A peripheral vessel tissue modification system includes a first longitudinal member, a second longitudinal member, and a radiofrequency energy source. The first member is configured for advancement into a peripheral vessel of a patient, is coupled to the energy source, and extends along a length between a proximal end and a distal end. The first member includes an inner lumen extending along its length and a distal electrode located on an outer surface proximate to the distal end and electrically coupled to the energy source. The second member is configured for insertion into the vessel through the lumen, is coupled to the energy source, and extends along a length between a proximal end and a distal end including a tip electrode. The second member is moveable with respect to the first member to create a bipolar arrangement between the distal electrode and the tip electrode for delivery of radiofrequency energy.

A medical device may include an ablation device configured to deliver ablation energy to a treatment site. The medical device may further include a probe device configured to deliver excitation radiation to the treatment site. Further the medical device may include a radiation-receiving device configured to receive photoluminescence radiation emitted from the treatment site in response to the treatment site being illuminated by the excitation radiation and to generate a detection signal in response to the received photoluminescence radiation. Additionally, the excitation radiation may be different from the ablation energy.

The present disclosure relates to methods and systems for removing a vascular obstruction in a subject using a combination of thrombolytic and laser ablation therapy. Treatment methods include positioning a catheter adjacent to an obstruction within a vessel of a subject. A portion of the obstruction may be ablated by delivering laser energy through the optical fibers to the distal end of the catheter, where the optical fibers are exposed, and circulating a fluid containing one or more thrombolytic agents to a remaining portion of the obstruction for a predetermined amount time. Fluid containing one or more thrombolytic agents capable of dissolving a remaining portion of the obstruction may be circulated through the fluid delivery lumen and removed through the fluid removal lumen.

New devices and methods for deflecting a catheter progressing within a lumen, into a preferred direction, typically in order to accomplish ablative removal of obstructive material within that lumen without the danger of uncontrolled catheter deflection risking perforation of the lumen. The catheter may ride on a guide wire, or it may be free riding down the lumen, limited by the passages available in the obstructive material, and generating its own passage by debulking the material within the lumen. The types of deflection required may be radial or lateral. A number of novel configurations are described, including improvements to the slotted wall catheter, by selection of the shape, spacing and location of the slots. Other implementations include a catheter with a novel spring configuration, which can release itself from a situation in which the catheter becomes stuck when widening an initial narrow bore in an obstructed vessel.

Embodiments relate to the design and use of a low profile ablation catheter with a liquid core for use in laser ablation removal of arterial plaque blockages to restore blood flow.

A medical device may include an ablation device configured to deliver ablation energy to a treatment site. The medical device may further include a probe device configured to deliver excitation radiation to the treatment site. Further the medical device may include a radiation-receiving device configured to receive photoluminescence radiation emitted from the treatment site in response to the treatment site being illuminated by the excitation radiation and to generate a detection signal in response to the received photoluminescence radiation. Additionally, the excitation radiation may be different from the ablation energy.

A device includes a first end portion, a second end portion, an intermediate portion, and a graft material. The first end portion has a first end diameter. The second end portion has a second end diameter smaller than the first end diameter. The first end portion comprises a first material. The second end portion comprises a second material different than the first material. The intermediate portion is between the first end portion and the second end portion. The intermediate portion tapers between the first end portion and the second end portion. The graft material is coupled to at least the intermediate portion.

Catheter systems of the invention are directed to the removal of occlusions, such as thrombi and plaque, within blood vessels. In certain aspects, catheter systems of the invention include an elongate body defining a first lumen and comprising a distal portion, an inner member configured for insertion into the first lumen, the inner member comprising an energy source configured to deliver therapeutic energy to a treatment site; and a dissolution element coupled to the distal portion of the elongate body. The dissolution element may include a heating element, steam, and a balloon.

Apparatus and methods for determining a type of a material in a region within a vascular system of a patient and/or a distance to the material are provided. At least one source fiber is provided that supplies light from a light source to a region within a vascular system of a patient. At least one return fiber is provided to receive light reflected from the region within the vascular system. At least one controller is provided to determine at least one property of the region within the vascular system from the reflected light, and to determine a type of a material in the region within the vascular system and/or an indication of a distance to the material. Techniques such as laser ablation may then be performed based on the determined material type and/or distance to remove unwanted buildup, deposits, etc., while avoiding harmful results such as tearing of tissue.

Apparatus and methods for determining a type of a material in a region within a vascular system of a patient are provided. The determination is made after light has been reflected from the region after being supplied to the region from a light source by at least one optical fiber. The determination is made based on an analysis of the light reflected from the region and of a received at least one indication of a force applied to the material in the region by one or more of the at least one optical fiber. The indication of the force applied by the one or more of the at least one optical fiber is provided by at least one force sensor coupled to the at least one optical fiber.