A method of two-phase atherectomy for removal of plaque within an artery forming a stenosis including a first phase of rotational drilling by exerting a rotational force on a cutter to form a channel within the plaque having a diameter substantially equal to a diameter of the cutterthe cutter being rotated at a first rotational speed sufficient to maintain rotation of the cutter about a stationary rotational axisand a second phase of orbital impact by exerting a rotational force on the cutter to result in radial orbital motion of the cutter within the channel resulting in periodic impact of the cutter upon the plaque to form micro-fractures within the plaque and enlarge the diameter of the channel to a diameter substantially greater than the diameter of the cutterthe cutter being rotated at a second rotational speed to result in the radial orbital motion of the cutter.

A method and delivery system are disclosed for creating an aqueous flow pathway in the trabecular meshwork, juxtacanalicular trabecular meshwork and Schlemm's canal of an eye for reducing elevated intraocular pressure. Pulsed laser radiation is delivered from the distal end of a fiber-optic probe sufficient to cause photoablation of selected portions of the trabecular meshwork, the juxtacanalicular trabecular meshwork and an inner wall of Schlemm's canal in the target site. The fiber-optic probe may be advanced so as to create an aperture in the inner wall of Schlemm's canal in which fluid from the anterior chamber of the eye flows. The method and delivery system may further be used on any tissue types in the body.

A device for exchanging heat with a subject having skin is provided. The device includes a heat exchanging member having a heat transfer surface configured to form a heat conducting interface with the subject's skin. The device further includes a substantially flexible sensing device disposed in the interface between the heat exchanging member and the subject's skin. The sensing device is configured to measure a parameter of the interface without substantially impeding heat transfer between the heat exchanging member and the subject's skin.

Systems and methods for delivering energy to passageways in a patient, such as airways in the lung of a patient for treating asthma. One embodiment of a method for delivering energy to a passageway comprises positioning an access device in a lung airway of a patient and advancing an elongated body of a treatment device along the access device until an energy delivery unit at a distal portion of the elongated body projects from the access device. The method can further include expanding the energy delivery unit such that energy delivery elements contact a sidewall of the airway and activating an energy supply coupled to the treatment device such that energy is delivered to the sidewall of the airway. A single person physically operates both the access device and the treatment device while expanding the energy delivery unit and activating the energy supply.

An embodiment includes a system comprising: a catheter; an optic fiber having a long axis and a short axis that is orthogonal to the long axis; first and second radiopaque elements coupled to the optic fiber; a first wire coupled to the optic fiber and extending from the first radiopaque element to the second radiopaque element; a fluid; wherein (a)(i) the first wire wraps at least partially around an exterior surface of the optic fiber; (a)(ii) an outer diameter of the first wire and an outer diameter of the optic fiber are collectively less than an inner diameter of the catheter, and (a)(iii) the first wire is configured to center the optic fiber within the catheter within a plane orthogonal to the long axis.

An ultrasonic surgical instrument includes a cooling system having a blade conduit disposed within the blade and a cooling fluid. The cooling fluid configured to absorb heat from the blade as the cooling fluid flows through the blade conduit. A surgical system having an ultrasonic surgical instrument and a cooling system is also disclosed. The cooling system can include a fluid control system that automatically pumps a cooling fluid through a blade conduit disposed within the blade of the surgical instrument based on feedback received from sensors.

In one embodiment of the present invention, an ultrasound catheter system comprising a catheter having at least one ultrasonic element; and a control system configured to generate power parameters to drive the ultrasonic element to generate ultrasonic energy is provided. The control system is configured to provide an ultrasonic pulse with a high pressure gradient with respect to time and/or distance. In another embodiment, a method of enhancing delivery of a therapeutic compound comprising delivering the therapeutic compound to a treatment site in a patient; and exposing the treatment site to an ultrasonic energy generated by an oscillating electrical signal pattern having a rise or fall rate greater than an sinusoidal pattern for the same amplitude and frequency is provided.

An ultrasonic surgical instrument includes a waveguide defining a blade at a distal end thereof and a lumen extending through a portion of the blade. The blade is configured to receive ultrasonic energy for treating tissue. The instrument further includes first and second conduits each defining a proximal end and a distal end. The second conduit is coaxially disposed about the first conduit. The distal ends of the first and second conduits extend into the lumen. The distal end of the first conduit extends further distally into the lumen than the distal end of the second conduit.

Body tissue ablation is carried out by inserting a probe into a body of a living subject, urging the probe into contact with a tissue in the body, generating energy at a power output level, and transmitting the generated energy into the tissue via the probe. While transmitting the generated energy the ablation is further carried out by determining a measured temperature of the tissue and a measured power level of the transmitted energy, and controlling the power output level responsively to a function of the measured temperature and the measured power level. Related apparatus for carrying out the ablation is also described.

A method for producing a medical instrument, the method includes coupling a balloon-based distal end of the medical instrument to a jig that sets the distal end to an expanded position. While the distal end is coupled to the jig, one or more electrodes are disposed on an outer surface of the distal end, one or more openings are formed in a wall of the distal end, and are threaded through the openings respective leads coupled to at least one of respective sensors and electrodes that are mounted on the outer surface of the distal end. One or more patches that cover the openings and couple the at least one of respective sensors and electrodes to the outer surface of the distal end, are coupled on the outer surface of the distal end.