Exemplary embodiments of the present disclosure apparatus and methods that provide for subtractive material processing, including efficient and precise ablation of tissues. Certain embodiments include a first laser configured to direct a first pulse of energy at a first wavelength to a region of tissue; a second laser configured to direct a second pulse of energy at a second wavelength to the region of tissue; and a control system configured to control operation of the first laser and the second laser.

A probe of a target identification system can be extended via a first lumen of a viewing instrument, such as for illuminating an area beyond a distal end of the viewing instrument via an optical path of the viewing instrument. An optical response to the illumination of the area can be received via an optical path of the probe and can be split from other optical signals of the optical path. The optical response information can be used to identify characteristics of a target and to adjust parameters of a working instrument such as a working instrument contemporaneously using the probe.

An illumination system is provided that includes a laser light source, a light guide, a connector, and an emission element. The laser light source has a numerical aperture. The light guide has a proximal end and a distal end. The connector has a connector housing and connects and/or assigns the laser light source at the proximal end. The emission element is at the distal end. The connector housing has a device that reduce an influence of a range of variation of the numerical aperture so that an emission behaviour of the emission element is independent of a range of variation of the numerical aperture.

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).

A tapered fiber optoacoustic emitter includes a nanosecond laser configured to emit laser pulses and an optic fiber. The optic fiber includes a tip configured to guide the laser pulses. The tip has a coating including a diffusion layer and a thermal expansion layer, wherein the diffusion layer includes epoxy and zinc oxide nanoparticles configured to diffuse the light while restricting localized heating. The thermal expansion layer includes carbon nanotubes (CNTs) and Polydimethylsiloxane (PDMS) configured to convert the laser pulses to generate ultrasound. The frequency of the ultrasound is tuned with a thickness of the diffusion layer and a CNT concentration of the expansion layer.

Disclosed herein is a medical device. The medical device includes a sheath, a laser fiber, a basket section, and a laser beam splitter. The laser fiber is configured to extend from an end of the sheath. The basket section includes flexible members. At least a portion of the flexible members are between the sheath and the laser fiber. The laser beam splitter is coupled to the laser fiber.

An Optical fiber with modified distal end and related methods are provided. The optical fiber extends from a proximal end portion to a distal end portion and includes a core, a cladding, a coating, and an optional jacket. The distal end portion comprises a portion with an enlarged outer diameter.

A catheter system (100) for treating a vascular lesion (106) within or adjacent to a heart valve (108) within a body (107) of a patient (109), includes an energy source (124), and a plurality of spaced apart treatment devices (143). The energy source (124) generates energy. Each treatment device (143) includes (i) a balloon (104) that is positionable substantially adjacent to the vascular lesion (106), the balloon (104) having a balloon wall (130) that defines a balloon interior (146), the balloon (104) being configured to retain a balloon fluid (132) within the balloon interior (146); and (ii) at least one of a plurality of energy guides (122A) that receive energy from the energy source (124) so that plasma (134) is formed in the balloon fluid (132) within the balloon interior (146).

Various methods, systems, and devices for treating tissue ablation are disclosed. Some embodiments disclosed herein pertain to methods of treating tumors, systems used for irradiating tissue and tumors with electromagnetic radiation, components and devices of that system, and kits for providing systems used for irradiating tissue and tumors with electromagnetic radiation. In some embodiments, the system provides sub-ablative infrared radiation that is absorbed by nanoparticles. In some embodiments, the nanoparticles absorb the radiation converting it into heat energy. In some embodiments, though the infrared radiation itself may be sub-ablative, the heat energy generated by the nanoparticles is sufficient to cause thermal coagulation, hyperthermia, and/or tissue ablation.