An ultrasonic probe assembly includes a handle configured to be handheld, and has a housing that defines a chamber. A carriage is slidably coupled to the housing. The carriage has an operator arm configured to be operable by a user to move the carriage between a first position and a second position. An ultrasonic catheter has a catheter sheath and an ultrasonic core wire. The ultrasonic catheter has a proximal end portion and a distal end portion. An ultrasonic transducer is positioned in the chamber of the housing. The ultrasonic transducer is connected to the proximal end portion of the ultrasonic catheter, and the ultrasonic transducer is connected to the carriage. The ultrasonic transducer is configured to longitudinally move in the chamber of the housing between a retracted position and an extended position coincident with a corresponding longitudinal movement of the carriage.

A system for aspirating thrombus and delivering an agent includes an aspiration catheter having a supply lumen having a proximal end, a distal end, and a wall, and an aspiration lumen having a proximal end, an open distal end, and an interior wall surface adjacent the open distal end, and at least one orifice at or adjacent the distal end of the supply lumen, in fluid communication with the aspiration lumen and located proximally of the open distal end of the aspiration lumen, wherein the at least one orifice is configured to create a spray pattern that is caused to impinge on the interior wall surface of the aspiration lumen such that the spray pattern upon impinging on the interior wall surface is caused to transform into at least a substantially distally-oriented flow capable of exiting the open distal end of the aspiration lumen.

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 is directed to end effectors. An end effector includes an outer shaft extending along a longitudinal axis and an inner shaft partially located within the outer shaft. The end effector may include an ultrasonic blade. The inner shaft may include biased and unbiased portions. The inner shaft and outer shaft may be translatable relative to one another. At one translatable position, the biased portion of the inner shaft may be located within the outer shaft and the unbiased portion may be substantially straight along the longitudinal axis. At another translatable position, the biased portion of the inner shaft may be located outside of and distally positioned from the outer shaft such that the biased portion of the inner shaft is bent away from the longitudinal axis.

A method for attempting to fragment or comminute an object in a body using ultrasound includes producing a burst wave lithotripsy (BWL) waveform by a therapy transducer. The BWL waveform is configured to fragment or comminute the object. The BWL waveform includes a first burst of continuous ultrasound cycles and a second burst of continuous ultrasound cycles. A burst frequency corresponds to a frequency of repeating the bursts of the BWL waveform. The method also includes determining a cycle frequency f of the continuous ultrasound cycles within the first burst and the second burst based on a target fragment size D, where the cycle frequency is:
f(MHz)=0.47/D(mm).

A connector for connecting together first and second mechanical waveguides, including a first connector body having a first jaw portion provided with a first aperture for receiving the first mechanical waveguide therein, a second connector body having a second jaw portion provided with a second aperture for receiving the second mechanical waveguide therein, with the first and second connector bodies removably securable together, a first mediating body having an acoustic impedance lower than that of the first mechanical waveguide, with the first mediating body being inserted within the first aperture to be positioned between the first jaw portion and the first mechanical waveguide, and a second mediating body having an acoustic impedance lower than that of the second mechanical waveguide, with the second mediating body inserted within the second aperture to be positioned between the second jaw portion and the second mechanical waveguide.

An apparatus is for use in a vascular space in a body. A catheter has a lumen adapted for communicating fluid between a distal end for insertion in the vascular space and a proximal end. A transducer is adapted for removably connecting to the catheter for contacting the fluid and transmitting energy through the fluid in the lumen for dissolving an obstruction therein. A suction is provided for removing any debris from the obstruction in the lumen of the catheter. The wave guide may be tubular, and may have a length corresponding to the length of the lumen. A catheter or an implantable port including an embedded ultrasonic transducer is also provided.

A method for using an endoluminal device to modify an intravascular lesion includes providing an ultrasound-producing mechanism that converts an electric current into vibrational energy at an ultrasonic frequency; providing a sheath including a sheath lumen, wherein the sheath is configured to retract from a first, fully extended position of the sheath and extend from a second, fully retracted position of the sheath; providing a core wire disposed within the sheath lumen of the sheath, the core wire being coupled to the ultrasound-producing mechanism via a sonic connector, the core wire being excited by the vibrational energy at the ultrasonic frequency when the ultrasound-producing mechanism is activated; and retracting the sheath relative to the core wire to expose a working length of a distal portion of the core wire for ultrasound-based modification of one or more intravascular lesions.

A surgical apparatus for treating a blood clot in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the blood clot. An energy emitter emits energy to the blood clot or hardenings and a connector connects the energy emitter to an external energy source, wherein blood flows into the second hole positioned proximal of the blood clot and exits the first hole distal of the blood clot during activation of the energy emitter. In some instances when the apparatus is introduced from a retrograde ‘upstream” approach blood may flow through the device in the opposite direction.

A surgical apparatus for treating a vessel blockage in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the vessel blockage. A motor driven impeller is rotatable during blood flow through the first lumen to enhance blood flow as blood flows into the second hole positioned proximal of the vessel blockage and exits the first hole distal of the vessel blockage during injection of fluid through one or more openings to treat the vessel blockage.