A catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (108A) of a blood vessel (108) within a body (107) of a patient (109) includes an energy source (124), a catheter fluid (132), and an emitter assembly (129). The energy source (124) generates energy. The emitter assembly (129) includes (i) at least a portion of an energy guide (122A) having a guide distal end (122D) that is selectively positioned near the treatment site (106), (ii) a plasma generator (133), and (iii) an emitter housing (260) that is secured to each of the energy guide (122A) and the plasma generator (133) to maintain a relative position between the guide distal end (122D) of the energy guide (122A) and the plasma generator (133). The energy guide (122A) is configured to receive energy from the energy source (124) and direct the energy toward the plasma generator (133) to generate a plasma bubble (134) in the catheter fluid (132). The plasma generator (133) directs energy from the plasma bubble (134) toward the treatment site (106).

A multi-conductor cable for use in a catheter is described. The conductor-cable is isotropically flexible to allow catheter steering, but is also longitudinally stiff enough to push and pull the entire cable through the catheter lumen. In one implementation, the multi-conductor cable is bundled for most of its length, to provide longitudinal stiffness and support pushing and pulling the cable through a catheter lumen. However, in one such implementation, the portion of the cable within a steerable section of the catheter is unbundled and divided into individual conductors or groups that are flexible enough that they do not bias or otherwise interfere with the steering of the catheter. In one such approach, a spring wire or other stiffening element is added to the cable at that location to preserve or enhance longitudinal stiffness (tension and compression) of the cable through the unbundled flexible section.

A catheter system and method for treating a treatment site within or adjacent to a vessel wall or a heart valve within a body of a patient includes an energy source, an inflatable balloon, an energy guide, and an acoustic sensor. The inflatable balloon is positionable substantially adjacent to the treatment site. The inflatable balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The energy guide receives energy from the energy source and guides the energy into the balloon interior. The acoustic sensor is positioned outside the body of the patient. The acoustic sensor senses acoustic sound waves generated in the balloon fluid within the balloon interior. The acoustic sensor generates a sensor signal based at least in part on the sensed acoustic sound waves.

Microsurgical instruments having combined illumination, laser ablation, and viscoelastic injection functions. A surgical instrument includes a probe having a main lumen and a port at a distal end thereof. The probe may further include one or more optical fibers within the main lumen, the optical fibers configured to project laser light and illumination light. Laser light may be emitted from the distal end of the probe for disrupting an ocular tissue, while illumination light may be simultaneously emitted, axially or laterally, to provide enhanced visualization of the intraocular space during tissue disruptance. Upon disrupting the tissue, a viscoelastic fluid may be injected from the port to maintain an integrity of the intraocular space.

A catheter system includes an inflatable balloon, an optical fiber and a laser. The optical fiber has a distal end positioned within the inflatable balloon. The optical fiber receives an energy pulse to emit light energy in a direction away from the optical fiber to generate a plasma pulse within the inflatable balloon. The laser includes a seed source that emits a seed pulse, and an amplifier that increases energy of the seed pulse. The energy pulse can have a somewhat square or triangular waveform with a duration T, a minimum power P.sub.0, a peak power P.sub.P, and a time from P.sub.0 to P.sub.P equal to T.sub.P, wherein T.sub.P is not greater than 40% of T. T can be within the range of greater than 50 ns and less than 3 μs. T.sub.P can be within the range of greater than 2.5 ns and less than 1 μs. P.sub.P can be within the range of greater than 50 kW and less than 1000 kW. A ratio in kW to ns of P.sub.P to T.sub.P can be greater than 1:5. The seed pulse can at least partially increase in amplitude over time.

The present disclosure relates generally to the use of medical devices for the treatment of vascular conditions. In particular, the present disclosure provides devices and methods for using laser-induced pressure waves created within a sheath to disrupt intimal and medial calcium within the vasculature.

A catheter for debulking of an undesired deposit from an inner surface of at least one of a blood vessel wall and a stent located in a blood vessel, the catheter having a tip section comprising: circumferentially-directed laser optics; and a circular-action cutter, wherein said circumferentially-directed laser optics is configured to transmit laser radiation for modifying an area of the undesired deposit thereby preparing said area for penetration of said cutter, wherein said cutter is configured to cut through said modified area and thereby debulk at least a part of the undesired deposit. In addition, a catheter for pacemaker and ICD (Implantable Cardioverter Defibrillator) lead extraction is disclosed.

Apparatus and methods for segmental treatment of hollow anatomical structures using an optical fiber are disclosed. An elongate energy application device can absorb, scatter and/or reflect laser energy over a length of the elongate energy application device to thereby treat the hollow anatomical structure along one or more lengthened treatment segments.

Devices and methods for treating rhinitis are described where the devices are configured to ablate a single nerve branch or multiple nerve branches of the posterior nasal nerves located within the nasal cavity. A surgical probe may be inserted into the sub-mucosal space of a lateral nasal wall and advanced towards a posterior nasal nerve associated with a middle nasal turbinate or an inferior nasal turbinate into a position proximate to the posterior nasal nerve where neuroablation of the posterior nasal nerve may be performed with the surgical probe. The probe device may utilize a visible light beacon that provides trans-illumination of the sub-mucosal tissue or an expandable structure disposed in the vicinity of the distal end of the probe shaft to enable the surgeon to visualize the sub-mucosal position of the distal end of the surgical probe from inside the nasal cavity using, e.g., an endoscope.

The present disclosure relates generally to the use of medical devices for the treatment of vascular conditions. In particular, the present disclosure provides devices and methods for using laser-induced pressure waves created within a sheath to disrupt intimal and medial calcium within the vasculature.