text:
|Número de publicación
|Tipo de publicación
|Número de solicitud
|Fecha de publicación
|6 Oct 2005
|Fecha de presentación
|31 Mar 2004
|Fecha de prioridad
|31 Mar 2004
|También publicado como
|Número de publicación
|Benjamin McDaniel, Dean Ponzi
|Cesionario original
|Mcdaniel Benjamin D, Ponzi Dean M
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|BiBTeX, EndNote, RefMan
|Citas de patentes (90), Citada por (19), Clasificaciones (7), Eventos legales (2)
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet
The present invention relates to an improved ablation catheter that is particularly useful for ablating in a tubular region in or around the heart.
Atrial fibrillation is a common sustained cardiac arrhythmia and a major cause of stroke. This condition is perpetuated by reentrant wavelets propagating in an abnormal atrial-tissue substrate. Various approaches have been developed to interrupt wavelets, including surgical or catheter-mediated atriotomy.
A common procedure involves ablating a lesion to interrupt the wavelets using one or more electrodes mounted on the distal end of a generally-straight catheter. This procedure works well, for example, when ablating a line of block in the atria. However, for tubular regions in or around the heart, this procedure is less effective. For example, when the line of block is to be made about a circumference of the tubular region, it is difficult to manipulate and control the distal end of a straight catheter so that it effectively ablates about the circumference.
Catheters with circular ablation assemblies are known. For example, a particularly useful catheter is disclosed in U.S. Pub. No. 20030195508 (Scheib), the disclosure of which is hereby incorporated by reference. This catheter comprises a catheter body having at its distal end an ablation assembly with a preformed generally circular curve with an outer surface and being generally transverse to the axis of the catheter body. In this arrangement, the catheter has at least a portion of the outer circumference of the generally circular curve in contact with the inner circumference of a tubular region in or near the patient's heart, e.g., a pulmonary vein. However, one drawback with catheters of this type may be the relatively fixed size or circumference of the circular ablation assembly, which may not match the circumference of the tubular region undergoing treatment.
Ablation catheters with expandable assemblies are also known. Such a catheter is disclosed in U.S. Pat. No. 6,416,511 (Lesh), wherein the circumferential ablation element includes an expandable member with a working length that is adjustable from a radially collapsed position to a radially expanded position. This catheter employs an equatorial band that circumscribes the outer surface of the working length and is adapted to ablate tissue adjacent thereto when actuated by an ablation actuator. However, like most catheters with expandable members, the expandable member is a balloon structure that is inflated with a pressurized fluid source. In addition to certain complexities associated with use of a pressurized fluid source, inflation of the balloon undesirably restricts blood flow. Added complications may also arise when a balloon is forced to seat in the ostium near the treatment region, such as a pulmonary vein.
Moreover, the use of an ultrasound transducer, which often accompanies a balloon for purposes of locating or visualizing the assembly at the ostium has also caused complications because of the size of the transducer. As a relatively bulky and cumbersome accessory, the transducer can be difficult to maneuver and hamper the positioning of the balloon/transducer combination.
Also known is a basket catheter having a basket-shaped electrode array with a mechanism for expanding and retracting the electrode array, as described in U.S. application Ser. No. 10/017,564, the content of which is hereby incorporated by reference. The basket assembly has a plurality of spines connected at their proximal and distal ends to an expander that is movable longitudinally to expand and contract the basket-shaped electrode. While this assembly can accomplish circumferential ablation, it may be better suited for mapping and other diagnostic procedures in the chamber areas of the heart. Furthermore, wire spines of basket assemblies can in certain circumstances move or shift relative to each other, rendering the structure of the basket assemblies less stable than desirable.
Accordingly, a need exists for an improved catheter that is particularly useful for circumferential ablation in or near the ostium of tubular regions of the heart, especially in regions of varying or nonuniform circumference, and/or noncircular cross-sections. It is desirable that the ablation assembly has a sufficiently stable framework and that it minimizes disturbance to blood flow in the region. It is further desired that the ablation assembly be detectable by means other than through the use of ultrasound transducer which requires the application of a saline field.
The present invention is directed to a catheter with a three-dimensional, hollow ablation assembly that carries at least one ribbon electrode for circumferential ablation. The catheter comprises an elongated flexible tubular catheter body having an axis and proximal and distal ends, and an ablation assembly that is mounted at the distal end of the tubular body. The ablation assembly has a framework whose interdependent dimensions include a length and a circumference (or diameter) that readily vary and conform to a tubular volume. The framework is collapsed for passage into a tubular region at or near a patient's heart and expanded upon deployment at the treatment site to conform to the tubular region.
The framework in one embodiment is constructed of multiple tensile members or wires that are interwoven such that the length of the framework increases while the circumference of the framework decreases, and vice versa. When collapsed, the framework assumes a greater length and a lesser circumference; when expanded, the framework assumes a lesser length and a greater circumference. Each tensile member extends the length of the ablation assembly on a changing diagonal in a helical pattern about a longitudinal axis of an expander that extends through the catheter body and is movable in a longitudinal direction to expand and collapse the ablation assembly.
In one embodiment, the expander extends through the framework of the ablation assembly such that the expander forms the axis of the framework. As such, the catheter assembly may be expanded with proximal movement of the expander and collapsed with distal movement of the expander. In another embodiment, the framework is mounted on a distal end of the expander and is constructed of a material with shape memory. As such, the catheter assembly is pushed past the catheter body with distal movement of the expander for self-deployment when there is no constraint against expansion and withdrawn into the catheter body with proximal movement of the expander after ablation.
In yet another embodiment, the framework is configured from a tubular or cylindrical structure having a length and a circumference (or diameter) and whose side wall has longitudinal slots between longitudinal slats for radial expansion to a greater circumference when the length is decreased. In particular, each slat has a substantially rectangular cross-section such that deflection or bowing of the slats is predictably outwardly in the radial direction when the framework is deployed with proximal movement of the expander. As a seamless unitary structure configured by, e.g., laser cutting, this embodiment also has improved structural stability. The construction material of the tube or cylinder may also have shape-memory. In that regard, the catheter can also be configured such that the ablation assembly is withdrawn into the catheter body with proximal movement of the expander and pushed past the catheter body for deployment with distal movement of the expander.
Regardless of the embodiment of the ablation assembly and its framework, the flexible ribbon electrode carried thereon is elastic, or is pleated so that it folds when the framework is collapsed and unfolds when the framework is deployed. In either case, the ribbon electrode is held firmly against the inner circumference of the tubular region when the ablation assembly is deployed to apply a circumferential lesion. The ablation assembly therefore offers improved anchoring capabilities at the treatment site and improved contact for circumferential ablation.
In use, the catheter is fed into the patient's body through a guiding sheath. The catheter assembly remains in a collapsed configuration assuming a minimum diameter (or circumference) and a maximum length until the assembly travels past the distal end of the guiding sheath (and is pushed past the distal end of the catheter body as the case may be). With the catheter in position, such as at or near the ostium or in a pulmonary vein, the framework of the deployed assembly assumes a greater circumference in conformity with the tubular region.
