A method is disclosed for treating calcified lesions within a wall of a blood vessel. The first step includes breaking apart a calcified lesion using a plurality of shockwaves generated in an angioplasty balloon of an angioplasty catheter device. The angioplasty balloon is dilated via a fluid to a first extent to fit against at least a portion of the wall of the blood vessel. A plurality of electrical pulses are delivered to a pair of electrodes disposed within the fluid inside the balloon. The electrical pulses have an amplitude sufficient to create plasma arcs in the fluid to generate shockwaves that are conducted through the fluid and through the balloon to the blood vessel, to crack the calcified lesion. After breaking apart the calcified lesion, the angioplasty balloon is allowed to further expand to a second extent greater than the first extent, thereby expanding an opening in the blood vessel.

An apparatus includes a balloon adapted to be placed adjacent a calcified region of a body. The balloon is inflatable with a liquid. The apparatus further includes a shock wave generator within the balloon that produces shock waves that propagate through the liquid for impinging upon the calcified region adjacent the balloon. The shock wave generator includes a plurality of shock wave sources distributed within the balloon.

This disclosure disclosed an ultrasonic needle and apparatus used for removal of the vitreous body and other tissues. An ultrasonic vitrectomy needle, comprising: a connector, a connected inner needle, and an outer sheath. The length of the outer sheath at the distal end is slightly longer than that of the inner needle; the sheath distal end is of blind with smooth surface, but there is an open cut at the side of the distal end used for aspirating the vitreous body. The benefits of this disclosure: due to the difficulty if not impossible in the prior arts making a slim long center bore needle for ultrasonic surgical system, this disclosure clears the way to make the ultrasonic vitrectomy a practical reality; the ultrasonic vibration inherent advantages of the quietness, minuscule displacement, liquid repulsion and viscosity reduction improve safety of the surgery; the possibility of integrating ultrasonic vitrectomy and ultrasonic phaco emulsification procedures simplifies the complexity from prior arts, thus brings ease to the ophthalmic surgeries and reduces the cost.

Described herein are shock wave devices and methods for the treatment of calcified heart valves. One variation of a shock wave device may comprise an elongated flexible tube carried by a sheath. The tube may have a fluid input end, which may be located near a proximal end of the sheath. The tube may include a loop portion. The loop portion may be configured to be at least partially accommodated within a cusp of the heart valve. The tube may be fillable with a conductive fluid. In some variations, the shock wave device may include an array of electrode pairs associated with a plurality of wires positioned within the loop portion of a tube. The electrode pairs may be electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses.

An intracorporeal pressure shock wave device to provide treatment within blood vessels artificial vessels and grafts that includes a frontal pressure shock wave reflector positioned at the distal end of an intracorporeal catheter to direct shock waves toward a treatment target, such as an occlusion and clot.

A guidewire includes an elongated member and a shaft extending distally from the elongated member, wherein the elongated member and shaft are configured to be navigated through vasculature of a patient. The guidewire further includes a first conductor extending around the shaft to define an outer perimeter of the guidewire and a first electrode adjacent the shaft. The first conductor is configured electrically connect the first electrode to an energy source. The guidewire further includes a second electrode and a second conductor configured to electrically couple the second electrode to the energy source. The first and second electrodes may be configured to deliver an electrical signal to fluid contacting the first and second electrodes to cause the fluid to undergo cavitation to generate a pressure pulse wave within the fluid.

A catheter assembly includes a catheter comprising a flexible elongated member including a distal portion that includes a tubular body defining an inner lumen and a plurality of body apertures that extend through a sidewall of the tubular body into the inner lumen, and a plurality of primary electrodes positioned along the tubular body. The catheter assembly includes a wire defining at least one secondary electrode, the wire being configured to be slidably moved through the inner lumen of the tubular body, where the wire and the plurality of primary electrodes are configured to electrically couple to an energy source that delivers an electrical pulse to a fluid in contact with the plurality of primary electrodes and the at least one secondary electrode to cause the fluid to undergo cavitation to generate a pressure pulse wave within the fluid.

In some examples, a catheter includes an elongated member including at least one balloon connected to the elongated member, the at least one balloon being configured to inflate to an expanded state. In the expanded state, the at least one balloon forms at least a portion of a cavity with a wall of a vessel of the patient. The catheter including at least one electrode carried by the elongated member and having at least one surface exposed to the cavity formed by the at least one balloon. The electrode is configured to connect to an energy source that is configured to deliver, via the electrode, an electrical signal to a fluid contained in the cavity and in contact with the electrode to cause the fluid to undergo cavitation to generate a pressure pulse wave within the fluid.

Devices, assemblies, systems, and techniques described herein may deliver a pressure wave to structures of a heart, such an aortic valve. For example, a medical assembly may include an expandable member configured to expand from a collapsed configuration to an expanded configuration, the expandable member configured to at least partially define a channel through the expandable member in the expanded configuration and one or more electrodes carried by the expandable member. The one or more electrodes may be configured to transmit an electrical signal through a fluid to cause the fluid to undergo cavitation that generates a pressure wave within the fluid.

Systems, devices, and methods for removing and/or treating obstructions in the vascular channels, such as blood clots, are provided. The systems may include a capture sock device including a shaft defining a lumen; and a mouth coupled to the shaft. The mouth includes a distal end portion defining a distal opening and is sized and configured to move between a collapsed configuration and an expanded configuration within a body channel. The mouth is formed of a mesh having porosity large enough to allow blood flow to pass through it but small enough to prevent an obstruction or a fragment of the obstruction from escaping from the mouth back into the body channel. In some embodiments, the mesh is folded to create at least two mesh layers at least at the distal opening to create a smooth atraumatic edge. In some embodiments, the system further includes a trap and/or retriever assembly.