A catheter and catheter system for treatment of a blood vessel of a patient include an elongate flexible catheter body with a radially expandable structure. A plurality of electrodes or other electrosurgical energy delivery surfaces can radially engage material to be treated when the structure expands. A material detector near the distal end of the catheter body may measure circumferential material distribution, and a power source selectively energizes the electrodes to eccentrically treat of a body lumen.

Retrieval of material from vessel lumens can be improved by electrically enhancing attachment of the material to the thrombectomy system. The system can include a catheter having a distal portion configured to be positioned adjacent to a thrombus in a blood vessel, an electrode disposed at the distal portion of the catheter, and an interventional element configured to be delivered through a lumen of the catheter. The electrode and the interventional element are each configured to be electrically coupled to an extracorporeal power supply.

Devices can be used to deliver pulsed electrical field for targeted cellular ablation. For example, this document describes catheter-based devices that deliver non-thermal irreversible electroporation to treat deep vein thrombosis by ablating cells of the venous thrombus to prevent cellular mechanisms that lead to clot organization, leaving the clot susceptible to physiological degradation.

An electrode assembly includes an electrically-conductive wire configured for insertion into a blood vessel of a subject, an electrode surrounding the wire, and a discontinuous electrically-insulating cover disposed between the wire and the electrode such that the wire lies radially opposite the electrode at a break in the discontinuous electrically-insulating cover. Other embodiments are also described.

A catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (108) or a heart valve includes an inflatable balloon (104), an optical fiber (122), and an energy source (124). The optical fiber (122) has a fiber proximal end (122P), and a fiber distal end (122D) positioned within the inflatable balloon (104). The optical fiber (122) is configured to receive an energy pulse so that the optical fiber (122) emits light energy in a direction away from the optical fiber (122) to generate a plasma pulse within the inflatable balloon (104). The optical fiber (122) can be tapered from the fiber proximal end (122P) toward the fiber distal end (122D). The energy source (124) in optical communication with the fiber proximal end (122P) of the optical fiber (122), and can include a laser. The optical fiber (122) includes a first fiber member (250) and a second fiber member (258) that is coupled to the first fiber member (250). The first fiber member (250) can be fused to the second fiber member (258) in a fused region (256). The first fiber member (250) and the second fiber member (258) can be formed as a unitary structure. The catheter system (100) can also include a ferrule (248) that encircles the fused region (256).

A method for treating a treatment site (106) within or adjacent to a vessel wall (108) or heart valve includes tapering an optical fiber (122) from a fiber proximal end (122P) to a fiber distal end (122D); positioning the optical fiber (122) such that the fiber distal end (122D) is positioned within an inflatable balloon (104); coupling an energy source (124) in optical communication with the fiber proximal end (122P); and receiving an energy pulse from the energy source (124) into the fiber proximal end (122P) so that the optical fiber (122) emits light energy in a direction away from the optical fiber (122) to generate a plasma pulse within the inflatable balloon (104). The method can further include coupling a first fiber member (250) to a second fiber member (258), which can include fusing the first fiber member (250) to the second fiber member (258) at a fused region (256); and encircling the fused region (256) with a ferrule (248).

Described is a method and device for dilating a tubular anatomical structure. The device and method can be useful for extracting a blood clot in an artery of a mammal by concentrically irradiating an inner wall of the occluded artery using an ultraviolet (UV) laser beam delivered by an optical fiber having an external or inverted conical tip. Dilation results from photophysical production and release of nitric oxide from the cells lining the arterial wall when UV laser light is projected as a ring beam onto the inner arterial wall. This “minimal contact persistent dilation system” prepares the artery for safer mechanical extraction by thrombectomy, owing to decrease in friction and dissolution of chemical bonding.

Retrieval of material from vessel lumens can be improved by electrically enhancing attachment of the material to the thrombectomy system. The system can include a catheter having a distal portion configured to be positioned adjacent to a thrombus in a blood vessel, an electrode disposed at the distal portion of the catheter, and an interventional element configured to be delivered through a lumen of the catheter. The electrode and the interventional element are each configured to be electrically coupled to an extracorporeal power supply. The interventional element may be configured to evert over and around the clot material while current is delivered to the interventional element.

A medical treatment device is disclosed herein. In one example, the medical treatment device includes a core assembly which has a first conduct and a second conductor. An insulative material can surround the second conductor and define an electrode portion of the second conductor that is uncovered by the insulative material. The medical treatment device can include an interventional element that electrical couples to the first conductor. The electrode portion of the second conductor can be disposed radially adjacent to or distal of the interventional element.

The endovenous treatment device has a delivery system (1; 2) for delivering of at least one treatment dose, which delivery system (1; 2) includes a wire element (1) for delivery of a treatment dose, which has a distal end part (10) able to be inserted, over at least part of its length, longitudinally into a vein, and which allows at least one treatment dose to be delivered into a vein in the region of the end of said distal end part (10). It additionally includes a drive system (4) by which the wire element (1) for dose delivery can be driven in at least a first given drive direction (R), and a guide (3) which is flexible along all or part of its length. The device includes a holding system (5) by which the distal end part (30) of the guide (3) can be temporarily held with respect to the body of a patient, near the insertion zone (7) of the wire element (1).