A dilation balloon is wrapped in one or more patterns with a wire or braided material having diamond abrasive or other abrasive material bonded thereto. The wire or braided material is vibrated in one or more ways to enhance the cutting action of the wire abrasive. The wire abrasive may be vibrated using high, low, or even ultrasonic waves transmitted to the wire abrasive via local or remote methods. Alternatively, the dilation balloon may be dilated with a contrast media that exhibits a high absorption to laser light. The contrast material is lazed with a laser fiber or fibers inserted into the balloon interior, creating a substantial shockwave that vibrates the balloon and assists in the cracking or abrading of the surrounding plaque in contact with the dilation balloon. The cutting balloon may employ the abrasive coated wires described above or cutting blades.

Described herein are shock wave devices and methods for the treatment of calcified heart valves. One variation of a shock wave device may comprise an elongated flexible tube carried by a sheath. The tube may have a fluid input end, which may be located near a proximal end of the sheath. The tube may include a loop portion. The loop portion may be configured to be at least partially accommodated within a cusp of the heart valve. The tube may be fillable with a conductive fluid. In some variations, the shock wave device may include an array of electrode pairs associated with a plurality of wires positioned within the loop portion of a tube. The electrode pairs may be electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses.

Transcatheter device for the treatment of calcified native heart valve leaflets comprising an outer hollow shaft (5), an inner hollow shaft (4) slidingly contained within said outer shaft (5) and an axle body (6) slidingly contained within said inner shaft (4); wherein the device comprises a commissure debridement system (7), located at the distal end of the axle body (6), that is made of at least two radially expandable arms (7) that are adapted to be inserted in and aligned with native commissures.

A catheter system (100) includes an energy source (124), a catheter shaft (110), a balloon (104), a plurality of energy guides (122A), a plurality of emitters (135), and a system controller (126). The energy source (124) generates energy. The balloon (104) is coupled to the catheter shaft (110). The balloon (104) includes a balloon wall (130) that defines a balloon interior (146) that retains a catheter fluid (132). The energy guides (122A) selectively receive energy from the energy source (124). The emitters (135) are positioned within the balloon interior (146). Each emitter (135) includes a guide distal end (122D) of one of the energy guides (122A) and a corresponding plasma generator (133) that is spaced apart from the guide distal end (122D). The energy received by each of the energy guides (122A) is emitted from the guide distal end (122D) and impinges on the corresponding plasma generator (133) so that plasma is generated in the catheter fluid (132) within the balloon interior (146). The system controller (126) controls the energy source (124) so that energy from the energy source (124) is alternatively directed to each of the energy guides (122A) in a first pattern of firing and a second pattern of firing that is different than the first pattern of firing.

Described herein are shock wave devices and methods for the treatment of calcified heart valves. One variation of a shock wave device may comprise an elongated flexible tube carried by a sheath. The tube may have a fluid input end, which may be located near a proximal end of the sheath. The tube may include a loop portion. The loop portion may be configured to be at least partially accommodated within a cusp of the heart valve. The tube may be fillable with a conductive fluid. In some variations, the shock wave device may include an array of electrode pairs associated with a plurality of wires positioned within the loop portion of a tube. The electrode pairs may be electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses.

A surgical method and tool for establishing a steam bubble between a fiber tip and a surgical target. The device and process capable of maintaining the steam bubble by providing a low-power, continuous-wave laser emission. Furthermore, the method and tool capable of delivering to the surgical target through the steam bubble a therapeutic laser emission providing ablation of the surgical target.

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.

Embodiments of the present invention comprise a fiber optic guidewire having a hypotube with a plurality of openings that provide variable stiffness and tracking characteristics between at least one proximal segment and one distal segment of the guidewire. In some embodiments, the guidewire further comprises a mandrel disposed within the hypotube, the mandrel cooperating with the optical fibers to permit the distal end of the hypotube to be shaped as desired by a user. Methods of manufacturing and using the guidewire are also disclosed.

The application relates to a cleaning system configured for cleaning of cavities filled with a liquid, including fragmentation, debridement, material removal, irrigation, disinfection, and decontamination. The cleaning system includes an electromagnetic radiation system and a liquid. A treatment handpiece irradiates the liquid within a cavity with a radiation beam, producing a first vapor bubble using first pulse, and, at a different location, a second vapor bubble using a second pulse. The pulse repetition time is adjusted to ensure efficacy, for example such that an onset time of the second vapor bubble is within the first contraction phase of the first vapor bubble, when the first vapor bubble has contracted from its maximal volume to a size in a range from about 0.7 to about 0.1 of the maximal volume.

The present disclosure relates generally to the use of medical devices for the treatment of vascular conditions. In particular, the present disclosure provides devices and methods for using laser-induced pressure waves created within a sheath to disrupt intimal and medial calcium within the vasculature. The present disclosure also provides treatment mode selection systems that may be used with such devices and methods.