Described herein are low-profile electrodes for use with an angioplasty shockwave catheter. A low-profile electrode assembly may have an inner electrode, an insulating layer disposed over the inner electrode such that an opening in the insulating layer is aligned with the inner electrode, and an outer electrode sheath disposed over the insulating layer such that an opening in the outer electrode sheath is coaxially aligned with the opening in the insulating layer. This layered configuration allows for the generation of shockwaves that propagate outward from the side of the catheter. In some variations, the electrode assembly has a second inner electrode, and the insulating layer and outer electrode may each have a second opening that are coaxially aligned with the second inner electrode. An angioplasty shockwave catheter may have a plurality of such low-profile electrode assemblies along its length to break up calcified plaques along a length of a vessel.

In some examples, a medical device includes a flexible elongate member configured for navigation through vasculature of a patient to a target treatment site. A distal portion of the elongate member including a first balloon portion that is inflatable to an expanded state, a second balloon portion that is inflatable to an expanded state, and a cavitation generator. When the balloon portions are in their expanded states within the vasculature, a cavity is defined between the elongate member and the target treatment site and exterior to the first and second balloon portions. The cavitation generator is configured to deliver energy to a fluid within the cavity to cause the fluid to undergo cavitation to generate a pressure pulse wave within the fluid.

A catheter system for treating a treatment site includes an energy source, a balloon, an energy guide, and a pressure sensor. The balloon is positionable substantially adjacent to the treatment site. The balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The energy source generates energy that is received by the energy guide so that the energy guide can guide the light energy into the balloon interior. The pressure sensor senses a balloon pressure of the balloon fluid. A method for disrupting calcification at the treatment site includes the steps of generating energy with an energy source, positioning a balloon substantially adjacent to the treatment site, the balloon having a balloon wall that defines a balloon interior, the balloon interior being configured to receive a balloon fluid, receiving energy from the energy source with an energy guide, guiding the energy from the energy source into the balloon interior with the energy guide; and sensing a balloon pressure of the balloon fluid with a pressure sensor.

A catheter system for treating a vascular lesion within or adjacent to a vessel wall includes an energy source, a plurality of energy guides and a system controller. The energy source generates energy. The plurality of energy guides receive energy from the energy source. The system controller controls the energy source so that the energy is sequentially directed to each of the plurality of energy guides in an advancing wavefront. The system controller controls a firing rate of the energy source to each of the plurality of energy guides. The system controller can control a firing sequence to the plurality of energy guides so that the advancing wavefront is generated toward the vascular lesion from near the balloon proximal end and from near the balloon distal end. The system controller can control the energy source so that light energy from the energy source is alternatively directed to at least two of the plurality of energy guides at a different firing energy level from one another. The energy level can be based on pulse width, wavelength and/or amplitude of the energy pulse(s).

The present invention is directed toward a method for treating a vascular lesion within or adjacent to a vessel wall. The method includes the steps of generating energy with an energy source; receiving the energy with a plurality of energy guides; and controlling the energy source with a system controller of a catheter system so that the energy from the energy source is sequentially directed to each of the plurality of energy guides in a first firing sequence. The method can include the system controller controlling a firing rate of the energy source to each of the plurality of energy guides. The method can include the system controller controlling a firing sequence to the plurality of energy guides so that an advancing wavefront is generated toward the vascular lesion from near a balloon proximal end and/or from near a balloon distal end. The system controller can control a firing energy level, which can be dependent at least partially upon the pulse width, the wavelength and/or the amplitude of the energy pulses.

A catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (108A) of a blood vessel (108) within a body (107) of a patient (109) includes an energy source (124), a catheter fluid (132), and an emitter assembly (129). The energy source (124) generates energy. The emitter assembly (129) includes (i) at least a portion of an energy guide (122A) having a guide distal end (122D) that is selectively positioned near the treatment site (106), (ii) a plasma generator (133), and (iii) an emitter housing (260) that is secured to each of the energy guide (122A) and the plasma generator (133) to maintain a relative position between the guide distal end (122D) of the energy guide (122A) and the plasma generator (133). The energy guide (122A) is configured to receive energy from the energy source (124) and direct the energy toward the plasma generator (133) to generate a plasma bubble (134) in the catheter fluid (132). The plasma generator (133) directs energy from the plasma bubble (134) toward the treatment site (106).

Described herein is a shock wave device for the treatment of vascular occlusions. The shock wave device includes an outer covering and an inner member inner connected at a distal end of the device. First and second conductive wires extend along the length of the device within the volume between the outer covering and the inner member. A conductive emitter band circumscribes the ends of the first and second wires to form a first spark gap between the end of the first wire and the emitter band and a second spark gap between the end of the second wire and the emitter band. When the volume is filled with conductive fluid and a high voltage pulse is applied across the first and second wires, first and second shock waves can be initiated from the first and second spark gaps.

A catheter system for treating a vascular lesion within or adjacent to the vessel wall or heart valve includes a balloon and a fluid circulator. The balloon includes a balloon wall that defines a balloon interior. The balloon is configured to retain a catheter fluid within the balloon interior. The fluid circulator is coupled in fluid communication to the balloon interior. The fluid circulator is configured to selectively circulate the catheter fluid out of and back into the balloon interior during use of the catheter system. The fluid circulator is configured so that a temperature of the catheter fluid within the balloon interior is maintained within a predetermined temperature range. Additionally, the fluid circulator can be configured so that a pressure of the catheter fluid within the balloon interior is maintained within a predetermined pressure range. Further, a filtration system can be coupled in fluid communication with the fluid circulator to remove microparticles from the catheter fluid.

A valvuloplasty system comprises a balloon adapted to be placed adjacent leaflets of a valve. The balloon is inflatable with a liquid. The system further includes a shock wave generator within the balloon that produces shock waves. The shock waves propagate through the liquid and impinge upon the valve to decalcify and open the valve.

Described herein are shock wave devices and methods for the treatment of vascular plaques. One variation of a shock wave device may include a pair of elongated, flexible concentric tubes comprising an inner tube and an outer tube. The inner tube and the outer tube may be connected together at one end, and at least a portion of the volume between the inner tube and the outer tube may be filled with a conductive fluid via the other end. At least two electrodes may be positioned between the inner tube and the outer tube, the at least two electrodes being electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses.