The present disclosure provides a system for delivery of therapeutic energy. The system includes an energy unit configured to convert the acoustic energy signals transmitted to therapeutic ultrasound directed to fragment tumors and carcinogenic tissue in the body. The system also includes an energy unit configured to convert the acoustic energy signal transmitted from the energy unit to ultrasonic energy to image and monitor the treatment site with ultrasound. The system also includes a control unit including a computer for data storage and display.

The present disclosure is directed to end effectors. An end effector includes an outer shaft extending along a longitudinal axis and an inner shaft partially located within the outer shaft. The end effector may include an ultrasonic blade. The inner shaft may include biased and unbiased portions. The inner shaft and outer shaft may be translatable relative to one another. At one translatable position, the biased portion of the inner shaft may be located within the outer shaft and the unbiased portion may be substantially straight along the longitudinal axis. At another translatable position, the biased portion of the inner shaft may be located outside of and distally positioned from the outer shaft such that the biased portion of the inner shaft is bent away from the longitudinal axis.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises an elongate endovascular element such as a wire. The element has a proximal section, a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections . The apparatus comprises an ultrasonic transducer, mechanically coupled to the proximal section of the element for ultrasonically activating the element, hence exciting the distal tip section to facilitate crossing through the obstruction. A catheter surrounds the element, leaving at least part of the distal tip section of the element protruding distally beyond a distal end of the catheter.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises: an elongate endovascular element such as a wire; an ultrasonic transducer, mechanically coupled to the endovascular element for ultrasonically exciting a distal tip portion thereof to facilitate the crossing through the obstruction, and one or more damping features, mechanically coupled to the endovascular element to attenuate lateral displacement of the endovascular element at positions away from the distal tip portion.

A method of and a system for treating a lesion. A waveguide is inserted into a vessel of a subject, with the lesion being present in the vessel and the waveguide extending longitudinally between a proximal end and a distal end. The distal end of the waveguide is positioned adjacent to the lesion, and a high amplitude broadband mechanical pulse is generated and propagated from the proximal end to the distal end of the waveguide. At least a portion of the high amplitude broadband mechanical pulse is propagated from the distal end of the waveguide to the lesion, with the at least a portion of the high amplitude broadband mechanical pulse propagating up to the lesion, thereby treating at least partially the lesion.

An elongate endovascular element for crossing through an obstruction in a blood vessel comprises: a proximal section; a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections; wherein the tapered intermediate section has a length that is substantially λ/2 or a multiple of λ/2, where λ is a wavelength of a driving frequency that will produce longitudinal resonance in the element.

A medical device for assisting the break-up, disruption or disintegration of calcified or other hardened material within vessels of the human or animal body which material otherwise prevents or inhibits stenting procedures or passage of guidewires, catheters and other devices through the vessels. The device includes a catheter having a lumen extending between a distal end and a proximal end of the catheter and a displaceable element at the distal end of the catheter configured for axial and/or radial displacement relative to the catheter when driven by pressure fluctuations within the lumen. A pressure pump is coupled to a proximal end of the catheter and is configured for application of a baseline pressure to the catheter lumen. A pressure modulation source is also coupled to the proximal end of the catheter, configured to modulate the baseline pressure in the catheter lumen with one or more pressure impulses, and preferably with a series of pressure pulses.

A compound transmission member including: a first tube sub-member and a second tube sub-member, each including: a first end having a first opening and a second end having a second opening, wherein the first opening is in fluid communication with the second opening, and wherein at least the first tube sub-member is configured to transmit ultrasonic energy; and a fitting configured to receive the first ends of the tube sub-members.

An ultrasound catheter includes a catheter body, an ultrasound transmission member, a sonic connector, a constraining member, and a vibrational absorber. The vibrational absorber has an opening through which the ultrasonic transmission member extends. The vibrational absorber is located in a recessed portion of the constraining member. The vibrational absorber is both longitudinally interposed between the constraining member and the distal portion of the sonic connector and laterally interposed between the recessed portion of the constraining member and the ultrasound transmission member. The recessed portion of the constraining member overlaps a portion of an exterior of the distal portion of the sonic connector.

The present invention provides methods and devices for treating endovascular disease. Vibrational energy is delivered to change compliance and increase permeability at the treatment area. To improve clinical outcomes, one or more therapeutic drugs may be delivered to the treatment area.