An intravascular catheter for nerve activity ablation and/or sensing includes one or more needles advanced through supported guide tubes (needle guiding elements) which expand to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the extra-luminal tissue including the media, adventitia and periadvential space. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. Electrodes at the distal ends of the guide tubes allow sensing of nerve activity before and after attempted renal denervation. In a combination embodiment ablative energy or fluid is delivered to ablate nerves outside of the media.

An ablation device includes a first jaw, a second jaw including an ablation unit including a protrusion for ablating a tissue and being rotatable with respect to the first jaw under the first jaw, and a signal unit configured to provide a signal to the tissue and receive a reflected signal and disposed on the second jaw, in which the signal unit moves in a longitudinal direction of the ablation unit, the first jaw does not overlap the signal unit in a vertical direction, and the second jaw overlaps the signal unit in the vertical direction.

Systems and methods for controlled sympathectomy procedures for neuromodulation are disclosed. A system for controlled micro ablation procedures is disclosed. A guidewire including one or more sensors or electrodes for accessing and recording physiologic information from one or more anatomical sites within the parenchyma of an organ as part of a physiologic monitoring session, a diagnostic test, or a neuromodulation procedure is disclosed. A guidewire including one or more sensors and/or a means for energy delivery, for performing a neuromodulation procedure within a small vessel within a body is disclosed.

A catheter device for renal denervation ablation includes a flexible catheter shaft having an electrically insulating expandable member in its distal portion with at least one electrode located proximal to the member, at least one electrode located distal to the member, and with openings in the distal shaft with at least one opening proximal to the proximal electrode and one opening distal to the distal electrode of said electrode pair, said openings connected through an inner lumen in the catheter that provides a path for blood to flow through the expandable member. In one embodiment, the device comprises a flexible catheter shaft with a multiplicity of recessed paired electrodes disposed in recessed spaces in its distal portion, such that an electrically conducting portion of each electrode is exposed to the exterior of the catheter within a recessed space, and with an electrical insulator separating the electrodes of each pair.

Apparatus, systems, and methods of controlling energy delivered to electrodes used in electrically and/or thermally induced neuromodulation are provided to improve neuromodulation. In particular, a catheter treatment device having a control algorithm that regulates current or current density delivered to an electrode is provided. The electrode may maintain a known and consistent electrode contact surface area with the vessel. The control algorithm controls energy delivery to provide consistent current or current density to the treatment site, even though the tissue impedance Z may vary from patient to patient and vessel to vessel, and despite changes in impedance of the treatment, site during the course of the treatment. The controlled delivery of energy can be used to control and maintain placement of the zone of thermal treatment and reduce undesirable energy delivery to unwanted locations near the treatment site.

A catheter system for ablation of tissue around a blood vessel, e.g., the pulmonary artery, to reduce neural activity of nerves surrounding the blood vessel. The catheter system includes an elongate shaft having a proximal portion coupled to a handle, and a distal portion. The distal portion includes a transducer and an expandable anchor, which may be actuated to transition between a collapsed delivery state and an expanded deployed state where the anchor centralizes the transducer within the blood vessel. The transducer may be actuated to emit energy to reduce neural activity of the nerves surrounding the blood vessel. Systems and method are further provided for confirming that neural activity of the nerves surround the blood vessel has been sufficiently reduced.

The invention provides systems and methods providing precision targeting of neural structures for the treatment of a condition while avoiding collateral damage to surrounding structures, such as blood vessels and/or other nerve tissue. The invention further provides systems and methods for treating at least one of rhinitis, congestion, and/or rhinorrhea via thrombus formation. The invention further provides systems and methods for detection, identification, and precision targeting of neural tissue for the treatment of a neurological condition while minimizing or avoiding collateral damage to surrounding or adjacent non-neural tissue, such as blood vessels and bone, as well as non-targeted neural tissue.

Described herein is a method of treating migraines using PFA ablation technology which includes advancing a pulse field ablation delivery member into a nasal cavity (both unilateral and bilateral) of a patient with the pulse field ablation member in a first collapsed configuration and contacting a surface of a nasal cavity tissue with the pulse field ablation delivery member without penetrating or piercing the nasal cavity tissue surface. The treatment further includes reconfiguring the pulse field ablation delivery member from the first collapsed configuration to an expanded configuration after introducing the pulse field ablation member into the desired position within the nasal cavity, and ablating a target treatment site with the pulse field ablation delivery member in order to treat or prevent at least one of the group of medical conditions, wherein the target treatment site includes at least one nasal nerve tissue or nasal blood vessel with or without contact.

A forceps includes a handle, a shaft having a proximal end coupled to the handle, and an end effector assembly coupled to a distal end of the shaft. The forceps includes a first jaw member and a second jaw member for grasping tissue therebetween. One or both of the first and second jaw members may include one or more needles extending therefrom. The one or more needles are in fluid communication with a fluid conduit extending along one or both of the first and second jaw members. The fluid conduit couples to a source of contrast agent to enable selective delivery of the contrast agent through the one or more needles.

A catheter system for treating a treatment site within or adjacent to a vessel wall within a body of a patient includes an energy source, a balloon, and an energy guide. The energy source generates energy. The balloon includes a balloon wall that defines a balloon interior. The balloon is configured to retain a balloon fluid within the balloon interior. The balloon is selectively inflatable with the balloon fluid to expand to an inflated state, wherein when the balloon is in the inflated state the balloon wall is configured to be positioned substantially adjacent to the treatment site. The balloon further includes a balloon central axis that extends through a geometric center of the balloon when the balloon is in the inflated state. The energy guide selectively receives energy from the energy source and guides the energy from the energy source into the balloon interior. The energy guide including a guide distal end that is positioned on the balloon central axis when the balloon is in the inflated state.