The ribbon electrode may be constructed of any electrically conductive material that is also preferably detectable by X-ray and/or has shape memory. The catheter assembly may include multiple ribbon electrodes for bipolar ablation and/or for providing an electrode array with a grid-like pattern for ablation or mapping. The catheter assembly may also include a straight or deflectable tip electrode distal to the 3-D framework. As with conventional catheters, the ribbon electrode(s) and the tip electrode are energized by RF or electrical energy.
If needed, the ablation assembly is rotated so that the assembly can establish different points of contact to ensure a continuous circumferential lesion. Before the catheter assembly is retrieved from the patient's body or relocated therein, the assembly is returned to its elongated configuration and/or drawn into the guiding sheath (and the catheter body as the case may be) for better maneuvering and passage in the patient's body.
With any of the foregoing framework designs, the catheter of the present invention permits the user to have more control when ablating about a circumference of a tubular region in or around the heart, e.g., a pulmonary vein, the coronary sinus, the superior vena cava, or the pulmonary outflow tract.
These and other features and advantages of the present invention will be better understood by reference to the following detailed description when considered in conjunction with the accompanying drawings wherein:
The invention is directed to a catheter 10 having at its distal end a hollow, three-dimensional ablation assembly with one or more ribbon electrodes. As shown in
The catheter body 12 comprises an elongated tubular construction having a single, axial or central lumen (not shown), but can optionally have multiple lumens if desired. The catheter body 12 is flexible, i.e., bendable, but substantially non-compressible along its length. The catheter body 12 can be of any suitable construction and made of any suitable material. A presently preferred construction comprises an outer wall made of polyurethane or PEBAX.RTM. (polyether block amide). The outer wall comprises an imbedded braided mesh of stainless steel or the like to increase torsional stiffness of the catheter body 12 so that, when the control handle 16 is rotated, the distal end of the catheter body will rotate in a corresponding manner.
The outer diameter of the catheter body 12 is not critical, but is preferably no more than about 8 french, more preferably about 7 french. Likewise the thickness of the outer wall is not critical, but is preferably thin enough so that the central lumen can accommodate a puller wire, lead wires, sensor cables and any other wires, cables or tubes. If desired, the inner surface of the outer wall is lined with a stiffening tube (not shown) to provide improved torsional stability. An example of a catheter body construction suitable for use in connection with the present invention is described and depicted in U.S. Pat. No. 6,064,905, the disclosure of which is incorporated herein by reference.
Referring to
Dimensions of the framework 20 include a circumference C (or diameter D, used interchangeably herein) and a length L that vary interdependently to each other to conform to a surrounding volume or tubular region. The terms diameter D, circumference C and the length L are loosely used herein and in a broad sense in that the framework is somewhat tubular, but it may not have a constant diameter or circumference along its length, nor a constant length along its circumference. Moreover, the circumference at any point along the length need not define a circular cross-section. That is, the cross-section could be oval, ellipsoid, or asymmetrical due to various factors, for example, abnormal tissue growth, injury, scarring or birth defect.
The framework 20 of the embodiment shown in
Despite its hollow configuration, the framework 20 is a relatively stable structure in any of its possible configurations. That is, with the catheter assembly 18 in position, an intersecting angle or a distance between intersecting or adjacent tensile member 30 is substantially maintained within the framework 20 until the framework configuration is changed or otherwise manipulated by the expander 26, as discussed further below. As such, the catheter assembly 18 offers improved anchoring capabilities and hence a more uniform circumferential lesion over conventional circumferential ablation catheters.
The tensile members 30 of the framework are all attached, directly or indirectly, to the expander 26 at their distal ends, and to the catheter body 12 at their proximal ends. As shown in
As will be recognized by one of ordinary skill in the art, the number of tensile members or wires can vary as desired depending on the particular application, so that the number of tensile members may range between about 4 and 128 wires, preferably between about 4 and 32 wires and more preferably between about 4 and 16 wires. As used herein, the term "3-D", "tubular" or "hollow" in describing the assembly is not limited to the depicted configuration, but can include other designs, such as wire frame, space frame or geodesic designs.
Also shown in
The ribbon electrode 42 is constructed of an electrically-conductive material. Moreover, the ribbon electrode can be made of an elastic material which stretches and shrinks in accordance with the dimensions of the framework 20 (
Unexpanded or collapsed circumference of the ribbon electrode may range between about 1 mm and 2 mm or in accordance with the circumference of the collapsed assembly 18. Expanded or deployed circumference of the ribbon electrode may range between about 125-260 mm, preferably between about 125-150 mm. Width of the ribbon electrode may range between about 0.0001 inches and 0.75 inches, preferably between about 0.080 inches and 0.30 inches.
The assembly 18 may provide multiple ribbon electrodes, each at a different location along the length. Whether they are elastic or have shape memory, each of the ribbon electrodes can attain a different diameter or circumference depending on the shape or configuration of the volume of the tubular region. So equipped, the catheter assembly 18 provides an electrode array with a grid-like pattern suitable for readings proximally and/or distally within the assembly region or an entire 3-D surface, regardless of any nonuniformity in the circumference of the tubular region of interest. In a mapping context, the locations identified by the array could provide information as to the cascade of electricity flowing through the heart tissue.
In accordance with the present invention, the expander 26 is moved longitudinally to elongate and shorten the ablation assembly 18, so that in the elongated configuration the framework 20 adopts a collapsed position, and in the shortened configuration the framework 20 adopts a fuller, expanded position. In the collapsed configuration, the framework 20 can have a minimum length ranging between about 0.050 inches and 0.50 inches, and a maximum length ranging between about 2.0 inches and 8.0 inches. Further in the collapsed configuration, the framework 20 can have a minimum diameter ranging between about 7 and 8 french and a maximum diameter ranging between about 12 and 14 french.
In the expanded configuration, the framework 20 can have a minimum length ranging between about 0.015 inches and 0.25 inches, and a maximum length ranging between about 1.0 inches and 4.0 inches. Further in the expanded configuration, the framework 20 can have a minimum diameter ranging between about 5 mm and 10 mm and a maximum diameter ranging between about 45 mm and 60 mm.
It is understood by one of ordinary skill in the art that the diameter of the collapsed framework 20 is dependent on factors including the diameter of any guiding sheath used with the catheter and/or the catheter body. It is also understood by one of ordinary skill in the art that the diameter of the expanded framework 20 is dependent on factors including the diameter of the tubular region undergoing treatment. To that end, the framework 20 is hollow when deployed so there is minimum disruption or impedance to blood flow in the treatment area.
