Device and method for selectively ablating a submucosal layer of a duodenal wall and/or of sensory neurons therein, including a laser transmitting element coupled with the catheter body and configured to transmit a laser beam having a spot diameter of less than 200 microns and to provide an ablative dose of 0.5-2.5 J/mm; wherein the laser beam is configured to selectively ablate an area of the submucosal layer that is at least twice the size of the spot diameter, while essentially preventing damage of the surrounding mucosal, muscularis and/or serosal layers of the duodenal wall; and an expandable member configured to stretch the duodenal wall and to generate a fixed distance between the catheter's laser transmitting element and the duodenal wall.

A catheter that fits within a blood vessel wall includes electrodes aligned along a longitudinal axis of the catheter that produce unfocused shock waves that propagate radially toward the blood vessel wall for treatment.

Methods, Apparatuses, and Systems of operating a laser atherectomy system to perform an endoscopic atherectomy procedure within a vessel at a therapeutic region of an anatomical condition by use of an atherectomy laser device coupled to an ultrasound imaging probe. The atherectomy laser device operates to generate photoacoustic signals from a light source of the atherectomy laser device to for guidance within the vessel and to characterize tissue about the therapeutic region by delivery of pulsed wavelengths within the vessel, and to perform operations of tissue ablation directed to the anatomical condition. This enables guidance of the atherectomy laser device by feedback from the viewing of photoacoustic images based on photoacoustic signals generated the atherectomy laser device and created in response to changes in acoustic intensity due to changes of optical wavelength monitored by the ultrasound imaging probe.

Methods, Apparatuses, and Systems of operating a laser atherectomy system to perform an endoscopic atherectomy procedure within a vessel at a therapeutic region of an anatomical condition by use of an atherectomy laser device coupled to an ultrasound imaging probe. The atherectomy laser device operates to generate photoacoustic signals from a light source of the atherectomy laser device to for guidance within the vessel and to characterize tissue about the therapeutic region by delivery of pulsed wavelengths within the vessel, and to perform operations of tissue ablation directed to the anatomical condition. This enables guidance of the atherectomy laser device by feedback from the viewing of photoacoustic images based on photoacoustic signals generated the atherectomy laser device and created in response to changes in acoustic intensity due to changes of optical wavelength monitored by the ultrasound imaging probe.

A probe is configured with a flushing port and an evacuation port to establish a flow path to remove blood from a resected tissue. The probe comprises a balloon configured to expand and contact the resected tissue to compress filaments and improve access to the underlying blood vessels for coagulation with an energy source. An endoscope can be used to view the tissue, and the balloon may comprise a transparent material or a viewing port to allow imaging of the bleeding tissue through the balloon. The probe may have a light source to illuminate the tissue with a beam oriented at an oblique angle to the tissue surface, which can decrease interference from blood and may allow more localized coagulation of the blood vessel.

A probe is configured with a flushing port and an evacuation port to establish a flow path to remove blood from a resected tissue. The probe comprises a balloon configured to expand and contact the resected tissue to compress filaments and improve access to the underlying blood vessels for coagulation with an energy source. An endoscope can be used to view the tissue, and the balloon may comprise a transparent material or a viewing port to allow imaging of the bleeding tissue through the balloon. The probe may have a light source to illuminate the tissue with a beam oriented at an oblique angle to the tissue surface, which can decrease interference from blood and may allow more localized coagulation of the blood vessel.

Devices, systems, and methods are provided for breaking a kidney stone(s) into smaller particles, fragments, and/or stone dust; and removing the same from a patient. The medical device may include a tube having a distal end, a proximal end, a port located proximal of the distal end, and a length of the tube extending between the proximal end and the distal end. A first portion of the tube may be proximal of the port and have a first cross-sectional area, while a second portion of the tube may be distal of the port and have a second cross-sectional area smaller than the first cross-sectional area. A first lumen may extend from the proximal end to the distal end of the tube. A second lumen may in communication with the port to fluidly connect the proximal end of the tube with the port.

An ablation system comprises: an ablation catheter and a console. The ablation catheter comprises: a shaft including a proximal end, a distal portion and a distal end; an ablation element configured to deliver energy to tissue; and a force maintenance assembly comprising a force maintenance element and configured to control and/or assess contact force between the ablation element and cardiac tissue. The console is configured to operably attach to the ablation catheter and comprises: an energy delivery assembly configured to provide energy to the ablation element. Methods of ablating tissue are also provided.

Medical methods and devices for treating aortic dissections. A catheter-based cutting device permits cutting a septum of acute or chronic aortic dissections, in a retrograde manner. The catheter includes a base section having a central lumen therethrough and two flexible arms extending from a distal end thereof. The flexible arms can each have a guide wire channel therethrough. With distal ends of the two flexible arms separated, the two arms form a Y-shape with the base section. In one embodiment, with distal ends of the two flexible arms together, the two arms have a longitudinal profile, about a periphery thereof, identical to a longitudinal profile of the base section. A cutting component resides between the two arms. The cutting component can face distally outward between the two arms with the distal ends of the two flexible arms separated.

Medical methods and devices for treating aortic dissections. A catheter-based cutting device permits cutting a septum of acute or chronic aortic dissections, in a retrograde manner. The catheter includes a base section having a central lumen therethrough and two flexible arms extending from a distal end thereof. The flexible arms can each have a guide wire channel therethrough. With distal ends of the two flexible arms separated, the two arms form a Y-shape with the base section. In one embodiment, with distal ends of the two flexible arms together, the two arms have a longitudinal profile, about a periphery thereof, identical to a longitudinal profile of the base section. A cutting component resides between the two arms. The cutting component can face distally outward between the two arms with the distal ends of the two flexible arms separated.