A system is provided for stimulating renal nerves. The system includes an interstitial device to provide stimulation and denervation of the renal nerves from outside the renal artery. The interstitial device extends through non-vascular tissue and into a periarterial space. The system also includes a control unit in communication with the interstitial device, configured to: obtain, from a sensor, first information pertaining to a blood pressure or heart rate; stimulate, using one or more electrodes of the interstitial device, renal sympathetic nerves associated with the renal artery; and obtain, from the sensor, second information pertaining to the blood pressure or heart rate of the subject. Based on a difference between the first information and the second information, the control unit determines whether the subject is suitable for a sympathetic denervation procedure and causes the interstitial device to perform the sympathetic denervation procedure if the subject is suitable.

Methods for treating a patient using therapeutic renal neuromodulation and associated devices, systems, and methods are disclosed herein. One aspect of the present technology, for example, is directed to a catheter apparatus including an elongated shaft defined by a braid embedded within a polymer. The braid can include one or more thermocouple assemblies intertwined with a braiding element. The thermocouple assemblies can be coupled to one or more electrodes at a distal portion of the shaft.

An endoscope includes: an insertion portion formed along a longitudinal axis extending from a proximal end to a distal end; a light guide having an optical characteristic that enables transmitting lithotriptic light and illuminating light having respective wavelength bands that are different from each other, from the proximal end toward the distal end of the insertion portion; and a treatment instrument insertion channel provided in the insertion portion, the treatment instrument insertion channel extending from the proximal end to the distal end.

Disclosed are systems and methods for determining target characteristics during a laser procedure, comprising (i) obtaining a relationship between (i) a number of pixels associated with a light beam reflected from a target or an object located in proximity to the target on an endoscopic image obtained from a video sensor coupled to an endoscope and (ii) a distance of the target from a tip of the endoscope. The method further comprising (ii) measuring the number of pixels associated with the light beam reflected from the target or the object located in proximity to the target during a procedure, and (iii) based at least in part on the relationship obtained in step (i) and the measured number of pixels in step (ii), determining at least one of a size of the target or a distance of the target from the tip of the endoscope.

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.

Systems, devices, and methods for delivering laser energy to a target in an endoscopic procedure are disclosed. An exemplary method comprises providing a first laser pulse train and a different second laser pulse train emitting from a distal end of an endoscope and incident on a target. The first laser pulse train has a first laser energy level, and the second laser pulse train has a second laser energy level higher than the first laser energy level. In an example, the first laser pulse train is used to form cracks on a surface of a calculi structure, and the second laser pulse train causes fragmentation of the calculi structure after the cracks are formed.

An intraluminal microneurography probe has a probe body configured to be introduced into an artery near an organ of a body without preventing the flow of blood through the artery. An expandable sense electrode and an expandable stimulation electrode are fixed to the probe body at one end of each electrode such that movement of the other end toward the fixed end causes the sense electrode to expand from the probe body toward a wall of the artery. A ground electrode is configured to couple to the body, and a plurality of electrical connections are operable to electrically couple the electrodes to electrical circuitry. The sense electrode is operable to measure sympathetic nerve activity in response to excitation of the stimulation electrode. A radio frequency ablation element is located between the expandable sense electrode and expandable stimulation electrode, and is operable to ablate nerves proximate to the artery.

Disclosed herein is a system for ablating and characterizing tissue. The system comprises an ablation element configured to emit ablative energy toward a tissue of interest, an imaging apparatus configured to emit energy and collect imaging data including reflected signals from the tissue of interest, and a characterization application. The characterization application comprises a signal analyzer for analyzing the imaging data and determining one or more signal properties from the reflected signals, and a correlation processor configured to associate the one or more signal properties to pre-determined tissue signal properties of different tissue components through a pattern recognition technique. The pre-determined tissue signal properties are embodied in a database, and the correlation processor is configured to identify a tissue component and an ablation level of the tissue of interest based on the pattern recognition technique.

Systems and methods for tumor ablation with controlled precision of a temperature profile utilizing a tumor ablation probe device may include disposing a distal end of the tumor ablation probe device in a tissue, the distal end including a plurality of electrothermal modules (ETMs) on probe arm(s), each ETM including a first surface component electrically connected to a second surface component; supplying a first voltage of a first polarity or a second voltage of a second polarity to at least one ETM, and repeatedly alternating between the first polarity and the second polarity based on a time sequence cycle. When the first polarity is supplied, the ETM heats the first surface component and cools the second surface component, and when the second polarity is supplied, the ETM cools the first surface component and heats the second surface component. Each ETM and/or probe arm is configured for independent control.

The present disclosure provides catheter systems, electrode assemblies, and methods for electrically stimulating one or more points about the circumference of the renal artery to provide real time intraprocedural operational feedback to the operator of a renal denervation procedure to allow for more precise and thorough ablation of the renal artery and better patient outcomes. In many embodiments, an electrode assembly is provided that includes multiple splines that extend from an insulated proximal hub to an insulated distal hub and are interconnected to an electrical wire to allow the splines to independently function as electrical stimulation electrodes. The electrically active splines can then be energized at one or more desired points during a renal denervation procedure to provide operational feedback.