Best shown in
A preferred construction of the distal end of the assembly 18 is depicted in
A preferred construction of the proximal end of the assembly 18 and distal end of the catheter body 12 is shown in
The expander 26 must be afforded longitudinal movement within the catheter body 22. Accordingly, a tunnel 66 is formed from a piece of polyimide tubing or the like and is provided near the distal end of the catheter body 12 through which the expander 26 extends. The flexible Nitinol wires 38 are mounted, preferably evenly-spaced, between a proximal tubing 68 and an outer proximal ring 70, both of which are preferably made of polyimide, and held in place with polyurethane glue or the like. The proximal tubing 68 and outer proximal ring 70 are preferably relatively short, e.g., about 3 mm in length. Preferably electrode lead wire(s) 72 and sensor cable 60 that is attached to the distal location sensor 50 are also afforded some longitudinal movement within the catheter body 12 so that they do not break when the catheter body bends. Accordingly, in the depicted embodiment, the lead wires 72 and sensor cable 60 that is attached to the distal location sensor 50 extend within the proximal tubing 68 through which the expander 26 and tunnel 66 also extend, so that these components are not fixed in place along with the flexible Nitinol wires 38. This entire construction is mounted in the plastic housing 62. The proximal ends of the non-conductive coverings 40 of the wires 38 also extend into the plastic housing 62, but preferably end prior to the distal ends of the proximal tubing 68 and outer proximal ring 70.
The proximal location sensor 64 is also mounted within the housing 62. In the depicted embodiment, a second tunnel 74 is provided at the junction of the catheter body 12 and housing 62, with its proximal end extending into the catheter body and its distal end extending into the housing. The tunnel 74 is preferably made of polyimide and has a length ranging from about 5 to 7 mm. The tunnel 74 protects the expander 26, electrode lead wires 72 and sensor cable 60 that is attached to the distal location sensor 50 from being glued to the catheter at the junction of the catheter body and housing during assembly. Prior to assembly, the proximal location sensor 64 is mounted in a window 76 of the second tunnel 74. The proximal location sensor 64 preferably has a length of about 1 to 3 mm. The sensor cable 60 attached to the proximal location sensor 64 extends through the second tunnel 74 and catheter body 12 along with the other components. Accordingly, all of these components are afforded longitudinal movement at the junction of the catheter body 12 and the housing 62.
It is understood by one of ordinary skill in the art that the proximal end and/or distal ends of the tensile members may be movable within the tubing 54 and the ring 70 (for example, with the use of ball-bearings), where it is desired that the framework 20 be able to tighten or loosen the coils of the tensile members 30 with longitudinal movement of the expander 26. With such movement capability in the tensile members, the number of windings or coils of each tensile member about the expander can change as the expander moves longitudinally.
Longitudinal movement of the expander 26 distally the catheter body 12, which results in elongation of the assembly 18, is accomplished by manipulation of the control handle 16. As shown in
Within the control handle 16, the proximal end of the expander 26 extends through a passage 82 in the piston 80, through the handle housing 78 and into a support tube 84, preferably made of braided polyimide or PEBAX.RTM. The support tube 84 extends out the proximal end of the control handle 16 and terminates in a luer hub 86. The support tube 84 and expander 26 are together fixedly attached to the handle housing 78 by any suitable method, preferably with polyurethane glue or the like. The guidewire lumen 48 of the expander 26 can also be used for infusion of fluids through the catheter, as is generally known in the art.
In a preferred embodiment, the piston 80 is approximately about 2 inches long, and the support tube 84 and expander 26 are attached to the handle housing 78 at a position about 0.5 inch distal to the proximal end of the handle and about 1 inch proximal to the proximal end of the piston in the neutral position. The piston is in the neutral position when the assembly 18 is generally collapsed, i.e., not expanded.
The lead wires 72 and sensor cables 60 also extend through the piston passage 82 and handle housing 78 and are attached to a suitable connector 88 at the proximal end of the handle housing. Alternatively, the lead wires 72 and sensor cables 60 can extend through protective support tubes (not shown), similar to the support tube 84 that carries the expander 26, which have distal ends inside the handle housing 78 and proximal ends attached to appropriate connectors.
To use the catheter of the invention, an electrophysiologist introduces a guiding sheath, guidewire and dilator into the patient, as is generally known in the art. A suitable guiding sheath for use in connection with the inventive catheter is the PREFACE.TM. Braided Guiding Sheath (commercially available from Biosense Webster, Inc., Diamond Bar, Calif.). The dilator is removed, and the catheter is introduced through the guiding sheath whereby the guidewire lumen 48 in the expander 36 permits the catheter 10 to pass over the guidewire. The guiding sheath covers the framework 20 of the assembly 18 internally in a collapsed position so that the entire catheter can be passed down a vein or artery to a desired location. Once the distal end of the catheter reaches the desired location, the guiding sheath is withdrawn. The expander 26 is then manipulated so that the length of the framework is shortened and framework expands outwardly into an expanded arrangement. In such an arrangement the tensile members 30 and/or the ribbon 42 contact the tissue of the tubular region. As will be recognized by one skilled in the art, the assembly 18 can be fully or partially expanded in a variety of configurations depending on the configuration of the region of the heart being mapped. As mentioned in reference to
With reference to
As shown in
The framework 90 has at least one flexible ribbon electrode 108 which may be elastic, or is folded when the assembly is collapsed and unfolded when the assembly is expanded. The ribbon electrode may be of Nitinol.
Another alternative embodiment of the ablation assembly 18 is shown in
The structure 112 is advantageously seamless as having been laser-cut with multiple longitudinal slots 124 to form longitudinal slats 126 which (due at least in part to their rectangular cross sections, see
In accordance with the present invention, a ribbon electrode 128 (whether elastic or pleated) mounted circumferentially on the slats 126 at a location within the length Ls follows the expansion of the structure 112 at deployment (
It is understood by one of ordinary skill in the art that the slots 124 may be merely slits or cuts (that is, with minimal or no effective width dimension) and that the number of slots or slats can range between about 3 and 100, preferably about 5 and 25 and more preferably about 12. Moreover, the length Ls and the width Ws of each slot or slat can vary, or the slots and slats can be out of longitudinal alignment with other slots or slats. The structure 112 may also be constructed out of Nitinol, or any other material with suitable strength and flexibility.
Also abutting the distal end 130 of the tunnel 74 is a disk insert 132 that is fitted to sit within the proximal end 116 of the cylinder 112. The disk 132 is configured with an aperture 134 through which the expander 120 and any lead wire(s) 72 extend and are afforded longitudinal movement.
The catheter 10 may also include a tip electrode 136 mounted at the distal end of the ablation assembly 18 for ablating tissue. The tip electrode can be mounted on the distal end of the framework 20 (
In addition to circumferential ablation, where the catheter 10 carries multiple ribbon electrodes along with the distal end proximal location sensors, an electrophysiologist can map local activation time, which can guide the electrophysiologist in providing therapy to the patient. The catheter can include one or more reference ring electrodes mounted on the catheter body 12, or one or more reference electrodes can be placed outside the body of the patient. By using the inventive catheter with the multiple electrodes on the assembly 18, the electrophysiologist can obtain a true anatomy of the heart by measuring less points than with traditional catheters, allowing him to map the heart more quickly. Moreover, by introducing the assembly 18 over the guidewire, the electrophysiologist can remove the catheter from the heart and later reintroduce the assembly to the same position after therapy, thereby permitting the electrophysiologist to accurately view the results of the therapy. Prior basket catheter designs did not permit this reproducibility.
