An apparatus for delivering energy, and in particular laser energy, to a tissue is adapted to minimize or eliminate burn back caused by contact between the energy delivery apparatus and bodily fluids by (i) preventing the energy delivery apparatus from contacting bodily fluids or tissues that might burn or cause the apparatus to burn; and/or (ii) monitoring the apparatus to detect overheating in order to withdraw the apparatus or control the energy supply in case overheating is detected. The apparatus is applicable, by way of example, to treatment of blood vessels using endovascular techniques.

A method and system for increasing safety of cardiac ablation procedures comprises a computer based system that monitors the esophageal temperature, and a fluoroscopy (medical images) based cardiac mapping system for cryoballoon or radiofrequency (RF) ablations. The esophageal temperature is monitored utilizing an esophageal probe which may have any number of temperature sensing members. The esophageal probe may also have pre-formed shape. During atrial fibrillation ablations, based on a pre-determined increase in esophageal temperature (from any thermistor), the computer based system activates different levels of alarm(s), and/or initiates ablation energy interrupt based on pre-defined programmed values. The method and system is also used for guiding placement of cryoballoon and performing cryoablations. The placement of cryoballoon catheter or a circular catheter is based on superimposing a high resolution (dye injected) image and a live fluoroscopy image and adjusting transparency between the two images.

Multi-electrode ablation systems, methods, and controllers are described. In one example, a method of beginning an ablation procedure using a multi-electrode ablation system is described. The method includes selectively coupling the output of a power supply to a first electrode of a plurality of electrodes to increase a temperature at the first electrode to a first temperature set-point and limit a rate of increase of the temperature at the first electrode to a predetermined first rate.

A heat exchanger is disclosed for causing cryolysis of adipose tissue of a human tongue. The heat exchanger includes a body having cooling channels for circulating fluids therein. The body forms a contact surface that contacts a portion of the dorsal surface of the tongue and a portion of the base of the tongue. The heat exchanger includes a pair of side walls extending from the body and forming a pair of side contact surfaces that are dimensioned so that they contact the dorsal and lateral surfaces of the tongue in a manner so as to constrict the tongue when the contact surface is in contact with the tongue. A method of treatment for apnea using the heat exchanger and/or administering a chemical adipolysis formulation/vasoconstriction agent is also disclosed.

Methods, systems, and treatment probes for delivering heating energy such as acoustic waves to a target tissue volume inside of a patient for medically treating the target tissue volume are disclosed. A method includes inserting a treatment probe into the patient through an exposed skin of the patient, the treatment probe including heating energy dispensing element. The method further includes applying heating energy to the target tissue volume via the dispensing element, the heating energy being applied so as to medically treat the target tissue volume. The method also includes monitoring an amount of energy absorbed by the target tissue as a result of applying the energy, and adjusting the heating energy being applied to the target tissue based on the amount of energy absorbed by the target tissue.

The disclosure provides a method of manufacturing a flexible circuit electrode assembly and an apparatus manufactured by said method. According to the method, an electrically conductive sheet is laminated to an electrically insulative sheet. An electrode is formed on the electrically conductive sheet. An electrically insulative layer is formed on a tissue contacting surface of the electrode. The individual electrodes are separated from the laminated electrically insulative sheet and the electrically conductive sheet. In another method, a flexible circuit is vacuum formed to create a desired profile. The vacuum formed flexible circuit is trimmed. The trimmed vacuum formed flexible circuit is attached to a jaw member of a clamp jaw assembly.

A method for creating a conductive junction in a system for performing a diagnostic or therapeutic procedure includes placing a first elongate conductor through a first lumen of an elongate body, creating a hole in a wall of the elongate body adjacent the first lumen at a distal portion of the elongate body, applying an electrically conductive material to a portion of an outer circumference of the elongate body at the distal portion of the elongate body to form an electrode, and electrically coupling the first elongate conductor to the electrode.

Described herein are various implementations of systems and methods for accessing and modulating tissue (for example, systems and methods for accessing and ablating nerves or other tissue within or surrounding a vertebral body to treat chronic lower back pain). Assessment of vertebral endplate degeneration or defects (e.g., pre-Modic changes) to facilitate identification of treatment sites and protocols are also provided in several embodiments. Several embodiments comprise the use of biomarkers to confirm or otherwise assess ablation, pain relief, efficacy of treatment, etc. Some embodiments include robotic elements for, as an example, facilitating robotically controlled access, navigation, imaging, and/or treatment.

A balloon for renal nerve modulation is disclosed. The balloon may include a polymer material forming a balloon wall having an outer surface and flexible circuits comprising a base selectively adhered to the exterior surface of the balloon wall. Adhesive is selectively applied to the outer surface of the balloon, to the flexible circuit or to both such that the adhesive is selectively deposited on the at least a portion of the at least two pads or on the at least a portion of the at least two pads and to a portion of the distal spline. The portion of the at least two pads or the portion of the at least two pads and a portion of the distal spline are adhered to the outer surface of the balloon and a remainder of the flexible circuit moves freely with respect to the outer surface of the balloon.

An apparatus comprises an end effector, an elongate shaft, and a handle assembly. The shaft includes an articulation section that is operable to deflect the end effector away from the longitudinal axis of the shaft. The handle assembly includes a rotary member positioned within an intermediate section of the handle assembly. The rotary member is rotatable about an axis that is parallel to the longitudinal axis of the shaft. The rotary member is operable to control the articulation section of the shaft. The rotary member may include opposing thread sections that simultaneously drive lead screws in opposite longitudinal directions, to thereby control the articulation section. The shaft may be rotatable relative to the handle assembly, and the apparatus may selectively lock or resist such rotation based on the articulation state of the articulation section.