. Please, no dreamers or tire kickers. Email me first then we will exchange info and set up a time to see it. If you want specific photos let me know and I will get them to you. ”
UPDATE: Price dropped to $14,500
(05/20/2016) Nice looking 3B with dual PTO.
“1954 Willy’s Jeep CJ 3B with Hurricane engine, complete off the frame professional restoration, no expenses spared, pto driven winch & rear pro, everything new or rebuilt, absolutely pristine, very rare!! Trades considered. YOU CAN SEE MORE PICTURES AND VIDEO OF VEHICLE RUNNING AT FACEBOOK.COM/FARMBARGAINS OR JUST GOOGLE TRIPLE P RANCH BARGAIN BARN LLC AND PLEASE LIKE US!!
The body is later than 53.
“For sale 1953 Willys CJ3. Almost all original and in great shape. Everything works and is a blast to drive. 4 cyl. Fiat engine with 4wd. Also have original gas cans and doors and other extras that go along. Only 52,XXX actual miles. Has been in our family for around 30 yrs.”
There’s been a piece taken out of the driver’s side entry way.
“Great running Jeep. 4cyl engine with 3spd trans. Engine rebuilt two years and has only been used on lease. Transmission and transfer case gone through. New brake tires lift kit before engine rebuild. Canvas top. Warn Vr8000 winch. The little Jeep is a work horse. Custom built roll bar and nerf bars. Runs and drive great. Perfect for lease or restoration project.”
UPDATE: Price dropped to $800.
“1954 willyz cj3b. Needs some love but is still in decent shape with everything original except windshield frame and tailgate. 1200 or best offer, trying to make this quick since I’m heading out of town next monday. Cash in hand, no financing. May be willing to consider a trade.“
No pics provided.
“Project Jeep, everything their, needs minor work.”
UPDATE: Still Available.
(08/06/2016) Could be worth a look.
“Antique Willys Jeep CJ-3B. Lots of new parts including new master cyl, brakes done, full tune up, new fuel pump(electric)lots more. Runs good for 62 years old. Looks like original motor(134 c.i. 4 cyl F-head Hurricane motor)transmission & transfer case. Needs radiator overhaul or replace. Unique paint job! Looking to sell or trade for John Deere Gator. Not in any hurry. Don’t need help selling.”
UPDATE: Price dropped to $950.
(09/07/2016) Not sure how much value is here.
“1954 Willy’s has no motor or tranny.
1961 Willy’s has 3B motor, no carb, no starter.
For further questions.”
Appears worth a look. Was listed here (thanks Joe).
“This fun Jeep is mostly original. Jump in and drive or restore. It hs never been on the road or off road. Its first life was a plow truck for a Church and a Fireman. It starts on first crank even after sitting a few months.”
UPDATE: Still Available. Includes a Warn OD and Winch.
(10/09/2015) Has a variety of updates and some mini terras.
“953 CJ3B Jeep
Metal half cab
327 Chevy Engine
Munsie 4 speed tranny
Tilt steering, 12 Volt through out, GTO Bucket Seats”
Looks like a nice build.
“1953 Willys CJ3B (High Hood). 327 Small Block Chevy with SM465 (Muncie) Granny low 4 speed. Spicer single stick 20 transfer case. Narrowed 9 inch ford rear with 4.11 gears (Mini Spool). Narrowed Dana 44 front (Open). Custom drag link with one ton rod ends. Power steering (Saginaw). Holbrook Specialties extended leaf springs. Wilwood hyd. clutch w/swing pedals. Original body tub. All rust has been repaired with new floors and relocated battery where tool box used to be under pass. seat. Rino lined inside tub and underside. Frame painted with POR-15. 15 gallon fuel cell. Warn 8000 pound winch. Bikini top. Two sets of wheels. List goes on. This jeep has had full frame up build and low hours since completed. Well over 10K in receipts. Serious buyers only. Call or text for more info and dont need help selling. ”
If it is a 66, it has the wrong tailgate. It looks like there’s value here.
“1966 High-Hood Willys Jeep. Excellent restoration project or great start for a rock climber. High Hoods are getting hard to find. The motor in the photo is a Buick v6 but have no idea if it is seized or not. Has a great winch on the front but again do not know if it is functioning. The floors for the most part are solid but do have a few patch areas that need work. Comes with extra grill which I think is from a cj2a or 5, not sure and haven’t checked it out. Clean Colorado title in hand.”
UPDATE: Still Available.
(08/30/2016) Is that a front bumper or a cutting board?
“1954 Willys Jeep
350cu Chevy engine
Quadrajet 4 barrel
35 in tires with aluminum wheels
Turbo 350 transmission-automatic
New alternator, new starter, new battery
3in roll bar and custom seats and console
Runs great and is fun to drive!
Asking $10,000 obo”
UPDATE: Price dropped to $7800.
(09/24/2016) Not all original. Looks in good shape.
“I am selling my 1954 Jeep Willys cj3a High Hood Factory Flathead 4 all original been taken apart and rebuilt with all original parts will not find one like it runs and drives great no rust just a great driver very fun removable top brand new bikini top Woodrow Bar a bunch of new parts and old parts original rims and tires also have the new rims and tires all the electrical works great turn signals heater headlamps brake lights everything works excellent will not find one in this condition that still original asking 12 5 or best offer ”


