Apparatus, systems, and methods provide access to the renal pelvis of a kidney to treat renal nerves embedded in tissue surrounding the renal pelvis. Access to the renal pelvis may be via the urinary tract or via minimally invasive incisions through the abdomen and kidney tissue. Treatment is effected by exchanging energy, typically delivering heat or extracting heat through a wall of the renal pelvis, or by delivering active substances.

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.

The present disclosure relates to a method and a device for treating heart failure by normalizing elevated blood pressure in the left and right atria of a heart of a mammal. The present disclosure includes methods for creating and maintaining an opening in the atrial septum. Tools for making an opening and enlarging the opening are also disclosed. Use of the techniques and tools described herein prolongs the patency of an intra-atrial pressure relief opening.

Devices and methods for monitoring the temperature of tissue at various locations in a treatment volume during fluid enhanced ablation therapy are provided. In one embodiment, an ablation device is provided having an elongate body, at least one ablation element, and at least one temperature sensor. The elongate body includes a proximal and distal end, an inner lumen, and at least one outlet port to allow fluid to be delivered to tissue surrounding the elongate body. The at least one ablation element is configured to heat tissue surrounding the at least one ablation element. The at least one temperature sensor can be positioned a distance away from the at least one ablation element and can be effective to output a measured temperature of tissue spaced a distance apart from the at least one ablation element such that the measured temperature indicates whether tissue is being heating to a therapeutic level.

A base member includes: a base member having a longitudinal direction; a first linear member extending in the longitudinal direction; and a second linear member extending in the longitudinal direction. The first linear member is fixed to the base member at a first position, and is movable with respect to the base member in the longitudinal direction, on one side of the first position in the longitudinal direction. The second linear member is fixed to the base member at a second position, and is movable with respect to the base member in the longitudinal direction, on the one side of the second position in the longitudinal direction. The base member is capable of detecting curvature of the base member between the first position and the second fixed position based on change in a relative position between the first linear member and the second linear member.

A balloon catheter includes: a balloon; an outside shaft connected to a proximal end of the balloon; an inside shaft extending inside the outside shaft and into the balloon to be connected to a distal end of the balloon; and a heating member disposed in the balloon for heating a liquid in the balloon. A distance between a distal end of the outside shaft and a proximal end of the heating member is 0 mm to 5 mm.

An in vivo potential measurement device includes an insulating member and an amplifier. The insulating member has an electrode. The insulating member is inserted into an organ of a living body such that an outer peripheral face of the insulating member contacts with an inner wall face of the organ at a contact site. The electrode senses electric potential at the contact site. The amplifier amplifies the electric potential to obtain output voltage. The amplifier has input capacitance Cin and input resistance Rin that satisfy Cin/Ce>0.1 and 1/(2πfCeRin)>0.1, where Ce represents capacitance of the insulating member at the contact site, and f represents frequency of the electric potential at the contact site on the inner wall face. A contact state between the outer peripheral face and the inner wall face is evaluated using the output voltage.

It is possible to highly precisely determine a surface temperature of a balloon. A balloon catheter includes: a balloon; an outer cylinder shaft connected to a proximal end of the balloon; an inner cylinder shaft passing through the outer cylinder shaft to extend into the balloon to be connected to a distal end of the balloon; and a heating component disposed in the balloon for heating a liquid in the balloon. A liquid delivery path in communication with the balloon is formed between the outer cylinder shaft and the inner cylinder shaft. A temperature sensor is disposed in the liquid delivery path.

Prostate treatment using fluid stream to resect prostate tissue, thereby relieving symptoms of conditions such as BPH, prostatitis, and prostatic carcinoma. A device having a fluid delivery element is positioned within a lumen of the urethra within the prostate. A fluid stream is directed outwardly from the fluid delivery element toward a wall of the urethral lumen. The fluid delivery element is moved to scan the fluid stream over the wall to remove a volume of tissue surrounding the lumen. The fluid may be combined with therapeutically active substances or with substances that increase resection efficiency. Fluid force may be adjusted to provide selective tissue resection such that soft tissue is removed while harder tissue is left undamaged. In order to gain a working space within the urethra, another fluid may be introduced to insufflate the urethra in the region of treatment.

A system to treat a patient comprises a user interface that allows a physician to view an image of tissue to be treated in order to develop a treatment plan to resect tissue with a predefined removal profile. The image may comprise a plurality of images, and the planned treatment is shown on the images. The treatment probe may comprise an anchor, and the image shown on the screen may have a reference image marker shown on the screen corresponding to the anchor. The planned tissue removal profile can be displayed and scaled to the image of the target tissue of an organ such as the prostate, and the physician can adjust the treatment profile based on the scaled images to provide a treatment profile in three dimensions. The images shown on the display may comprise segmented images of the patient with treatment plan overlaid on the images.