If desired the catheter can include a steering mechanism for deflection of the distal end of the catheter body 12. With such a design, the distal end of the catheter body 12 preferably comprises a short length of tubing, e.g., 2 to 4 inches, that is more flexible that the remainder of the catheter body. A suitable steering mechanism comprises a puller wire (not shown) that extends from a proximal end in the handle through the catheter body and into an off axis lumen in the catheter tip section. Within the catheter body, the puller wire extends through a closely wound coil that is bendable but substantially compressible. The coil is fixed near the proximal and distal ends of the catheter body and prevents deflection of the catheter body. The distal end of the puller wire is anchored at the distal end of the catheter body proximal to the proximal end of the basket. The proximal end of the puller wire is anchored to a movable member in the handle that can be moved relative to the catheter body. Proximal movement of the movable member relative to the catheter body results in deflection of the catheter tip section. An example of such a steering mechanism and construction is described in more detail in U.S. Pat. No. 6,064,905, the disclosure of which is incorporated herein by reference.
If a steering mechanism is included, the control handle 16 may be of any suitable construction for manipulating two wires, in this case, the expander and a puller wire. Preferably the handle has a pair of movable members to which the expander and puller wire attach, such as handles typically used for bidirectional and multidirectional catheters. Examples of such handles are disclosed in U.S. Pat. Nos. 6,210,407, 6,198,974, 6,183,463, 6,183,435, 6,171,277, and 6,123,699, the disclosures of which are incorporated herein by reference.
Suitable deflection control handles for use with such a catheter are described in U.S. patent application Ser. No. 08/924,611, filed Sep. 5, 1997, entitled "Omni-Directional Steerable Catheter", 09/130,359, filed Aug. 7, 1998, entitled "Bi-Directional Control Handle for Steerable Catheter", and 09/143,426, filed Aug. 28, 1998, entitled "Bidirectional Steerable Catheter with Bidirectional Control Handle", and U.S. patent application entitled "Single Gear Drive Bidirectional Control Handle for Steerable Catheter" to Tim Bumbalough, et al., filed Apr. 10, 2000, the disclosures of which are incorporated herein by reference.
In an alternative embodiment (not shown), the tensile members do not include non-conductive coverings so that the flexible Nitinol wires each act as an elongated electrode, obviating the ribbon electrode. In such an embodiment, the sensor cable attached to the distal location sensor can extend through a second lumen (not shown) in the expander. Electrode lead wires can then be attached to the proximal ends of the tensile members within the catheter body. As would be recognized by one skilled in the art, other electrode configurations on the assembly 18 could also be used in accordance with the invention.
In another alternative embodiment (not shown), the catheter does not include a control handle. In such an embodiment, the proximal end of the expander will extend out the proximal end of the catheter body and can be manipulated directly. However, such a design may be less desirable from a practical standpoint, as it may be more difficult for the electrophysiologist to control.
The preceding description has been presented with references to presently preferred embodiments of the invention. Persons skilled in the art and technology to which this invention pertains will appreciate that alterations and changes in the described structures can be practiced without meaningfully departing from the principle, spirit and scope of this invention. For example, the different embodiments of the ablation assembly can be used with any of the different embodiments of the expander, and vice versa. Moreover, the different methods and structures described for attaching, connecting or otherwise joining the ends of the expander and the tensile members of the frameworks can be interchanged as desired. Furthermore, all of the dimensions described herein are approximations. Accordingly, the foregoing description should not be read as pertaining only to the precise structures described and shown in the accompanying drawings (which may not be to scale), but rather should be read as consistent with and as support for the following claims, which are to have their fullest and fairest scope.
Accordingly, the foregoing description should not be read as pertaining only to the precise structures described and illustrated in the accompanying drawings, but rather should be read consistent with and as support to the following claims which are to have their fullest and fair scope.
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|The Uab Research Foundation
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|14 Oct 1997
|14 Dic 1999
|Medtronic, Inc.
|Stabilized electrophysiology catheter and method for use
|15 Ene 1998
|7 Mar 2000
|Medtronics, Inc.
|Electrophysiology catheter with multifunction wire and method for making
|16 Abr 1998
|16 May 2000
|C.R. Bard, Inc.
|Pulmonary vein ablation catheter
|18 Jun 1998
|16 May 2000
|Cordis Webster, Inc.
|Multi-element tip electrode mapping catheter
|31 Mar 1997
|11 Jul 2000
|Boston Scientific Corporation
|Tissue characterization to identify an ablation site
|7 Jun 1995
|18 Jul 2000
|Cordis Webster, Inc.
|Catheter with a spirally wound flat ribbon electrode
|5 May 1998
|1 Ago 2000
|Cardiac Pacemakers, Inc.
|Steerable catheter with preformed distal shape and method for use
|4 Ene 1999
|15 Ago 2000
|Tu; Lily Chen
|Rotatable apparatus having ablation capabilities
|10 Dic 1996
|22 Ago 2000
|Ep Technologies, Inc.
|Systems and methods for forming elongated lesion patterns in body tissue using straight or curvilinear electrode elements
|25 Nov 1998
|12 Sep 2000
|The Regents Of The University Of California
|Circumferential ablation device assembly
|5 Sep 1997
|26 Sep 2000
|Cordis Webster, Inc.
|Omni-directional steerable catheter
|13 Jun 1997
|10 Oct 2000
|Ep Technologies, Inc.
|Systems and methods for forming elongated lesion patterns in body tissue using straight or curvilinear electrode elements
|5 May 1998
|14 Nov 2000
|Cardiac Pacemakers, Inc.
|Catheter having distal region for deflecting axial forces
|21 Oct 1998
|19 Dic 2000
|Akzo Nobel N.V.
|2 Nov 1999
|19 Dic 2000
|Ep Technologies, Inc.
|Cardiac mapping and ablation systems
|27 Ago 1999
|2 Ene 2001
|Medtronic Inc.
|Electrophysiology catheter with multifunctional wire and method for making
|7 Ago 1998
|9 Ene 2001
|Cordis Webster, Inc.
|Bi-directional control handle for steerable catheter
|22 Mar 1999
|6 Feb 2001
|Cordis Webster, Inc.
|Multi-directional steerable catheters and control handles
|28 Ago 1998
|6 Feb 2001
|Cordis Webster, Inc.
|Bidirectional steerable cathether with bidirectional control handle
|18 Sep 1998
|6 Mar 2001
|Cordis Webster, Inc.
|Bi-directional steerable catheter
|3 Dic 1998
|3 Abr 2001
|Cordis Webster, Inc.
|Bi-directional electrode catheter
|30 Dic 1998
|17 Abr 2001
|Daig Corporation
|Temporary atrial cardioversion catheter
|28 Sep 1998
|17 Jul 2001
|Scimed Life Systems, Inc.
