A medical device may include an elongated body, a balloon positioned at a distal portion of the elongated body, and one or more pressure-wave emitters positioned along a central longitudinal axis of the elongated body within the balloon. The one or more pressure-wave emitters may be configured to propagate pressure waves radially outward through the fluid to fragment a calcified lesion at the target treatment site. The at least one of the one or more pressure-wave emitters may include an electronic emitter comprising a first electrode and a second electrode. The first electrode and the second electrode may be arranged to define a spark gap between the first electrode and the second electrode, and the second electrode may comprise a portion of a hypotube.

A thermal accelerant can be used as a drug delivery vehicle to deliver one or more drugs to a target site. For example, in some embodiments, a carrier such as albumin or human serum albumin (HSA) can be impregnated with, or covalently attached to, an anti-tumor agent and delivered to a location proximate to a tumor of a patient. The carrier can be exposed to an energy source that structurally alters the carrier and releases the agent therefrom. The sources of energy can include one or more of microwave, radiofrequency, electrical pulse (electroporation) or sonar (HIFU or histotripsy). In some embodiments, the anti-tumor agent can be delayed release such that a portion of the agent is released from the carrier over an extended period of time. The incorporation of an anti-tumor agent in a thermal accelerant provides a thermal ablation-drug delivery combination therapy (e.g., a thermally-activated combination therapy).

The disclosure provides various embodiments of systems to facilitate the cutting of luminal tissue structures percutaneously.

A medical device including an elongate body having a proximal portion and a distal portion. A plurality of active electrodes is coupled to the distal portion of the elongate body and being configured to electrically couple to a source of pulsed electric field energy. At least one passive electrode is coupled to the elongate body and is not configured to electrically couple to the source of pulsed electric field energy, the at least one passive electrode being configured to passively extend or focus an electric field generated by the plurality of active electrodes.

Various aspects of the present disclosure provide a medical device. The medical device includes a substrate. The medical device further includes a substantially transparent or translucent anti-stick coating disposed on a surface of the substrate. The anti-stick coating includes one or more fluorophores internally distributed in the anti-stick coating.

Systems, devices and methods of determining orientation of a distal end of a medical instrument (e.g., electrode-tissue orientation of an RF ablation catheter) are described herein. One or more processors may be configured to receive temperature measurements from each of a plurality of temperature-measurement devices distributed along a length of the distal end of the medical instrument and determine the orientation from a group of two or more possible orientation options based on whether temperature measurement values or characteristics of temperature response determined from the temperature measurement values satisfy one or more orientation criteria.

An end effector assembly for use with an electrosurgical instrument is provided. The electrosurgical instrument includes a handle having a shaft that extends therefrom, an end effector disposed at a distal end of the shaft, at least one electrode operably coupled to the end effector and adapted to couple to a source of electrosurgical energy, a titanium nitride coating covering at least a portion of the electrode, a chromium nitride coating covering at least a portion of the electrode and/or titanium nitride coating, and a hexamethyldisiloxane plasma coating covering at least a portion of the chromium nitride coating.

Described embodiments include an apparatus that includes an electrically-conductive layer, including a first face and a second face that are opposite one another, a first electrically-insulative layer that is shaped to define a plurality of apertures and that covers the first face without covering portions of the first face that are aligned with the apertures, and a second electrically-insulative layer that covers the second face. Other embodiments are also described.

An electrosurgical system includes an electrosurgical instrument having an electrode with a polymeric dielectric coating; and an electrosurgical generator, which includes a power converter configured to generate RF energy; a sensor coupled to the power converter and configured to sense a parameter of the RF energy; and a controller coupled to the sensor and the power converter. The controller is configured to control the power converter to output an RF waveform to achieve conductor breakthrough through the polymeric dielectric coating. The controller is further configured to determine whether the conductor breakthrough occurred based on the parameter; and execute a treatment algorithm based on a determination of the conductor breakthrough.

A surgical instrument comprising a shaft and an end effector is disclosed. The end effector is releasably attachable to the shaft by a lock biased into a locked condition to hold the end effector to the shaft.