Methods, systems, devices, assemblies and apparatuses for treatment of hypertension in a patient using renal denervation. The therapeutic assembly includes an energy delivery element. The energy delivery element is configured to provide renal denervation energy to a nerve within a blood vessel of a patient. The therapeutic assembly includes a controller. The controller is coupled to the energy delivery element. The controller is configured to determine that the hypertension in the patient is orthostatic. The controller is configured to apply renal denervation energy to the patient using the energy delivery element.

A surgical apparatus is disclosed for delivering a therapeutic device to a desired location within the vasculature of a patient, which includes an elongated tubular body defining a longitudinal axis and having opposed proximal and distal end portions, the tubular body including an outer wall surrounding an interior lumen, wherein an elongated target opening is formed through the outer wall of the tubular body within the distal end portion thereof in communication with the interior lumen. At least one distal sensing electrode is provided on the tubular body adjacent a distal side of the target opening, and at least one proximal sensing electrode is provided on the tubular body adjacent a proximal side of the target opening, wherein the sensing electrodes allow placement of the target opening within the vasculature of a patient for the delivery of a therapeutic device to a desired location.

Methods and systems for surfactant enhanced laser-induced vapor bubbles for use in laser lithotripsy. Urinary tract stone disease is a common and costly disease that effects approximately 10% of the United States population. A preferred minimally invasive method for treatment of urinary tract stones is laser lithotripsy, which involves insertion of a flexible ureteroscope through the urinary tract to the stone's location, and then transmission of infrared (IR) laser energy through a flexible optical fiber, which is in turn placed through the single working channel of the ureteroscope. The IR laser energy is used for ablation of the urinary tract stone which is then removed. In order to have a more efficient ablation, the ureteroscope is fed with a surfactant composition which is flowed into the ureter and/or kidney of the subject. The laser causes larger bubbles to form in the surfactant composition, making a robust and longer lasting bubble.

Devices and systems for the selective positioning of an intravascular neuromodulation device are disclosed herein. Such systems can include, for example, an elongated shaft and a therapeutic assembly carried by a distal portion of the elongated shaft. The therapeutic assembly is configured for delivery within a blood vessel. The therapeutic assembly can include a pre-formed shape and can be transformable between a substantially straight delivery configuration; and a treatment configuration having the pre-formed helical shape to position the therapeutic assembly in stable contact with a wall of the body vessel. The therapeutic assembly can also include a mechanical decoupler operably connected to the therapeutic assembly that is configured to absorb at least a portion of a force exerted on the therapeutic assembly by the shaft so that the therapeutic assembly maintains a generally stationary position relative to the target site.

The present disclosed subject matter provides a return electrode, such as a body surface electrode, which includes an accelerometer, for detecting movement of the body at and proximate to the location of the return electrode. The body movement results from pulses from an Irreversible Electroporation (IRE) pulse generator which are delivered to the return electrode, by a pulse delivery electrode. The data associated with the body movement at each location on the body of the return electrode, is used to determine suitable, and in some cases optimal, locations for return electrodes for IRE procedures.

The present technology relates to endoscope devices and methods of use for said endoscope devices. In one embodiment, the device comprises a semicircular aspiration channel with a blocking bar disposed at an outlet of the semicircular aspiration channel to prevent clogging of said channel. The endoscope devices of the present invention may further comprise a plurality of working channels, an image sensor, and a light source. In addition, for work within the ureter, a force sensor is incorporated to ensure safe passage of the largest flexible ureteroscope.

Apparatus comprises: (a) a longitudinal member (32), having a distal portion (34); (b) a plurality of electrodes (38) disposed on the distal portion of the longitudinal member, such that a first electrode (38a) of the plurality of electrodes is disposed distally along the longitudinal member from a second electrode (38b) of the plurality of electrodes; and (c) a controller (40). The controller comprises an actuator, and circuitry (42) electrically connected to the electrodes via the longitudinal member. The actuator is configured to move the longitudinal member in discrete incremental movements such that for each incremental movement, (i) before the incremental movement the first electrode is disposed in a starting position, (ii) during each incremental movement the actuator moves second electrode toward the starting position, and (iii) at the end of each incremental movement the second electrode is stationary at the starting position.

Provided herein are methods, devices and compositions for assessing neuromodulation efficacy based on changes in the level of one or more biomarkers in plasma or urine collected from a human subject following a renal neuromodulation procedure.

The present invention relates to comprehensive systems, devices and methods for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In certain embodiments, systems, devices, and methods are provided for treating a tissue region (e.g., a tumor) through application of energy.

Methods for treating a patient using therapeutic renal neuromodulation and associated devices, system, and methods are disclosed herein. One aspect of the present technology is directed to neuromodulating nerve tissue in selected anatomical regions. In one embodiment, the method can include intravascularly advancing an elongate shaft of a catheter to renal vasculature of a human patient and locating a first neuromodulation element of the catheter within a distalmost portion of a main renal artery. The method includes locating a second neuromodulation element of the catheter within a branch vessel of the renal artery distal to a bifurcation at a distal end of the main renal artery. Neuromodulation of the nerve tissue surrounding the selected anatomical treatment locations can inhibit sympathetic neural activity in nerves proximate a portion of a renal artery and/or a renal branch artery proximate a renal parenchyma.