|Intravascular imaging guidewire
|17 Jun 1999
|18 Sep 2001
|Wilton W. Webster, Jr.
|Method and apparatus for transvascular treatment of tachycardia and fibrillation
|5 Abr 1999
|4 Dic 2001
|Medtronic, Inc.
|Ablation catheter and method for isolating a pulmonary vein
|2 Mar 2000
|4 Feb 2003
|Atrionix, Inc.
|Positioning system and method for orienting an ablation element within a pulmonary vein ostium
|2 Mar 2000
|15 Abr 2003
|Atrionx, Inc.
|Medical device with sensor cooperating with expandable member
|14 Dic 2001
|25 May 2004
|Biosense Webster, Inc.
|Basket catheter with improved expansion mechanism
|7 Jun 2000
|30 Nov 2004
|Endocardial Solutions, Inc.
|Method of mapping a plug in a mapping catheter
|27 Abr 2001
|4 Ene 2005
|C.R. Bard, Inc.
|Apparatus and methods for mapping and ablation in electrophysiology procedures
|1 May 2003
|13 May 2008
|Biosense Webster, Inc.
|Catheter having circular ablation assembly
|16 May 2001
|7 Nov 2002
|Lesh Michael D.
|Deflectable tip catheter with guidewire tracking mechanism
|1 May 2003
|16 Oct 2003
|Biosense Webster, Inc.
|Catheter having circular ablation assembly
|Patente citante
|Fecha de presentación
|Fecha de publicación
|13 Sep 2004
|7 Jul 2009
|Ethicon Endo-Surgery, Inc.
|Mucosal ablation device
|28 Jun 2005
|13 Sep 2011
|Cardiac Pacemakers, Inc.
|Anchor for electrode delivery system
|23 Ene 2009
|7 Ago 2012
|Coherex Medical, Inc.
|Systems and methods for reduction of atrial fibrillation
|4 Oct 2011
|30 Jul 2013
|Biosense Webster (Israel), Ltd.
|Mapping catheter with spiral electrode assembly
|6 Ago 2012
|28 Ene 2014
|Coherex Medical, Inc.
|Systems and methods for reduction of atrial fibrillation
|24 Nov 2010
|26 May 2015
|Medwaves, Inc.
|Radio frequency ablation system with tracking sensor
|30 Dic 2013
|2 Jun 2015
|Coherex Medical, Inc.
|Systems and methods for reduction of atrial fibrillation
|9 Nov 2011
|28 Jul 2015
|Boston Scientific Scimed, Inc.
|Renal denervation catheter with RF electrode and integral contrast dye injection arrangement
|13 Sep 2004
|16 Mar 2006
|Long Gary L
|Mucosal ablation device
|28 Jun 2005
|28 Dic 2006
|Cardiac Pacemakers, Inc.
|Anchor for electrode delivery system
|19 Oct 2006
|22 Mar 2007
|Medwaves, Inc.
|Ablation catheter apparatus with one or more electrodes
|9 Nov 2011
|17 May 2012
|Willard Martin R
|Renal denervation catheter with rf electrode and integral contrast dye injection arrangement
|3 Oct 2012
|10 Abr 2013
|Biosense Webster (Israel), Ltd.
|Mapping catheter with electrode assembly in form of a spiral ribbon
|3 Oct 2012
|23 Oct 2013
|Biosense Webster (Israel), Ltd.
|Mapping catheter with spiral electrode assembly
|30 Mar 2012
|1 Ene 2014
|Tidal Wave Technology, Inc.
|Radio frequency ablation catheter device
|23 Ene 2009
|30 Jul 2009
|Coherex Medical Inc
|Systems and methods for reduction of atrial fibrillation
|25 May 2011
|4 Oct 2012
|Flux Medical N.V.
|System, device and method for ablation of a vessel's wall from the inside
|2 Abr 2012
|4 Oct 2012
|Flux Medical N.V.
|System, device and method for ablation of a vessel's wall from the inside
|30 Mar 2012
|4 Oct 2012
|Tidal Wave Technology, Inc.
|Radio frequency ablation catheter device
|Clasificación de EE.UU.
|Clasificación internacional
|Clasificación cooperativa
|Clasificación europea
|16 Ago 2004
Owner name: BIOSENSE WEBSTER, INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MCDANIEL, BENJAMIN D.;PONZI, DEAN M.;REEL/FRAME:015681/0029
Effective date: 20040809
|11 Feb 2015
|Fee payment
Year of fee payment: 4


text:
So, human is the way to go as a caster druid - the extra feat is just too important. Some feats I plan to take early on - such as Augment Summoning - are temporary, but i'm trying to figure out what to plan for later on. Same with Extend. (5 minute duration buffs suck, but by 20 you don't need it, so it's one to swap out later)
There weren't a lot of threads on druid builds (a lot of discussion on other areas, but not a lot of build posts), so what feats would people say are the key ones?
Maximize/Empower have traditionally been a staple of caster butt-whoopin'. With their change (empower = 75 spell power, maximize = 150), are they still? (Not for a first life druid with little gear at the start of the game, but later on)
Quicken/Heighten? Seems like a lot of the spells I used a lot on Lammaland were low-level and could benefit from heighten. Quicken? Not so much, unless I planned to be a healer. (May decide on that later on, but not right now.)
Spell Penetration/Spell Focus: Evocation (and their Greater equilivants)? Some of the 'key' spells I used didn't have a saving throw (produce flames / creeping cold), and I don't think any of them had a spell resistance check either, but maybe someone who got up higher level could confirm it's usefulness?
1: Augment Summoning
-Human: Extend Spell
3: Mental Toughness
6: Toughness
9: Empower
12: Maximize
15: Heighten
18: *
So, given that I can swap augment, extend, and - probably, by the end-game, mental toughness (figured i'd take it early when I needed the SP, again, being poorly geared), I can get SF: Evo, GSF: Evo, Spell pen, greater spell pen... but like I said, i'm not sure if I will *need* that, or if there are other feats... (My evo. nuke spells don't have a saving throw; Storm of Vengeance does, and it's conjuration, so maybe get SF: Conj. instead? Necro for the one spell that it benefits, which is a good one? One of each, and the two spell pen feats?
Or do I fly blind since there's still not much info on it and let you know how badly I'm doing later on. =) I'm good with that, too. I've got a (probably poor) plan in mind, so it's not like I'm paralyzed with indecision here, though a bit too wordy for my own good.
Anyway... happy druid'ing!

subset: commoncrawl


text:
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Mary Ann Ellis
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Tuesday, September 13. 2011
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The phosphorescent glow of the bridge in my headlights appeared simultaneously with the first fat rain drops on the windshield. No moonlight shone on the river far below. No other cars traveled Highway 221 that Friday night, not in my line of vision anyway. No companion sat in the passenger seat of my '61 Valiant, unless you want to count Fear. No roommate was coming to Hazlehurst to spend the weekend with me. Stifling and still, only solitude surrounded me out there in the backside of nowhere.
