Systems and methods for treating tissue by concentrating a laser emission to at least one depth at a fluence sufficient to create an ablation volume in at least a portion of the target tissue and controlling pulse width within the picosecond regime to provide a desired mechanical pressure in the form of shock waves and/or pressure waves.

A catheter system for imparting pressure to induce fractures in a vascular lesion within or adjacent a vessel wall, includes a catheter and a superheating system. The catheter can advance to the vascular lesion. The catheter includes an elongate shaft and a balloon coupled to the elongate shaft. The balloon includes a balloon wall. The balloon moves between a collapsed configuration and a first expanded configuration suitable for anchoring the catheter in position relative to a treatment site. The superheating system can heat a balloon fluid within the balloon rapidly enough to achieve spontaneous vaporization of the balloon fluid and to generate inertial bubbles and acoustic pressure waves. The superheating system can include a first light guide extending along the elongate shaft. The first light guide is in optical communication with a light source at a proximal portion of the first light guide.

A catheter system (100) includes an inflatable balloon (104), an optical fiber (122), and a laser (124). The optical fiber (122) has a distal end positioned within the inflatable balloon (104). The optical fiber (122) receives an energy pulse (431) to emit light energy in a direction away from the optical fiber (122) to generate a plasma pulse (134) within the inflatable balloon (104). The laser (124) includes a seed source (126) that emits a seed pulse (342) and an amplifier (128) that increases energy of the seed pulse (342) so that the laser (124) generates the energy pulse (431) that is received by the optical fiber (122), the energy pulse (431) having a waveform with a duration T, a minimum power PO, a peak power PP, and a time from PO to PP equal to TP.

A catheter system (100) includes an inflatable balloon (104), an optical fiber (122), and a laser (124). The optical fiber (122) has a distal end positioned within the inflatable balloon (104). The optical fiber (122) receives an energy pulse (431) to emit light energy in a direction away from the optical fiber (122) to generate a plasma pulse (134) within the inflatable balloon (104). The laser (124) includes a seed source (126) that emits a seed pulse (342) and an amplifier (128) that increases energy of the seed pulse (342) so that the laser (124) generates the energy pulse (431) that is received by the optical fiber (122), the energy pulse (431) having a waveform with a duration T, a minimum power PO, a peak power PP, and a time from PO to PP equal to TP.

A catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (108A) or a heart valve includes a light source (124), a first light guide (122A), a second light guide (122A), and a guide bundle (152). The light source (124) generates light energy. The first light guide (122A) receives the light energy from the light source (124) and has a guide proximal end (122P). The second light guide (122A) receives the light energy from the light source (124) and has a guide proximal end (122P). A guide bundle (152) is in optical communication with the light source (124). The guide bundle (152) bundles the first light guide (122A) and the second light guide (122A). The guide bundle (152) includes a first ferrule (778) that engages the guide proximal end (122P) of the first light guide (122A) and a second ferrule (778) that engages the guide proximal end (122P) of the second light guide (122A). At least one of the ferrules (778) can be formed at least partially from a ceramic material or a metallic material.

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.

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.

An endoscope includes: an insertion portion formed along a longitudinal axis extending from a proximal end to a distal end; a light guide having an optical characteristic that enables transmitting lithotriptic light and illuminating light having respective wavelength bands that are different from each other, from the proximal end toward the distal end of the insertion portion; and a treatment instrument insertion channel provided in the insertion portion, the treatment instrument insertion channel extending from the proximal end to the distal end.

Disclosed are systems and methods for determining target characteristics during a laser procedure, comprising (i) obtaining a relationship between (i) a number of pixels associated with a light beam reflected from a target or an object located in proximity to the target on an endoscopic image obtained from a video sensor coupled to an endoscope and (ii) a distance of the target from a tip of the endoscope. The method further comprising (ii) measuring the number of pixels associated with the light beam reflected from the target or the object located in proximity to the target during a procedure, and (iii) based at least in part on the relationship obtained in step (i) and the measured number of pixels in step (ii), determining at least one of a size of the target or a distance of the target from the tip of the endoscope.

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.