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 catheter system for treating a vascular lesion within or adjacent to the vessel wall or heart valve includes a balloon and a fluid circulator. The balloon includes a balloon wall that defines a balloon interior. The balloon is configured to retain a catheter fluid within the balloon interior. The fluid circulator is coupled in fluid communication to the balloon interior. The fluid circulator is configured to selectively circulate the catheter fluid out of and back into the balloon interior during use of the catheter system. The fluid circulator is configured so that a temperature of the catheter fluid within the balloon interior is maintained within a predetermined temperature range. Additionally, the fluid circulator can be configured so that a pressure of the catheter fluid within the balloon interior is maintained within a predetermined pressure range. Further, a filtration system can be coupled in fluid communication with the fluid circulator to remove microparticles from the catheter fluid.

A catheter system 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 energy source generates energy. 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. A system controller receives the sensor signal from the acoustic sensor and controls operation of the catheter system based at least in part on the sensor signal.

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.

In some embodiments, without limitation, the invention comprises a catheter having an elongated housing with a channel disposed therein. A laser delivery member is movable and at least partially disposed within the channel. A ramp is disposed within the housing at an angle to its central axis and proximate to its distal end. The ramp is adapted to move the distal end of the laser delivery member outwardly from the central axis of the housing. A guidewire biases the distal end of the laser delivery member generally inwardly toward the central axis of the housing. In some embodiments, without limitation, the offset of the central axis of the tip of the laser delivery member from the central axis of the housing is determined by adjusting the extent to which the laser delivery member travels on the ramp, and disposition of the laser delivery member on the guidewire maintains the offset tip substantially parallel to the central axis of the housing. Thus, in accordance with the invention, the distal end of the laser delivery member may be biased in a desired direction or offset, permitting ablation of an area larger than the area of the distal end of the catheter.

Systems for enabling delivery of very high peak power laser pulses through optical fibers for use in ablation procedures preferably in contact mode. Such lasers advantageously emit at 355 nm wavelength. Other systems enable selective removal of undesired tissue within a blood vessel, while minimizing the risk of damaging the blood vessel itself, based on the use of the ablative properties of short laser pulses of 320 to 400 nm laser wavelength, with selected parameters of the mechanical walls of the tubes constituting the catheter, of the laser fluence and of the force that is applied by the catheter on the tissues. Additionally, a novel method of calibrating such catheters is disclosed, which also enables real time monitoring of the ablation process. Additionally, novel methods of protecting the fibers exit facets are disclosed.

Devices and methods are discussed directed to the use of a low profile laser ablation catheter for use in laser ablation removal of arterial plaque blockages to restore blood flow in the treatment of arteriovenous fistulas. Also discussed are devices and methods directed to packaging, long term storage and sterilization of liquid core ablation catheters.

A catheter system for treating a vascular lesion within or adjacent to a vessel wall within a body of a patient includes a catheter fluid, an energy source that generates energy, an energy guide and an energy manifold. The energy guide includes a guide distal end that is selectively positioned near the vascular lesion. The energy guide is configured to receive energy from the energy source and generate a plasma bubble within the catheter fluid. The energy manifold is coupled to the energy guide near the guide distal end. The energy manifold includes (i) a manifold body that defines a body chamber, the body chamber being configured to retain at least some of the catheter fluid, and (ii) a manifold aperture that extends through the manifold body. The energy manifold directs energy from the plasma bubble out of the body chamber through the manifold aperture and toward the vascular lesion.

A shock wave treatment device to treat skin and adjacent tissue with a combination of mechanical stimulation and acoustic pressure shock waves, such as methods for cosmetic applications, enhancing blood circulation, and wound treatment, includes a pressure shock wave applicator having a reflector and a mechanical stimulator of one or both of a vacuum device and roller device.

A laser system may include a controller configured to direct a plurality of temporally spaced-apart electrical pulses to a device that optically pumps a lasing medium, and a lasing medium configured to output a quasi-continuous laser pulse in response to the optical pumping. The plurality of temporally spaced-apart electrical pulses may include (a) a first electrical pulse configured to excite the lasing medium to an energy level below a lasing threshold of the lasing medium, and (b) multiple second electrical pulses following the first electrical pulse. The quasi-continuous laser pulse is output in response to the multiple second electrical pulses.