"Ka Boom!"
The noise woke me from my reverie, and I plummeted from anxiety to abject terror. The car shifted to the right, sliding toward the narrow shoulder-a foot, now another, sliding toward my demise. I imagined my broken body inside the crushed green coffin that had once been my car.
"Flat tire," I thought, as the rain fell faster and faster.
Easing the car toward the wet clay shoulder, I prayed, "God help me. I'm too young to die."
The shoulder changed all too quickly to a deep chasm. I gripped the steering wheel with all my strength, but the car continued to slide toward the abyss waiting to my right, yawning like the jaws of a gargantuan crocodile. The car seemed to slide for hours in the wet red clay. I felt my life slipping, slipping away.
Finally the car stopped, resting on the edge of the precipice that dropped down to the deep channel filled with the overflow of the angry river. Rain had fallen for days, but I didn't know it. I'd been safe in Athens at the university. As I opened the door, the car shifted, but I managed to step onto the highway. The cold rain on my skin assured me that I still lived, and discomfort never felt so good. However, my car sat on the brink of disaster. I stood on the shoulder and cried, helpless in the storm. Rain ran down my collar and my long hair plastered itself to my head.
Cell phones didn't exist at that time. I could only cry, pray and wait. Climbing back into my precariously perched car was not an option, even if I had to walk the twelve miles home. When three men stopped to help me, I was so glad to see them that it never occurred to me that I might be in danger. Fortunately, they were not murderers or rapists; actually, they were godsends. Very efficiently they tied a rope to my car so it couldn't slide over the embankment and then proceeded to pull it back onto the highway. To my surprise, there was no flat tire. I never learned what I heard that night to make me pull off the road and into danger.
I was a college sophomore when that very real nightmare happened, but the times I've faced danger since then I couldn't even begin to count. There was the night the car jumped the median on I-20 West in Augusta and hit the car behind me, killing everyone in both vehicles. I, along with my month old child, was saved for some reason. I think of all the times I drove in terrible storms when I could barely see the road. And then there was the day the bulldog nearly got me. He was so close that I felt his hot breath on my bare leg. And from all these situations I was saved. By Fate? By God? Why?
I don't know why, but I guess God wasn't through with me yet. I cannot fathom living and not believing in God. How can anyone consider the rose on the vine and doubt God? How can we accept the seasons and not see God in them? I know for a fact that God doesn't bother to answer my every whispered prayer, but I know he's out there. For the present, that's good enough for me.
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Very thoughtful article by B.G Howard. keep these coming and keep writing. Thank you for voicing our thoughts so well.
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This was a awesome editorial article. Thanks Billy for your post
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The only pub and Irish music night in Dublin that is owned and run by traditional musicians, guaranteeing a high standard of authentic entertainment and hospitality. Dinner and show (including Irish Dancing) almost every night of the year.
B&B accommodation on a working farm with a beautiful scenic backdrop.
Hillcrest Country Home Bed and Breakfast. A warm welcome awaits you at HILLCREST COUNTRY HOME BED AND BREAKFAST ADARE . Hillcrest Bed and Breakfast accommodation in Adare, County Limerick is a hospitable, relaxed home, situated amidst beaut
Luxury Bed and Breakfast Special Offers for extended stay All rooms have Private Bathrooms , some overlooking the river and Superior Deluxe rooms have 4-poster king beds we are close to Killarneys National Park ,Muckross House , Ross Castle
Family run and family friendly guesthouse overlooking Brandon bay and at the foot of Mount Brandon. Enjoy traditional home cooked food in our cosy bar or scenic dining room. Relax and enjoy the 'craic'
Luxurious family run B & B on the Killarney /Tralee road (N22) with panoramic views of the mountains.Killarney 4 miles.In the heart of the countryside, making an ideal base for touring Killarney National Park, Dingle Peninsula and the Ring of Kerry
Harbour Crest Kilbrittain B&B is where you will enjoy a break in rural Ireland to experience the quality 'Irish' welcome, good food and entertainment which makes for a wonderful holiday.
Traditional Irish Family run hotel in the heart of the Gaelic speaking area offering beautiful accommodation and awarding winning food with live music séisuns. A place to base your exploration of Ireland's magical counties of Cork & Kerry.
we are ideally located to Westport , just a 5 minute walk,private car park,guest kitchen, storage for bicycles, golf clubs etc.
Find the perfect accommodations for vacations, romantic weekends and adventurous getaways. Find the right accommodations for your travels, from budget to luxury!


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This is my wife Veerle her first time-lapse movie that she captured when we were on vacation in the Smoky Mountains.
She said she learned a lot already and enjoyed making this "Silent Mist" time-lapse movie but is eager to learn much more about shooting time-lapses and is already working on a next time-lapse movie.She gave it a HDR tone look but her next time-lapse movie is being shot in HDR.
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A loyalty program that rewards you for your love of reading.
Browse titles you can get with points.
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Journal of Pontiac's conspiracy, 1763;
Society of colonial wars, Michigan, Clarence Monroe Burton, Mary Agnes Burton, Richard Clyde Ford
John D. Pierce, founder of the Michigan school system; a study of education in the Northwest
Charles Oliver Hoyt, R. Clyde (Richard Clyde) Ford
John D. Pierce, Founder of the Michigan School System: A Study of Education ...
Charles Oliver Hoyt, Richard Clyde Ford
Scheffel als Romandichter = Scheffel as a novelist [microform]
R. Clyde (Richard Clyde) Ford
Elementary German for sight translation
Scheffel als Romandichter. (Scheffel as a novelist)
Richard Clyde Ford


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Watch Storage Wars: Texas Season 3 Episode 28: The buyers hit Fort Worth.
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Storage Wars: Texas (2011) | Season 3 - Episode 28 - Moe's Def Links
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No Demands for French Workers Kidnapped in Niger, Ministry Says
Sept. 16 (Bloomberg) -- France hasn't received any demands from those who kidnapped seven employees of Areva SA and Vinci SA in Niger, Foreign Ministry spokesman Bernard Valero said.
"It could be a criminal, terrorist or political act," Valero said in a telephone interview today. "We don't know yet. We haven't received any claims." Five of the hostages are French citizens, one is from Madagascar and one from Togo, he said.
The two companies said today in an e-mailed statement they are working with Nigerian and French authorities to free employees taken hostage during the night of Sept. 15 to 16. Five employees of Vinci's Satom subsidiary and one Areva employee and his wife were kidnapped in Arlit, northern Niger, the companies said.
Both Vinci and Areva said they have increased security for their employees in the area.
To contact the reporters on this story: Helene Fouquet in Paris at email@example.com.