text:
- FEATURE: Borderlands: The Pre-Sequel OST Review
- Halo: Nightfall Trailer
- RUMOR: GTA San Andreas Going to Xbox 360
- Gamelock Introduces Guaranteed Resell Prices for Games
- Call of Duty: Advanced Warfare A New Era of MP Trailer
- Icewind Dale: Enhanced Edition Arrives Next Week
- Judge Rules That EA's Confidence in BF4 Launch is Not Securities Fraud
- Mornin '14
- Developer Who Threatened Gabe Newell Resigns
- Sunset Overdrive Awesomepocalypse Trailer
- Dragon Age: Inquisition Followers Trailer
- Shadow of Mordor Free DLC Lets You Play as the Enemy
- Ubisoft Details Far Cry 4 Season Pass
- Research Finds Portal 2 Better for Brain than 'Brain Training'
- REVIEW: Alien: Isolation
- Hatred is About Hating the Hate Caused By Other Haters to Hate the Hate
It's that grand time of year where the interwebs are populated with E3 rumors. While you can ignore any rumor that starts with Half-Life 3, this rumor has some possibility.
The Italian site Games Village claims that Crytek will be showing off two brand new games at E3 in June. One is called Arena of Fate, a PC multiplayer game, and the other is Grave Project. Only the title is known about the latter.
We shall have to see for ourselves in just a few weeks what Crytek has to offer.
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domain: game


text:
SAN Mig Coffee fought valiantly in the endgame, leaning on Peter June Simon’s second-half explosion while holding Talk ‘N Text scoreless in the final three minutes to pull off an 83-82 come-from-behind win in the PBA Commissioner’s Cup on Wednesday night at the Smart Araneta Coliseum.
The underrated Simon came away with 13 of his 15 points in the second half, including a turnaround jump shot off the smaller Jimmy Alapag that proved to be the game-clinching shot with 19 seconds to go.
The Tropang Texters had two golden chances to salvage the win in the game's final play, but Ryan Reyes’ two corner three-point attempts rattled out as time expired, allowing San Mig to escape with its sixth win in 12 starts.
“I’m just so happy we did it. But don’t ask me how we did it,” said San Mig Coffee coach Tim Cone.
“We not only needed the win for the standings but we needed the win because we‘ve been so inconsistent this conference. Win, loss, win loss, then we’ve had good stretches and bad stretches as well.”
Talk ‘N Text lost back-to-back games for the second time in the conference and fell to 5-6 after letting a 79-69 lead it held halfway through the final period slip away in the endgame.
Denzel Bowles led the Mixers with 18 points, eight rebounds and four blocks while Joe Devance chipped in 15 and six boards.
Devance and Simon stepped up for the Mixers with two-time MVP James Yap, who has been under the weather, finishing with just three points after playing for just nine minutes in the entire second half.
On the other hand, import Donnell Harvey led the Tropang Texters with 19 points and eight boards.
San Mig (83) - Bowles 18, Devance 15, Simon 15, Pingris 11, Barroca 7, De Ocampo 7, Yap 3, Reavis 3, Mallari 2, Gaco 2, Alvarez 0, Najorda 0
Talk ‘N Text (82) -Harvey 19, Castro 17, De Ocampo 13, Reyes 12, Al-Hussaini 8, Fonacier 5, Alapag 4, Aban 2, Carey 2, Gamalinda 0, Peek 0
Quarterscores: 23-30, 40-49, 66-65, 83-82

domain: sports


Download Mp3 Sarz – Focus ft. WurlD
Sarz – Focus ft. WurlD Mp3 Download Audio
Nigerian foremost record producer, Sarz team up with WurlD to release this beautiful tune titled “Focus“.
However, the new song was lifted off their newly released collaborative 8th-tracks project titled “I Love Girls With Trobul“.
Listen & Download ‘Focus by Sarz ft WurlD‘ mp3 below;
MUSIC: Sarz ft. WurlD — Focus
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text:
Ideal Power to Present at 13th Annual LD Micro Main Event
AUSTIN, Texas, Dec. 09, 2020 (GLOBE NEWSWIRE) -- Ideal Power Inc. (Nasdaq: IPWR), pioneering the development and commercialization of highly efficient and broadly patented B-TRAN™ bi-directional power switches, today announced that it will present at the LD Micro’s 13th Annual Main Event.
Dan Brdar, President and Chief Executive Officer, and Tim Burns, Chief Financial Officer, are scheduled to present as follows:
13th Annual LD Micro Main Event
Date: Monday, December 14, 2020
Time: 2:20 p.m. EST
A webcast of the presentation session and a copy of Ideal Power’s latest investor presentation will be available on the company’s website.
About Ideal Power Inc.
Ideal Power (NASDAQ: IPWR) is pioneering the development of its broadly patented bi-directional power switches, creating highly efficient and ecofriendly energy control solutions for industrial, alternative energy, military and automotive applications. The Company is focused on its patented Bi-directional, Bi-polar Junction Transistor (B-TRAN™) semiconductor technology. B-TRAN™ is a unique double-sided bi-directional AC switch able to deliver substantial performance improvements over today's conventional power semiconductors. Ideal Power believes B-TRAN™ modules will reduce conduction and switching losses, complexity of thermal management and operating cost in medium voltage AC power switching and control circuitry. For more information, visit www.IdealPower.com.
Ideal Power Investor Relations Contact:
LHA Investor Relations
Carolyn Capaccio, CFA; Keith Fetter
Released December 9, 2020


