Apparatus and methods for ablating material in a region within a vascular system of a patient are provided. A determination of at least one of a type of material in the region and an indication of a distance to the material in the region is made based on at least one property of the region determined from light reflected from the region. Light from a light source is transmitted in at least one of a plurality of optical fibers based on the determination, and at least some of the transmitted light is received at a first emitter disposed along a length of a laser catheter proximate a distal end thereof. The first emitter radially transmits the at least some of the light from the length of the laser catheter so that the light impinges upon and ablates the material through an opening in the length of the laser catheter.

Laser ablation catheters and methods of using same for efficient tissue ablation are disclosed. In some cases, laser ablation catheter embodiments may include expanded distal tips that allow for beam energy expansion and reduce dead space at the distal cutting surface of the laser ablation catheter.

An intracorporeal pressure shock wave device to provide treatment within blood vessels artificial vessels and grafts that includes a frontal pressure shock wave reflector positioned at the distal end of an intracorporeal catheter to direct shock waves toward a treatment target, such as an occlusion and clot.

A photoacoustic catheter can include an elongate shaft and a first photoacoustic transducer. The elongate shaft can extend from a proximal region to a distal region and can include a first light guide that is in optical communication with a light source. The first photoacoustic transducer can be disposed within the distal region of the elongate shaft and can be in optical communication with the first light guide. The first photoacoustic transducer can impart acoustic pressure waves upon a calcified lesion to induce fractures. The first photoacoustic transducer can include a light-absorbing material and a thermal expansion material that can be in contact with one another. The thermal expansion material can include polydimethylsiloxane, polytetrafluoroethylene, polyimide, polyisobutylene, polyisobutylene polyurethane, polyurethanes, styrene isoprene butadiene, ethylene propylene polyacrylic, ethylene acrylic, fluorosilicone, polybutadiene, polyisoprene, and/or thermoplastic elastomers. The light-absorbing material can include nanoparticles, carbon nanotubes, candle soot, candle soot nanoparticles, carbon black, a nanotube array, multiwall carbon nanotubes, and/or light absorbing dye. The first light guide can be an optical fiber and the light source can be a laser.

A method of delivering light energy to target matter in a mammalian body is described. The method may include inserting at least a portion of a catheter into a patient's vasculature, wherein the catheter comprises an open distal tip, a lumen extending proximally from the open distal tip, and at least one optical fiber within the lumen, wherein the at least one optical fiber has a distal end. The method may include flowing a liquid light guide medium through the open-ended catheter tip, wherein the liquid light guide medium flows beyond the distal end of the at least one optical fiber, wherein the liquid light guide medium comprises a magnesium chloride solution having an ion concentration that is isotonic with blood and tissue. The method may include forming a fluid optical channel with the liquid light guide medium between the catheter and the target matter. Other methods are described.

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

A laser atherectomy device includes a light delivery catheter equipped with sensors for monitoring physical characteristics at a laser application site. An integrated control unit utilizing data from said sensors is provided to optimally adjust laser energy parameters and to provide for safe and efficacious ablation of the blood vessel occlusion.

Catheters for ablation and removal of occlusions from blood vessels are provided. Laser cutting systems and mechanical cutting systems are provided in catheter devices, the cutting systems operable to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Catheters include expandable distal ends to facilitate, in some cases, relatively high bodily material removal rates compared to other devices.

A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. hi this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde 5 approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion. By appropriately maneuvering each member and applying radiofrequency energy between the proximal and distal ends of the occlusion, a continuous channel is created.

The present disclosure is directed to a medical device. Systems and methods are provided for utilizing a laser to break a kidney stones into smaller fragments and/or dust, and removing particles, stone fragments and/or stone dust from a patient. The medical device may include a delivery device including a tube, and an elongate member having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, wherein the elongate member is configured to move axially relative to the tube and apply suction through the distal end.