To contact the editor responsible for this story: James Hertling at email@example.com


text: Hey all, I spent a few days trying to dig for answers to no avail. Please be kind, I know you've seen this before. First off, I've had my Bugeye 13 years. I love it. But, it's tired and I think I have a small head gasket leak. 180k on the clock. I want to rebuild her but I am not chasing big HP. I want more torque and I want it to spool up quicker. I've got a Stromung cat back and that's about it. I did the belt and tensioners, pump, and a kick ass radiator at 90k. I build hopped up two stroke Italian scooters and messed around with small block Ford before I caught the "Bug". Point is I'm not afraid to get dirty. I had always thought that I would like a 2.2. I live in San Francisco and I notice there is no Bay Area group on here. I would love to know about a good machine shop as well. I am surprised that information about different conversions has been so hard for me to locate. I would love some help and guidance please. Thanks


text:
"The updated agreement should reflect the EU request that a national security exception is used only to the extent that it is strictly necessary and proportionate for a given incident," said Daniel Castro on CNBC.
News Room
News Clippings
October 7, 2015
October 7, 2015
"European citizens and policymakers are understandably concerned about privacy safeguards in U.S. law," said Daniel Castro in Investor's Business Daily.
October 6, 2015
"Policymakers should finish the process of creating a Safe Harbor 2.0 with terms that give comfort to all parties," said Daniel Castro in The Hill.
October 6, 2015
"Safe Harbor agreement has been the cornerstone of the transatlantic digital economy since before global companies like Facebook were founded," said Daniel Castro in Agence France-Presse.
October 6, 2015
"It's really hard to imagine anything that can be more disruptive to the digital economy than this," said Daniel Castro in the Washington Post.
October 6, 2015
"We are concerned that criticisms of transfer pricing may provide an excuse to shift tax receipts from the United States to other countries by levying taxes according to criteria other than where profits are actually earned," said Joe Kennedy in the Sydney Morning Herald.
October 6, 2015
"It will disrupt not just the thousands of US and European companies that currently depend on the Safe Harbor to do business across the Atlantic, but also the broader digital economy," said Daniel Castro in the Christian Science Monitor.
October 6, 2015
Today more than 3,000 businesses in the U.S. and the EU depend on the agreement to avoid running afoul of European privacy laws according to ITIF, writes USA Today.
October 5, 2015
"Europe grants at least 10 years of data protection, so this new agreement puts America behind the eight ball when it comes to competing with European nations," said Stephen Ezell in the Business Journals.
October 5, 2015
"The digital economy is global, and information must be able to flow freely across borders for that economy to flourish," said Stephen Ezell in The Hill. "By committing parties to protecting free cross-border data flows and prohibiting countries from requiring that their citizens' data be stored on local servers, the TPP agreement ensures information technology will remain the principal driver of modern economic growth."
Press Releases
December 16, 2014
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text:
Industry Leaders in Products of Intimacy Join Forces to Escape the Mistaken
HOLLYWOOD, Calif., Jan. 14 /PRNewswire/ -- The LOVE L.A. Show, a brand new approach to the promotion of sensual products, sexual education and relationship improvement is set to take place on January 27, 2008. LOVE L.A.'s objective is to provide couples and singles with seminars and products to enhance their love lives in a comfortable and entertaining environment.
LOVE L.A. marks the first event of its kind, as pornography will not be seen nor allowed within the venue. It will feature 30 handpicked local vendors in a romantic setting without the traditional impersonal booth setups, harsh lighting or male dominated crowd.
"We want vendors to share their favorite products, rather than hard-sell wares," said event creator Ian Denchasy, whose idea for a couples-oriented event was recently featured in L.A. Weekly. "The booth cost is low, [and] admission is low. We want visitors to explore their options with adult products, services, and lingerie in a sexy, pressure-free atmosphere."
The event's main differentiation from other adult oriented trade shows is due to the fact that pornography will be absent and education will be present. The event will feature multiple seminars hosted by well-known sex experts such as Midori and Patti Britton.
"It's about time that the industry recognizes a need for a high-end event that speaks to women and couples," said Kristen Tribby, Education/Marketing Coordinator for Babeland, who will both vend at the event and help organize and staff the many seminars. "LOVE L.A. is an exciting alternative to the typical sex expo. It provides a space for folks to explore their sexuality in a non-sleazy, inclusive environment."
LOVE L.A. organizers expect between 3,000 and 5,000 attendees during
the one-day show. LOVE L.A. staff will also be on hand to demystify sexual
taboos and ce
|SOURCE LOVE L.A. Show
Copyright©2008 PR Newswire.
All rights reserved


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text:
Book your room at Hotel Royal
Get an overview of this hotelFamily-friendly hotel with free breakfast and restaurant
This family-friendly Garda hotel is located on a lake, within 3 mi (5 km) of Golf Club Ca degli Ulivi, Garden of Casa Biasi and Church of San Severo. Baia delle Sirene Park and Church of San Nicolo and San Severo are also within 3 mi (5 km).
Hotel Features
This hotel features a restaurant, an outdoor pool, and a bar/lounge. Free buffet breakfast and free self parking are also provided. Additionally, a 24-hour front desk, multilingual staff, and a garden are onsite.
Room Amenities
All 170 rooms offer satellite TV, hair dryers, and safes. Showers, phones, and desks are among the other amenities that guests will find.Information missing or incorrect? Tell us!
Hotel Amenities
Hotel Amenities
The hotel offers a restaurant. A bar/lounge is on site where guests can unwind with a drink. A complimentary breakfast is offered.
This family-friendly hotel also offers an outdoor pool, multilingual staff, and a garden. Onsite self parking is complimentary.
- 24-hour front desk
- Bar/lounge
- Beach umbrellas
- Pool umbrellas
- Elevator/lift
- Free breakfast
- Free self parking
- Garden
- Multilingual staff
- Number of buildings/towers - 2
- Number of floors - 3
- Outdoor pool
- Restaurant
- Television in lobby
- Total number of rooms - 170
Free self parking
Room Amenities
- Air conditioning
- Bidet
- Climate control
- Cribs/infant beds available
- Desk
- Hair dryer
- In-room safe
- Phone
- Private bathroom
- Satellite TV service
- Shower only
Where to Eat
Guests are offered a complimentary buffet breakfast.
Hotel Royal has a restaurant serving breakfast and dinner.
Nearby Things to Do
The recreational activities listed below are available either on site or nearby; fees may apply.
- Golfing nearby
- Surfing/boogie boarding nearby
- Kayaking nearby
- Sailing nearby
- Water skiing nearby
- Windsurfing nearby
- Rafting nearby
- Scooter/moped rentals nearby
- Bicycle rentals nearby
- Hiking/biking trails nearby
- Mountain biking nearby
- Parasailing nearby
- Ecotours nearby
- Golf lessons available nearby
- Personal motorized watercraft on site
- Playground on site
Hotel Policies
Check-in time ends at 10 PM
Check-in time starts at 3 PM
Check-out time is 10 AM
Payment types
Children and extra beds
- Children are welcome.
- Cribs (infant beds) are available.
You need to know
Extra-person charges may apply and vary depending on hotel policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
- A tax is imposed by the city: EUR 1.00 per person, per night. This tax does not apply to children under 14 years of age.
