The present disclosure includes catheter systems and methods for treatment of occlusions, including coronary artery chronic total occlusions. The catheter system comprises a catheter coupled to a control system with a distal end inserted into a patient and proximal to a location within a blood vessel with an occlusion. The catheter comprises a flexible outer sheath surrounding a housing with a plurality of lumens to perform various functions to penetrate occlusions.

A catheter system includes a catheter having an elongate shaft, a balloon and a light guide. The balloon expands from a collapsed configuration to a first expanded configuration. The light guide is disposed along the elongate shaft and is in optical communication with a light source and a balloon fluid. A first portion of the light guide extends into a recess defined by the elongate shaft. A protection structure is disposed within the recess and is in contact with the first portion of the light guide. The light source provides pulses of light to the balloon fluid, thereby initiating plasma formation and rapid bubble formation within the balloon, thereby imparting pressure waves upon a treatment site. The protection structure can provide structural protection from the pressure waves to the first portion of the light guide.

A catheter system for treating a treatment site within or adjacent to a vessel wall within a body of a patient includes an energy source, a balloon, and an energy guide. The energy source generates energy. The balloon includes a balloon wall that defines a balloon interior. The balloon is configured to retain a balloon fluid within the balloon interior. The balloon is selectively inflatable with the balloon fluid to expand to an inflated state, wherein when the balloon is in the inflated state the balloon wall is configured to be positioned substantially adjacent to the treatment site. The balloon further includes a balloon central axis that extends through a geometric center of the balloon when the balloon is in the inflated state. The energy guide selectively receives energy from the energy source and guides the energy from the energy source into the balloon interior. The energy guide including a guide distal end that is positioned on the balloon central axis when the balloon is in the inflated state.

An endoscope device includes: a light source capable of switching an optical spectrum of illumination light; an imaging device configured to acquire an image by receiving reflection light of the illumination light; an image processor configured to determine whether or not visibility deterioration has occurred within a visual field of the image acquisition section due to a fragment of a calculus crushed by being irradiated with a laser beam from a laser pulse generator; and a controller configured to control the light source based on a determination result obtained by the image processor. The controller causes the light source to emit white light as the illumination light in response to the image processor determining that the visibility deterioration has not occurred, and switches the illumination light emitted from the light source to light in a blue region in response to the image processor determining that the visibility deterioration has occurred.

A sheath assembly for use with an endoscope and an endoscope that includes the sheath assembly. The sheath assembly can include an elongate tubular sheath configured to thread onto a shaft of the endoscope. The sheath can include a pliable segment at a distal end of the sheath, and a tensile filament extends along a circumference of the pliable segment. The tensile filament can form a cinching loop at a distal end of the pliable segment. The sheath can be displaceable along the endoscope between a retracted position and an extended position. The pliable segment can extend distally beyond a distal end of the endoscope to form a chamber, and proximal displacement of the tensile filament tightens the cinching loop to convert the chamber from an open configuration to a closed configuration.

A catheter system for treating a treatment site within or adjacent to a vessel wall or a heart valve, includes a light source, a balloon, a light guide and an optical analyzer assembly. The light source generates first light 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 light guide receives the first light energy and guides the first light energy in a first direction from a guide proximal end toward a guide distal end positioned within the balloon interior. The optical analyzer assembly optically analyzes a second light energy from the light guide that moves in a second direction that is opposite the first direction. The optical analyzer assembly includes a safety shutdown system to inhibit the first light energy from being received by the guide proximal end of the light guide.

A device and method of using the device to detect the presence and composition of clots and other target objects in a circulatory vessel of a living subject is described. In particular, devices and methods of detecting the presence and composition of clots and other target objects in a circulatory vessel of a living subject using in vivo photoacoustic flow cytometry techniques is described.

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.

Balloon catheters with an elongate shaft defining a hollow body have an inflatable balloon at a distal end thereof. The balloon has a plurality of internal chambers that are inflatable to differing pressures. When inflated, the balloon has a generally hourglass shape having a neck between a distal end and a proximal end and a port at the neck that is in open communication the hollow body of the shaft and in open communication with an environment external to the balloon. The balloon catheter is inflated in a lumen of a patient to its hourglass shape with its proximal and distal ends in direct contact with normal endothelium juxtaposed to a target lesion with the neck of the balloon at the target lesion. A cutting tool is deployed through the port and an opening having a flap is cut into the target lesion and the plaque is removed thereof.

Outer jacket support embodiments for laser ablation catheter embodiments are discussed herein. In some cases, such outer jacket support embodiments may be useful for improving the robustness and performance of laser ablation catheters.