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.

A surgical instrument including a shaft including a distal portion and an articulatable portion is disclosed. The articulatable portion, positioned proximal to the distal portion, includes a plurality of joint members. A first articulation cable extends through each first channel of each of the plurality of joint members and a second articulation cable extends through each second channel of each of the plurality of joint members to the distal portion. The first and second articulation cables are transitionable between: (i) an unlocked state, where the first and second articulation cables are free to translate distally and proximally and the plurality of joint members are slidable relative to one another to pivot the distal portion away from a longitudinal axis, and (ii) a locked state, where translation of the first and second articulation cables is locked, causing a position of the distal portion relative to the longitudinal axis to be locked.

The surgical instrument (10), in particular a phacoemulsification handpiece, is provided with a housing (12), an ultrasonic transducer (40) positioned in the housing (12), and a tool (46) which is operatively connected to the ultrasonic transducer (40) for the purpose of ultrasonic excitation. The ultrasonic transducer (40) has a sonotrode (56), a resonator (58) and a piezoelectric ceramic element (60) positioned therebetween. The sonotrode (56) and/or the resonator (58) has an aluminum alloy or consists of an aluminum alloy having a tensile strength greater than 400 N/mm.sup.2. The housing (12) can consist of plastic and has an inner housing part (16) made of plastic, in which the ultrasonic transducer (40) is positioned. Cooling openings (82) are formed in the plastic inner housing part (16) through which openings a rinsing fluid for cooling the sonotrode (56) or the ultrasonic transducer (40) flows, said fluid passing along between the outer housing part (14) and the inner housing part (16).

Surgical systems and methods are provided for controlling actuation and movement of various surgical devices.

A method and system for secure ultrasound treatment of living tissues using an ultrasound probe comprising a reflective cavity in acoustic communication with living tissues, a transducer to emit an ultrasound wave in the reflective cavity and a transducer to acquire a backscattered signal in the reflective cavity. The method comprises the steps of a) emitting a first ultrasound wave in the reflective cavity that generates a backscattered ultrasound wave in the reflective cavity, b) acquiring a backscattered signal in the reflective cavity, c) determining whether an insonification can be safely performed by computing a similarity value between the backscattered signal and a predefined reference signal, and d) if an insonification can be safely performed, treating the living tissues with a second ultrasound wave emitted in the reflective cavity. The second ultrasound wave is focused a target point of the living tissues and generates a pressure point resulting in cavitation at this target point.

A device for transmitting mechanical waves, including a mechanical waveguide having an elongated shape and extending between a proximal end and a distal end for propagating the mechanical waves coupled at the proximal end up to the distal end, and a radiopaque marker secured to the mechanical waveguide adjacent to the distal end thereof.

A method of treating a calculi mass can include using an ultrasonic probe to produce acoustic energy and fragment the mass. The method can include varying the frequency at which fragmentation occurs to treat the mass with a resonant frequency. The ultrasonic probe can have a distal tip for contact with the mass, where the tip has a morphology for concentrating stress on the mass. The ultrasonic probe can have two or more ultrasonic horns to allow for higher voltage and power levels.

A method of treating a patient exhibiting a lung disease or pulmonary disorder by applying shock waves or acoustic pulses directed to impinge lung tissue of the lung or lungs exhibiting a lung disease or pulmonary disorder, has the steps of: activating an acoustic shock wave or acoustic wave generator or source to emit acoustic shock waves or pressure pulses from a fixed acoustic wave source or a handheld shock wave or pressure pulse head; and administering a plurality of acoustic waves in a pressure pulse or shock wave pattern within the lung tissue of less than 10.0 mJ/mm2 per shock wave, the plurality of acoustic waves in a pressure pulse or shock wave pattern being directed to a portion of the lung exhibiting the lung disease or pulmonary disorder.

An ultrasound medical instrument includes a medical ultrasonic blade having a proximal blade portion and a distal blade portion. The distal blade portion bends more easily than does the proximal blade portion. A user-actuated articulated sheath surrounds a portion of the medical ultrasonic blade. The distal blade portion includes a distal end portion adapted to contact and ultrasonically treat patient tissue.

A catheter assembly including, in some embodiments, a sonic connector at a proximal end of a core wire, a damping mechanism around a proximal end portion of the core wire, and a heat sink connected to the damping mechanism. The sonic connector is configured to couple to an ultrasound-producing mechanism and transmit vibrational energy to the proximal end of the core wire, which core wire includes a distal end portion configured to modify intravascular lesions. The damping mechanism includes a gasket system around the proximal end portion of the core wire in a damping-mechanism bore of the catheter assembly. The damping mechanism is configured to damp the vibrational energy. A system including, in some embodiments, the catheter assembly and the ultrasound-producing mechanism is also disclosed.