A medical laser system for outputting laser pulses includes at least one laser cavity configured to generate at least one laser pulse, a rotating mirror configured to receive and reflect the at least one laser pulse, a beam splitter configured to receive and reflect a portion of the at least one laser pulse received from the rotating mirror, an energy-sensing device configured to detect the portion of the at least one laser pulse, an energy measurement assembly configured to generate a feedback signal based on the portion of the at least one laser pulse detected by the energy-sensing device, and a controller configured to generate an electronic control pulse based on the feedback signal received from the energy measurement assembly to generate at least one adjusted laser pulse.

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.

A medical laser system for outputting laser pulses includes at least one laser cavity configured to generate at least one laser pulse, a rotating mirror configured to receive and reflect the at least one laser pulse, a beam splitter configured to receive and reflect a portion of the at least one laser pulse received from the rotating mirror, an energy-sensing device configured to detect the portion of the at least one laser pulse, an energy measurement assembly configured to generate a measurement signal based on the portion of the at least one laser pulse detected by the energy-sensing device, and a controller. The controller may include a calibration module. The calibration module may be configured to generate at least one categorized calibration table, determine calibration parameters, interpolate the calibration parameters, and cause the at least one laser cavity to generate at least one calibrated laser pulse.

A medical laser system for outputting laser pulses includes at least one laser cavity, a rotating mirror, a user interface, and a controller. The controller is configured to receive at least one laser parameter associated with a laser pulse output by the system. The controller is configured to determine an average power level of the laser pulse based on the at least one laser parameter associated with the laser pulse. The controller is configured to determine a pulse width modulation (PWM) control signal based on at least one laser parameter. The controller is configured to generate the laser pulse based on the average power level and the PWM control signal, the laser pulse comprising at least one of a first shape, a second shape, or a third shape. Each of the first shape, the second shape, and the third shape of the laser pulse includes different pulse widths.

Apparatus for the treatment of a target tissue with a laser beam in which the target tissue is immersed in a liquid medium within a body lumen. The laser device is configured to provide one or more laser pulses which are configured by a controller to have an energy sufficient to form one or more vapor bubbles in the liquid medium at the distal delivery end of the fiber. The one or more pulses are configured by the controller to: first, cause a vapor bubble to be formed distally of the distal end portion of the endoscope and around the distal delivery end of the optical fiber; second, cause a second bubble to be formed distally of the first bubble; and, third, inflate the second bubble as the first bubble has begun to collapse to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the distal delivery end of the fiber and the target tissue.

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 method and apparatus that utilizes a force-time integral for real time estimation of steam pop in catheter-based ablation systems. The apparatus measures the force exerted by a contact ablation probe on a target tissue and an energization parameter delivered to the ablation probe. The exerted force and energization parameter can be utilized to provide an estimation of the probability of steam pop. In one embodiment, the force and energization metrics can be used as feedback to establish a desired contact force and energization level combination to prevent steam popping.

A method for controlling an operation of an ultrasonic blade of an ultrasonic electromechanical system is disclosed. The method includes providing an ultrasonic electromechanical system comprising an ultrasonic transducer coupled to an ultrasonic blade via an ultrasonic waveguide; applying, by an energy source, a power level to the ultrasonic transducer; determining, by a control circuit coupled to a memory, a mechanical property of the ultrasonic electromechanical system; comparing, by the control circuit, the mechanical property with a reference mechanical property stored in the memory; and adjusting, by the control circuit, the power level applied to the ultrasonic transducer based on the comparison of the mechanical property with the reference mechanical property.

A catheter ablation system includes: a catheter probe having distal end including: a temperature sensor; a plurality of irrigation holes; and an ablating electrode; a radiofrequency (RF) heating controller coupled to the catheter probe and configured to supply RF energy to the ablating electrode to control the ablating electrode to emit heat at a target power; an irrigation controller coupled to the catheter probe and configured to supply an irrigation fluid at a continuously adjustable irrigation flow rate through the catheter probe to exit through the irrigation holes; and an operating console having a processor and memory, the memory storing instructions that, when executed by the processor, cause the processor to control the irrigation controller to set the irrigation flow rate based on the target power and a target average temperature.

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.