Provided are devices, systems, and methods for treating or preventing heart failure or a symptom of heart failure through coordinated nerve activity interruption for one or more target nerves. Devices disclosed herein may comprise a vascular catheter comprising a telescopic needle assembly configured to puncture vascular tissue in contact with the catheter, wherein the needle assembly comprises one or more electrodes configured to deliver electrical energy to a tissue in contact with the one or more electrodes. Methods may include treating or preventing heart failure or a symptom of heart failure by inserting a catheter into a vascular tissue of the subject; guiding the catheter towards the greater splanchnic nerve; piercing the vascular tissue of the subject with a telescopic needle assembly extending outwards from the catheter towards the target nerve; and ablating the target nerve by delivering a stimulation energy to the target nerve with one or more electrodes.

One embodiment provides a tightly targeted minimally invasive therapy (TTMIT) parathyroid tissue ablating instrument. A substance that cytotoxically ablates parathyroidal tissue during application in the parathyroidal tissue of therapeutically sufficient units of an electromagnetic energy having a frequency only ranging from ultraviolet to visible to near infrared. A substance delivery device is configured to introduce the substance into the parathyroidal tissue. An electromagnetic energy treatment device is configured to apply the therapeutically sufficient units of the electromagnetic energy within a thermal range that is non-cytotoxic to the parathyroidal tissue to the substance after the substance has been introduced by the substance delivery device. A sensor is configured to monitor activation of the substance as the therapeutically sufficient units of the electromagnetic energy are applied. The electromagnetic energy treatment device is further configured to modulate applying the therapeutically sufficient units of the electromagnetic energy once the substance has been activated.

A device for cold plasma endoscopy may include a cold plasma generating system, a catheter and electrically conductive means. The cold plasma generating system includes a gas source, an electrical source, a dielectric chamber, a first electrode surrounding the dielectric chamber and electrically connected to the electrical source. The catheter has a first lumen for carrying the cold plasma fluidly connected to the dielectric chamber at a proximal end and having an opening at a distal end for delivering the cold plasma. The electrically conductive means extend inside the first lumen. The electrical source is configured to apply a pulsed excitation signal to the first electrode. The device includes remotely actuated deployable confinement means for creating a confined space, wherein the opening of the first lumen is arranged in the confined space, the deployable confinement means allowing for confining the plasma substantially within the confined space.

An intravascular catheter for peri-vascular and/or peri-urethral tissue ablation includes multiple needles advanced through supported guide tubes which expand around a central axis to engage the interior surface of the wall of the renal artery or other vessel of a human body allowing the injection an ablative fluid for ablating tissue, and/or nerve fibers in the outer layer or deep to the outer layer of the vessel, or in prostatic tissue. The system may also include a means to limit and/or adjust the depth of penetration of the ablative fluid into and beyond the tissue of the vessel wall. The catheter may also include structures which provide radial and/or lateral support to the guide tubes so that the guide tubes expand uniformly and maintain their position against the interior surface of the vessel wall as the sharpened injection needles are advanced to penetrate into the vessel wall.

An incision instrument includes an insertion section and a manipulation section. The insertion section includes a first insulating member and an incision section inserted within the first insulating member. The incision section includes a tubular shaped first conductive member which has conductivity; a second conductive member disposed in the first conductive member; a contact section provided on an outer circumference surface of the second conductive member; and a second insulating member fixed to a distal end of the first conductive member and having an opening section. The manipulation section includes a manipulation main body section and a handle member. The second insulating member is positioned between the contact section and the first conductive section in a state in which the second conductive member is protruded from the opening section of the second insulating member.

Targeted ablation of parathyroidal tissue is provided through hyperthermia adjuvant therapy. An in situ localization of parathyroidal tissue is obtained. A temperature-sensitive adjuvant is instilled into the parathyroidal tissue. Hyperthermia is therapeutically induced within the parathyroidal tissue. Heat-inducing energy is targeted into the parathyroidal tissue, which selectively includes the temperature-sensitive adjuvant. Application of the heat-inducing energy to the parathyroidal tissue is continued over a therapeutic range. In a further embodiment, the targeted ablation of the parathyroidal tissue is provided through hypothermia adjuvant therapy with the targeted use of cold-inducing energy.

A dilation assembly comprises an expandable and contractible main body having a corrugated outer surface, a guide cannula configured to be disposed through the main body to guide a movement of the main body, and an anchor configured to fix the main body in a target position.

Systems for nerve and tissue modulation are disclosed. An illustrative system may include an intravascular nerve modulation system including a catheter shaft, a first flexible mount, and a cylindrical ablation transducer. The ablation transducer may be affixed to the catheter shaft through the flexible mount to allow an infusion fluid to pass through a lumen of the transducer. Another illustrative system may include an intravascular nerve modulation system including an expandable basket for centering an ablation tra7nsducer within a lumen.

A vapor delivery system and method is provided that is adapted for ablating bladder tissue to treat overactive bladder (OAB). The vapor delivery system includes an anchor tip configured anchor the system in the bladder while condensable vapor is delivered to target tissue. In one method, the vapor delivery system is advanced transurethrally into the patient to access the target tissue of the bladder, which can include a surface sensor of the bladder responsible for creating an urge incontinence sensation. The vapor delivery system includes a vapor source that provides a high quality vapor for delivery to tissue.

A system for ablating internal heart tissue in an ablation pattern on a surface of the tissue within the heart. The system includes an ablation catheter with a distal end having an ablating tip portion operative to allow selective ablation of tissue. A guiding device is engageable with the ablation catheter and includes a tissue anchoring portion operable to engage with tissue proximate to the tissue to be ablated so as to temporarily anchor the guiding device relative to the tissue. Engagement of the guiding device with the ablation catheter operates to assist with guiding the ablating tip portion in moving along the pattern. Various devices and methods of use are further disclosed.