From the May 31, 1923 Skidmore News (Skidmore, Missouri), page 1:
The first band concert was given by the Skidmore band last Friday night. The notice of the concert was rather short but a good many were out to enjoy the music. The lights on the band stand were not in working order and the boys stood in front of Barrett’s store and played several selected pieces. The lights on the band stand were fixed the fore part of the week and were in working order for the concert last night. Most all of the town people and a good many cars from the country were out last night to hear the concert.
The night for the weekly concerts has been changed from Wednesday to Thursday night. Remember that the concerts will be given on Thursday night of each week, unless changed for some special occasion.


text:
By David A. Hinton
Drawing at the most recent to be had fabric, the e-book takes a chronological method of the archaeological fabric of the post-Roman interval with a view to emphasize the alterations that may be saw within the actual proof and a few of the explanations for them that may be prompt. the surroundings within which humans functioned and the way they expressed themselves - for instance of their homes and burial practices, their pottery and their outfits - express how they have been restricted by way of social customs and fiscal pressures.
Read Online or Download Archaeology, Economy and Society: England from the Fifth to the Fifteenth Century PDF
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Additional resources for Archaeology, Economy and Society: England from the Fifth to the Fifteenth Century

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Subject line says it all. Her webpage says she's coming to National Car Rental Center in Ft. Lauderdale in the beginning of June. While I've yet to buy her album, her single "A Thousand Miles" is one of the few good songs on MTV/radio that's caught my attention/imagination. So I'm wondering if it's worth it to catch her live... especially if I'm going to see Peter Murphy live earlier that week.
Any constructive feedback would be greatly appreciated. Thanks.
"Thanks RageRockrr! You're the coolest!" - Excalibur05, March 10, 2002.
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Vigo’s PSA factory reaches 13 million vehicles producedAutomotive News
A Citroën Grand C4 Picasso has been the 13 million vehicle manufactured in the center since it began its activity in 1958
The Citroën Grand C4 Picasso, which raises the 13 millionth production at the Vigo Center, left the production line this morning. Frédéric Puech, Director of the Iberian Industrial Center and Center of Vigo, together with the main executives of the plant, representatives of the Business Committee, and a representative of the workers carried out a commemorative photograph with the vehicle at the End of the Factory.
Subsequently, the Director of the Vigo Center, Frédéric Puech, accompanied by the Chairman of the Works Council, Antonio Rodríguez, boarded the vehicle on the Victory Leader vessel, docked at the Port of Bouzas, bound for the port of Zeebrugge, from where it will be distributed to Japan.
The second generation of the Citroën C4 Picasso, in its 5 and 7-seater versions, started to be produced in series in 2013. This vehicle, which incorporates numerous technological innovations, brought with it the implantation in the Center of Vigo of the modular platform EMP2, whose versatility allows to produce short and long saloons, coupés, minibuses, SUVs and light utility vehicles.
Since the Citroën C4 Picasso was launched in Vigo in 2006, there have been around 1.5 million vehicles to date, 15% to the domestic market and 85% to the international market. France, Great Britain, Spain, Italy and Germany the main countries of destination, to a total of 50 countries around the world.
The Vigo Center of the PSA Group produces 1,900 vehicles every day on the Citroën C4 Picasso, Grand C4 Picasso, Berlingo and C-Elysée models, and the Peugeot Partner and 301 models.
Frédéric Puech, Director of the Iberian Industrial Group of the PSA Group and the Center of Vigo: “I want to thank all the workers in our factory, suppliers and their employees, the Automotive Cluster, CTAG and all agents and agencies of the environment that help us to remain efficient. From Vigo to the World, in the global market, this vehicle is our best representation. We hope to give the maximum satisfaction to the Japanese customer waiting for him on the other side of the world. Your satisfaction is the greatest recognition of our work. ”
Antonio Rodríguez, President of the Company Committee: “This production milestone is a reflection of the work done, with great professionalism and dedication, by thousands of people of different generations throughout almost 60 years. Our concern for quality and customer satisfaction, work well done and involvement in continuous improvement, are our best letter of introduction and are part of our commitment as workers of this factory. Through an open and permanent dialogue, the Company Committee understands the challenges we face and we try to contribute to the maximum efficiency of the plant. ”
ABC MOTOR 9/29/2017 (Translation Soft)