We should mention
Cash transactions at this property cannot exceed EUR 999.99, due to national regulations. For further details, please contact the property using information in the booking confirmation. In accordance with national/local laws, air conditioning may be restricted to certain hours from 01 July to 31 August.


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Man needs a loan, woman has money. But can he deal with the terms of the loan?
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Recently Viewed Items
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Political Costumes
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- Child George Washington Costume$34.99
- Uncle Sam Costume$24.99
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- Mister President MaskSale - 60%$1.99$4.99
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- Adult Benjamin Franklin Costume$34.99
- Reagan Zombie MaskSale - 20%$11.99$14.99
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1 - 55 of 55
You usually think of politics in terms of current events, not history. But today's politics will become tomorrow's history. We have a range of masks and costumes that will let you become a figure from history or from today's newspaper headlines.
Become a U.S. president, a presidential candidate, or one of our nation's founders. If you think politicians are brainless zombies, we can accommodate you. You can get zombie versions of several former presidents. Whether you admire politicians or want to poke fun at them, you're sure to find a mask or costume that lets you express your opinion.


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Welcome to the Drive Alive Web site.
This site is for
parents, teens and businesses in Indiana. The
site has information that can help parents prepare teen
drivers for the road ahead. The goal is to reduce teen
deaths on local roads!
About Us
Contact Us
Indiana Young
Driver Statistics
Drive Alive
Dangerous Roads
Media Newsroom
Make a Donation
5-Alive Plan
Talking with
Your Teen
Applying for
Change Bad Habits
Epidemic of Crashes
Raise a Safe
Teen Driver
10 Commandments
Poll/Key Facts
Tips for
safer motorcycling
Be a
Safe Passenger
$3,000 Ticket
Cell Phones
Multiplier Effect
Sleepy? Don't Drive
Most Important Things
children throughout the area return to school,
drives will notice more school buses on the road.
State law requires motorists to stop when a school
bus is picking up or dropping off children. Watch
for school buses with their stop arm extended and
red lights flashing, which means
STOP, not
proceed with caution!
This law applies to
all roadways except those that are divided by a
physical barrier or an unimproved median. On a
divided roadway, only vehicles traveling in the same
direction as the school bus are required to stop.
Extra awareness is also required in rural areas
where distracted or impatient drivers often ignore
school buses when children are getting on or off the
bus. Disregarding a school bus stop signal is
serious, and
you can receive a traffic
ticket for doing so.
Disregarding a school bus stop arm can be
considered reckless driving, a Class B Misdemeanor
which is
punishable by up to 180 days in jail
and a
maximum fine of $1,000.
Drivers should
also be aware of increased pedestrian traffic,
particularly around bus stops and schools. Please
remember, if your child was boarding a school bus,
you would want motorists to be attentive as they
School Zone Speed Limits
Sources: Indiana State Police, Indiana
Department of Transportation
Know road construction and conditions
you depart by visiting
http://www.trafficwise.in.gov/ for
up-to-the-minute traffic information, detours and
road construction BEFORE you leave.
You may also want to check
http//www.weather.com website to find the
weather conditions of the interstates and roads you
will be traveling.
Eyes Forward: Drive Alive
Click here for video


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Harness Accessories
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- Boatswain Chair, Leather/PE/Aluminum/PolyBoatswain Chair
- Item # 31XM20
- Mfr. Model # AAT-BC
Boatswain Chair, Color Black, For Use With Mfr. No. ACT-QCSMG, ACT-QCUG, ACT-QC23XG, ACT-QCBCSMG, ACT-QCBCUG,...More
Price $525.50 / each
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Catalog Page # 2416
Note: Product availability is real-time basis and adjusted continuously. The product will be reserved for you when you complete your order. More


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Daily Sales Up to 70% OFF Limited-time deals start every day at 12 pm ET.
Free Shipping
Product Information:
Accent with function! The traditional look of solid wood blends with the modern look of brushed aluminum in these distinctive coat racks. Features include attractive aluminum accents and eight over-sized ball tipped hooks that will not damage garments, and wide steel base provides stability and style.
Product Details
Special Offer:
12 Issues of Money Magazine
Included with purchase ($20 value).
Additional Documents
Weights & Dimensions
|Frame/Rail Material: Metal; Wood
|Installation Type: Wall mounted
|Umbrella Stand Base: No
|Product Type: Coat Rack
|Hardware Material: Stainless steel
|Wall Art Hooks: No
|Room Use: Foyer; Office
|Mirror Included: No
|Decorative Hooks: No
|Coat Hangers Included: No
|Height Adjustable: No
|Stool / Chair Base: No
|Exterior Shelves: No
|Drawers Included: No
|Legs Included: No
|Total Weight Capacity: 80 Pounds
|Weight Capacity Per Hook: 10 Pounds
|Product Care: Wipe clean with a damp cloth
|Assembly Required: Yes
|Tools Needed: Allen wrench
|Product Warranty: Limited Lifetime Warranty
About the ManufacturerSafco Products Company, a division of Liberty Diversified International, was founded over 40 years ago. Since then, Safco has grown to be a leading provider of organization and comfort enhancing products for the workplace. Their product offering ensures high quality, up market design, at mid-market prices and surrounded by remarkable service.
Today, they are proud to offer over 2,200 premier products that have been designed to fit the needs of individuals and the way they work, while meeting the needs for organization in the workplace, home, school, or where ever they work.
More About This Product
Free Shipping
Ships to:
Ships via: FedEx/UPS
Enter your shipping zip or postal code to calculate shipping estimatesGet Delivery Estimate
We want you to love it. If you don't, you may return your purchase within 30 days of delivery. All you need to do is visit our Self-Service Return Center for instructions. Return credits are issued within 24 hours once the item is received and inspected. Please note that shipping charges are non-refundable. The cost of return shipping will be deducted from your refund. 30-Day Return Policy
Overall Rating
Based on 11 reviews
Customer PhotosAdd your own photo
Really great. anna from Columbia, MO on 10/15/2014 – Verified Buyer– Top 1000 Reviewer
This looks great. Was worried it would be wobbly and not hold up, but it's great.
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Perfect Kristen from Saint Johns, FL on 01/09/2015 – Verified Buyer
We have had this in our office for 6 years and it still looks and functions great!
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Solid Coat Rach BM from Boston, MA on 02/13/2011 – Verified Buyer
I use this product to hang our heavy coats and winter items after coming in from the outside. It is well built and looks nice. My only dislike is the smooth round balls that act as hooks. So smooth, that coats and itmes sometime fall off. Would have been better to add some roughness or tackiness to the hooks.
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Modern & slick CF from Toronto, Ontario on 03/21/2011 – Verified Buyer
This was purchased for an office having modern furniture, dark wood and brushed metal accents. The rich colour and style of this coat rack matches beautifully. Very pleased, and great value.
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Great Product John A. from Rancho Palos Verdes, CA on 01/10/2011
Was very easy to assemble. The fit and finish are excellent. Just enough hooks for holding all my coats and hats. I will be buying another very soon.
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