An endovascular apparatus for crossing through an obstruction in a blood vessel comprises an elongate endovascular element such as a wire. The element has a proximal section, a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections. The apparatus comprises an ultrasonic transducer, mechanically coupled to the proximal section of the element for ultrasonically activating the element, hence exciting the distal tip section to facilitate crossing through the obstruction. A catheter surrounds the element, leaving at least part of the distal tip section of the element protruding distally beyond a distal end of the catheter.

An adjustable interface device for connecting two components of a medical device includes an elongate body and an elongate member. The elongate body has a first end, a second end, an interior channel, and a side wall that surrounds the interior channel. The side wall defines a first connector portion adjacent the second end. The first connector portion attaches to a respective one of the components of the medical device. The elongate member has a head end portion and a shaft portion that longitudinally extends from the head end portion. The shaft portion is located at least partially in the interior channel of the elongate body. The shaft portion is configured to slidably move axially along the longitudinal axis to adjust a length of the adjustable interface device. The head end portion defines a second connector portion that attaches to another of the components of the medical device.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises: an elongate endovascular element such as a wire; an ultrasonic transducer, mechanically coupled to the endovascular element for ultrasonically exciting a distal tip portion thereof to facilitate the crossing through the obstruction, and one or more damping features, mechanically coupled to the endovascular element to attenuate lateral displacement of the endovascular element at positions away from the distal tip portion.

A catheter that fits within a blood vessel wall includes electrodes aligned along a longitudinal axis of the catheter that produce unfocused shock waves that propagate radially toward the blood vessel wall for treatment.

An ultrasonic catheter assembly includes a sheath having a sheath lumen. A core wire is at least partially disposed within the sheath lumen. The core wire has a proximal portion and a distal portion. The proximal portion of the core wire is configured to be coupled to an ultrasound-producing mechanism. A working length of the distal portion of the core wire extends distally from the sheath. The working length is configured for longitudinal displacement, transverse displacement, or a combination of longitudinal and transverse displacement, in accordance with a plurality of output modes for vibrational energy supplied to the core wire proximal portion by the ultrasound-producing mechanism.

A dynamic balloon angioplasty system for applying a dynamic pressure to fracture hardened materials embedded within an elastic conduit. The system having a pressure source system outputting at least a first predetermined pressure from a pressure source outlet, and an angioplasty unit fluidly coupled to the pressure source outlet receiving at least the first predetermined pressure. The angioplasty unit having an angioplasty inflation device, an angioplasty balloon connector, and an oscillating mechanism selectively actuated to output a plurality of pressure pulses to the angioplasty balloon via a fluid communication path. A control system is configured to determine an optimal hydraulic pressure oscillation frequency and amplitude for a given procedure and output a control signal to the oscillating mechanism, and monitor a pressure signal to detect fracture of the hardened material within the elastic conduit or system failure or leakage.

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.

An ultrasonic system includes an ultrasonic device having an ultrasonic transducer, and a core wire having a proximal end coupled to the ultrasonic transducer and a distal end portion that terminates at a distal tip. An ultrasonic energy source is electrically connected to the ultrasonic transducer. The ultrasonic energy source includes an ultrasonic signal generator circuit, a modulator circuit, and a controller. The ultrasonic signal generator circuit generates an ultrasonic electrical signal. The modulator circuit amplitude modulates the ultrasonic electrical signal with a macro-motion electrical signal to generate a modulated ultrasonic electrical signal. The controller executes program instructions to select between an engagement mode and a transverse mode, wherein in the engagement mode the first ultrasonic electrical signal is supplied from the ultrasonic energy source to the ultrasonic transducer and in the transverse mode the modulated ultrasonic electrical signal is supplied from the ultrasonic energy source to the ultrasonic transducer.

Systems and methods for localized drug delivery via undulating drug coated balloons (DCB), in particular using functionalized nanoparticles as a drug delivery medium in combination with an undulating balloon, are disclosed. In various disclosed embodiments, a nanoparticle matrix is adhered to in an external substrate-surface, such as the balloon surface, and is activated for release once at the treatment site. Activation for release may be enhanced through the use of an undulating balloon system including methodologies for precise control of timing, waveform and extent of undulations.

A method of controlling the temperature of an ultrasonic blade includes applying a power level to an ultrasonic transducer to achieve a desired temperature at an ultrasonic blade coupled to the transducer via an ultrasonic waveguide, inferring a temperature of the blade based on a voltage V.sub.g(t) signal and a current I.sub.g(t) signal applied to the transducer, comparing the inferred temperature of the blade to a predetermined temperature; and adjusting the power level to the transducer based on the comparison. In some aspects, the method includes measuring a phase angle φ between the voltage V.sub.g(t) and the current I.sub.g(t) and inferring the temperature of the blade from the phase angle φ. In some aspects, the method includes measuring an impedance Z.sub.g(t) equal to a ratio of the voltage V.sub.g(t) to the current I.sub.g(t) and inferring the temperature of the blade from the impedance Z.sub.g(t).