A medical delivery system can comprise a balloon catheter and an inflatable balloon associated with a portion of the balloon catheter. The inflatable balloon can comprise a balloon wall at least partially defining an inflated volume of the inflatable balloon, the balloon wall comprising a first balloon wall layer and a second balloon wall layer. The first balloon wall layer can have a Shore A durometer hardness value smaller than that of the second balloon wall layer, and the first balloon wall layer being an inner layer of the balloon wall relative to the second balloon wall layer.

A device and method for intravascular treatment of atherosclerotic plaque prior to balloon angioplasty which microperforates the plaque with small sharp spikes acting as serrations for forming cleavage lines or planes in the plaque. The spikes may also be used to transport medication into the plaque. The plaque preparation treatment enables subsequent angioplasty to be performed at low balloon pressures of about 4 atmospheres or less, reduces dissections, and avoids injury to the arterial wall. The subsequent angioplasty may be performed with a drug-eluting balloon (DEB) or drug-coated balloon (DCB). The pre-angioplasty perforation procedure enables more drug to be absorbed during DEB or DCB angioplasty, and makes the need for a stent less likely. Alternatively, any local incidence of plaque dissection after balloon angioplasty may be treated by applying a thin, ring-shaped tack at the dissection site only, rather than applying a stent over the overall plaque site.

A system for treatment target tissue comprises an ablation device and an energy delivery unit. The ablation device comprises an elongate tube with an expandable treatment element. The system delivers a thermal dose of energy to treat the target tissue. Methods of treating target tissue are also provided.

A catheter 100 is comprised of a shaft 120 having a distal end and a proximal end, the distal end being the end an end of the catheter 100 to be placed within the bladder 105, the proximal end being the end of the catheter 100 to be coupled to the inputs outside of the body, the shaft 120 having at least three discrete lumens, the at least three lumens including an inflation lumen 124, the inflation lumen 124 in fluid communication with an inflation side hole 130 in the shaft 120. The shaft has a drug delivery lumen 122, the drug delivery lumen 122 in fluid communication with a drug fluid side hole 128 in the shaft 120. The shaft has a bladder fluid lumen 126, the bladder fluid lumen 126 in fluid communication with a bladder drainage aperture 132 in the shaft 120, wherein distally refers to a distal reference direction 101 towards the elements to be placed in the bladder, and proximally refers to a proximal reference direction 103 towards inputs that remain outside of the body, wherein drug delivery lumen 122, the inflation lumen 124, and the bladder fluid lumen 126 are not in fluid communication.

The present invention provides methods and devices for controlling a cold slurry that is delivered to a target tissue and for limiting heat transferring from surrounding tissue to the target tissue. In particular, a balloon structure is deployed at or near a point of delivery to act as a physical and/or thermal barrier. In some instances, the balloon structure can act as a pressure device obstructing the flow of warm blood into a treatment area, which can melt the cold slurry.

The present invention provides methods and devices for making a cold slurry at a point of delivery. A point of delivery device delivers cold slurry components to a location at or near a target tissue. The components are combined to form the cold slurry at or near the point of delivery. This approach to generating a cold slurry at the point of delivery allows the characteristics of the cold slurry, such as temperature, particle shape and particle size, to be maintained and controlled.

A drug delivery catheter includes a first axially extending elongate member, a second axially extending elongate member, and a main chamber wall. The inner surface of the main chamber wall defines a main chamber. The distal end of the main chamber wall is joined to the distal end of the second axially extending elongate member and the proximal end of the main chamber wall is joined to the distal end of the first axially extending elongate member such that the main chamber is disposed over a distal portion of at least the second elongate member. One or more shockwave-generating elements are disposed within the main chamber. The main chamber is in fluid communication with the lumen of the first elongate member. The drug delivery catheter is configured to deliver an active agent to a target site through the lumen of the first elongate member.

Methods and apparatus are provided to facilitate the minimally invasive removal of tissue biopsies and to facilitate the direct approach to anesthetizing the chest wall, in accordance with embodiments of the present invention. A pull-type cutting device 1 comprises two coaxially nested tubes, each extending from a proximal end 21 to a distal end 22. The first tube 61 defines a guide wire lumen 23 for slidingly receiving a guide wire. The second tube 63 extends over the first tube 60 and coupled thereto at the distal end 22 defining an expandable portion 13 adjacent the distal end 22. The second tube 63 defines an inflation lumen 25 extending from the shaft proximal end 21 to the expandable portion 13. The inflation lumen 25 communicates inflation fluid from the proximal end 21 to the expandable portion 13 so as to inflate and deploy the expandable portion 13. Disposed adjacent the shaft distal end 22 is a cutting head 10 comprising the expandable portion 13 having a cutting portion 11 distal from the shaft distal end 22.

A percutaneous transluminal angioplasty (PTA) catheter may be configured to perform vein expansion and occlusion. A infusion port located proximal to the occlusion feature can be used to inject contrast enhancement agent as well as other substances. The catheter can be used especially advantageously in vascular regions associated with hemodialysis access.

An irrigation balloon catheter includes one or more inner balloons inside of an irrigation balloon. The inner balloon(s) can be compliant with a volume that is dynamically adjustable for rapid inflation, rapid deflation, complete deflation, and/or irrigation flow adjustment.