A laser lithotripsy system includes a thulium-based laser that, upon activation, selectively produces a continuous wave of laser light with a first wavelength or uniformly spaced, intermittent pulses of laser light with the first wavelength. The system further includes a second laser that, upon activation, produces laser light with a second wavelength, which is shorter than the first wavelength. The system includes an optical detector positioned to receive light emitted by a target in response to the target being impacted by the light produced by the second laser, and a controller communicatively coupled to both the optical detector and the first laser such that the controller selectively activates and deactivates the first laser based on one or more measured characteristics of the light emitted by the target and received by the optical detector.

A catheter system for treating a treatment site within or adjacent to the heart valve within a body of a patient includes an energy source, an energy guide and an energy director. The energy source generates energy. The energy guide includes a guide proximal end and a guide distal end. The energy guide is configured to receive energy from the energy source and guide the energy from the guide proximal end toward the guide distal end. The energy director includes a director wall that defines a director interior, and a director distal end that is selectively positioned substantially adjacent to the treatment site. The guide distal end of the energy guide is positioned within the director interior. The director distal end is at least partially open toward the treatment site.

A medical interventional tool has distal and proximal ends. A responsive material is located at the distal end or elsewhere along the interventional tool and is capable of providing a temperature-dependent or pressure-dependent optical response. At least one optical guide is in optical communication with the responsive material to collect an optical signal from the responsive material located at the distal end or other location along the interventional tool. The at least one optical guide further guides the collected optical signal to an optical output at the proximal end of the interventional tool. An optical response analyzer is configured to receive the collected optical signal from the optical output and to process the collected optical signal to derive therefrom a temperature or pressure reading or indication representative of a temperature or pressure at the distal end or other location along the interventional tool.

A fluid stream is directed toward tissue to generate a plurality of shedding clouds. The fluid stream can be scanned such that the plurality of shedding clouds arrive a different overlapping locations. Each of the plurality of shedding clouds can remove a portion of the tissue. In many embodiments, an apparatus to ablate tissue comprises a source of pressurized fluid, and a nozzle coupled to the source of pressurized fluid to release a fluid stream, in which the fluid stream generates a plurality of shedding clouds.

A catheter system (100) for treating a vascular lesion (106) within or adjacent to a heart valve (108) within a body (107) of a patient (109), includes an energy source (124), and a plurality of spaced apart treatment devices (143). The energy source (124) generates energy. Each treatment device (143) includes (i) a balloon (104) that is positionable substantially adjacent to the vascular lesion (106), the balloon (104) having a balloon wall (130) that defines a balloon interior (146), the balloon (104) being configured to retain a balloon fluid (132) within the balloon interior (146); and (ii) at least one of a plurality of energy guides (122A) that receive energy from the energy source (124) so that plasma (134) is formed in the balloon fluid (132) within the balloon interior (146).

Embodiments of the invention include a compact, lightweight, hand-held laser treatment device that combines the emissions of two separate laser energy sources into a common optical pathway for improved therapeutic effect. In some embodiments, the device includes a housing having separate first and second laser sources disposed within the interior thereof. In some embodiments, the laser energy emissions from the two internal laser sources can be individually or concurrently transmitted to a delivery tip of the device via a laser transmission path also defined within the interior of the housing. In some embodiments, the structural and functional features of the first and second laser sources, in concert with the unique architecture of the laser transmission path, can be configured to provide efficacy and efficiency in the operation of the device within the spatial constraints of the lightweight, hand-held housing thereof.

A catheter system for treating a vascular lesion within or adjacent to a vessel wall within a body of a patient includes a single light source that generates light energy, a first light guide and a second light guide, and a multiplexer. The first light guide and the second light guide are each configured to selectively receive light energy from the light source. The multiplexer receives the light energy from the light source in the form of a source beam and selectively directs the light energy from the light source in the form of individual guide beams to each of the first light guide and the second light guide.

Articles of manufacture, including terminations of or attachments to optical fibers are configured to substantially prevent axial emission and redirect radially most if not all light emanating from optical fibers. In that, a termination may include a fiber cap of a unitary construction of a tube and an optical element disposed to face a sealed end of the tube and dividing a hollow of the tube and having a conical surface, or an optical element dividing the hollow and complemented by a cone. An example of termination includes an optical fiber element having an up-tapered end with a maximum taper-diameter exceeding the core-diameter and ending at a conical element with an apex angle from about 70° to about 100°. Articles of manufacture additionally including mounting contraptions cooperating such terminations with cannulae to form an attachment to a laser system. Methods for transmitting light through such articles of manufacture.

A catheter system for treating a treatment site within or adjacent to a vessel wall or a heart valve includes an energy source, a balloon, an energy guide, and an electrical analyzer assembly. The energy source generates energy. The balloon is positionable substantially adjacent to the treatment site. The balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The energy guide is configured to receive energy from the energy source and guide the energy into the balloon interior. The electrical analyzer assembly is configured to monitor a balloon condition during use of the catheter system. The electrical analyzer assembly can include a first electrode, a second electrode, and an impedance detector that is electrically coupled to the first electrode and the second electrode. The impedance detector is configured to detect impedance between the first electrode and the second electrode.

A side-firing laser system with a standoff catheter includes an optical fiber configured to emit therapeutic laser radiation in a direction generally transverse to an axis of the fiber; and a catheter through which the optical fiber is inserted during a surgical procedure. The catheter includes a transparent end section through which the therapeutic laser radiation passes to vaporize tissue outside the catheter, an open distal end to permit exit of irrigation fluid from the catheter, and an opening in a side of the end section, the opening having dimensions that are approximately equal to or less than cross-sectional dimensions of the therapeutic laser radiation. When the fiber is moved to a position at which the therapeutic laser radiation passes through the opening, the laser radiation causes coagulation or vaporization of tissues.