A method for using an endoluminal device to modify an intravascular lesion includes providing an ultrasound-producing mechanism that converts an electric current into vibrational energy at an ultrasonic frequency; providing a sheath including a sheath lumen, wherein the sheath is configured to retract from a first, fully extended position of the sheath and extend from a second, fully retracted position of the sheath; providing a core wire disposed within the sheath lumen of the sheath, the core wire being coupled to the ultrasound-producing mechanism via a sonic connector, the core wire being excited by the vibrational energy at the ultrasonic frequency when the ultrasound-producing mechanism is activated; and retracting the sheath relative to the core wire to expose a working length of a distal portion of the core wire for ultrasound-based modification of one or more intravascular lesions.

The invention provides a system for treating an occlusion within a body lumen. The system may comprise an insulated outer sheath; an elongated conductive tube, wherein the insulated outer sheath is circumferentially mounted around the elongated conductive tube; and an insulated wire having a helically coiled portion at a distal end of the insulated wire. The coiled portion includes an exposed distal tip, and a distal portion of the elongated conductive tube is circumferentially mounted around the distal coiled portion of the insulated wire. When a voltage is applied across the insulated wire and the elongated conductive tube, a current is configured to flow from the exposed distal tip of the insulated wire to the elongated conductive tube to generate a plurality of cavitation bubbles. In an alternate embodiment, an elongated central electrode is used in place of the conductive tube.

A surgical apparatus for treating a blood clot in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the blood clot. An energy emitter emits energy to the blood clot or hardenings and a connector connects the energy emitter to an external energy source, wherein blood flows into the second hole positioned proximal of the blood clot and exits the first hole distal of the blood clot during activation of the energy emitter. In some instances when the apparatus is introduced from a retrograde ‘upstream” approach blood may flow through the device in the opposite direction.

A surgical apparatus for treating a vessel blockage in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the vessel blockage. A motor driven impeller is rotatable during blood flow through the first lumen to enhance blood flow as blood flows into the second hole positioned proximal of the vessel blockage and exits the first hole distal of the vessel blockage during injection of fluid through one or more openings to treat the vessel blockage.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises an elongate endovascular element such as a wire. The element has a proximal section, a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections. The apparatus comprises an ultrasonic transducer, mechanically coupled to the proximal section of the element for ultrasonically activating the element, hence exciting the distal tip section to facilitate crossing through the obstruction. A catheter surrounds the element, leaving at least part of the distal tip section of the element protruding distally beyond a distal end of the catheter.

An adjustable interface device for connecting two components of a medical device includes an elongate body and an elongate member. The elongate body has a first end, a second end, an interior channel, and a side wall that surrounds the interior channel. The side wall defines a first connector portion adjacent the second end. The first connector portion attaches to a respective one of the components of the medical device. The elongate member has a head end portion and a shaft portion that longitudinally extends from the head end portion. The shaft portion is located at least partially in the interior channel of the elongate body. The shaft portion is configured to slidably move axially along the longitudinal axis to adjust a length of the adjustable interface device. The head end portion defines a second connector portion that attaches to another of the components of the medical device.

An endoscope surgery device includes a vibration unit and a surgery unit. The vibration unit generates a vibration. The surgery unit includes a sheath and a surgery member. The sheath has a tube shape with a hollow extended in a longitudinal direction, and is entirely vibrated due to the vibration from the vibration unit with inserted into the ureter. The surgery unit passes through the hollow of the sheath, and is extended to an end of the sheath for an surgical procedures on the ureter.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises: an elongate endovascular element such as a wire; an ultrasonic transducer, mechanically coupled to the endovascular element for ultrasonically exciting a distal tip portion thereof to facilitate the crossing through the obstruction, and one or more damping features, mechanically coupled to the endovascular element to attenuate lateral displacement of the endovascular element at positions away from the distal tip portion.

A catheter that fits within a blood vessel wall includes electrodes aligned along a longitudinal axis of the catheter that produce unfocused shock waves that propagate radially toward the blood vessel wall for treatment.

A system for removing occlusive clot from a blood vessel comprises a catheter and an apparatus for generating a pulsatile vacuum force to pulse the pressure gradient at a distal end of the catheter. The pulse generator may be integral with or separate from the vacuum pump. The pulse generator may be applied to a flexible tubing between the vacuum pump and the proximal end of the catheter.