The invention generally relates to catheter systems and methods for guided formation of vascular access sites (such as fistulas and grafts). According to certain aspects, a catheter system for forming a vascular access site include an elongate body comprising a distal end and configured to be inserted into a first vessel. The elongate body includes an exit port along its side that is proximal to the distal end. An imaging assembly is associated with the elongate body and configured to generate image data of the first vessel and a second vessel positioned next to the first vessel. For vascular access formation, a penetrating member of the catheter system extends out of the exit port and through a wall of the first vessel and a wall of the second vessel.

A method and apparatus are disclosed for an optimized transseptal procedure for providing left heart access, that reduces the number of devices that are used in order to minimize procedural time, complexity and cost. The apparatus comprises a hybrid dilator that comprises the combined functionality of a transseptal sheath and dilator assembly. The hybrid dilator comprises: a dilator shaft defining a lumen for receiving a crossing device therethrough, the dilator shaft being structured to provide support for the crossing device when the crossing device is used to create a puncture in a tissue; and a distal tip having an outer diameter which tapers down to an outer diameter of the crossing device for providing a smooth transition between the crossing device and the distal tip when the crossing device is inserted through the lumen and protrudes beyond the distal tip.

Catheters with deployable instruments (e.g., needles) can damage tissue if the instrument unintentionally deploys during use. Described herein are devices and methods for controlling the position of a deployable catheter instrument. In one embodiment, a catheter can include an instrument slidably disposed within an inner lumen of the catheter and coupled to at least one protrusion, as well as a retraction stop coupled to the catheter. The catheter can further include a biasing element coupled to the instrument that can urge the instrument proximally such that the at least one protrusion abuts against the retraction stop, as well as an advancing mechanism to selectively engage the instrument and urge it distally. In some embodiments, the biasing element can be omitted and a deployment stop can be included distal to the retraction stop. These configurations can prevent unintentional instrument deployment and provide greater positioning precision during instrument deployment.

Devices and methods for shaping an ablation treatment volume formed in fluid enhanced ablation therapy are provided. The devices and methods disclosed herein utilize the interaction of fluids to create ablation treatment volumes having a variety of shapes. In one embodiment, a method for forming an ablation treatment volume having a desired shape includes delivering therapeutic energy to tissue to form an ablation treatment volume and simultaneously delivering a first fluid and a second fluid to the tissue. The first and second fluids can convect the therapeutic energy in a desired direction such that the ablation treatment volume has a desired shape.

Needles are deployed in tissue under direct ultrasonic or other imaging. To aid in deploying the needle, a visual needle guide is projected on to the image prior to needle deployment. Once the needle guide is properly aligned, the needle can be deployed. After needle deployment, a safety boundary and treatment region are projected on to the screen. After confirming that the safety boundary and treatment regions are sufficient, the patient can be treated using the needle.

The invention relates to a shaft for a medical instrument (12), in particular a homopolar or bipolar medical instrument, comprising a shaft member (16) that accommodates a tool (18) at the distal end, said tool (18) being provided with a first jaw part (19) and a second jaw part (21) which can be moved relative to each other from an open position (29) into a closed position (28) by a draw bar/push rod (26) that is guided inside the shaft member (16); at the proximal end, the shaft member (16) has a connecting piece (14) for attachment to a manipulating device (23) that allows the draw bar/push rod (26) to be moved back and forth; at the distal end, each jaw part (19, 21) is pivotally guided inside the shaft member (16) by means of a sliding block (49).

Systems and methods for treating a patient's mucus hypersecretion condition are disclosed herein. Certain implementations may involve a method for reducing mucus secretion in an upper airway of a patient to treat at least one of post nasal drip or chronic cough. The method may include advancing a treatment delivery portion of an energy-based treatment device into a nostril of the patient. The treatment delivery portion may contact mucosal tissue of the upper airway without piercing the mucosal tissue. The treatment delivery portion may deliver treatment to at least one tissue selected from the group of the mucosal tissue and another tissue underlying the mucosal tissue to modify a property of the at least one tissue and thus treat at least one of post nasal drip or chronic cough in the patient.

An ablation device includes a cannula having a proximal end, a distal end, and a lumen extending between the proximal and the distal ends, and a first array of electrodes at least partially disposed within the lumen, the first array of electrodes slidable relative to the cannula, each of the electrodes having a first configuration when inside the lumen, and a second configuration when unconfined outside the lumen, wherein one of the electrodes has a flared deployed profile.

An electrosurgical device coated an epoxy modified rigid silicone powder coating. This coating is applied to the surfaces of an electrosurgical device minimize the build-up of charred tissue (i.e., eschar) on the surfaces of the electrosurgical device.

A tissue ablation probe comprises an electrically conductive probe shaft, at least one electrode, and an electrically insulative sheath disposed on the probe shaft. The insulative sheath has thickened regions forming alternating ribs and depressions that longitudinally extend along the probe shaft. The ribs allow the ablation probe to be delivered through a tightly toleranced delivery device. While the ribs may shear off during the delivery process, the underlying probe shaft will remain covered by the remaining portion of the insulative sheath. The tissue ablation probe may be used in a tissue ablation assembly that additionally comprises a delivery cannula having a lumen in which the tissue ablation probe may be removably disposed. In this case, the sheath has an outer periphery having a size substantially the same as the diameter of the lumen, so that the inner surface of the delivery cannula cooperates with the depressions to create lumens that longitudinally extend within the cannula.