A laser fiber for use in performing a medical laser treatment includes an optical fiber and a fiber tip. The optical fiber includes a terminating end surface at a distal end. The fiber tip is positioned at the distal end of the optical fiber and includes a transmissive portion and a spacer portion. Laser energy discharged from the terminating end surface of the optical fiber is transmitted through the transmissive portion. The spacer portion defines a distal terminating end of the fiber tip that is spaced a predetermined distance from the terminating end surface of the optical fiber. The predetermined distance is set for shock wave generation for calculus destruction at the distal terminating end of the fiber tip.

A medical device may include an elongated body having a distal elongated body portion and a central longitudinal axis. The medical device may include a balloon positioned along the distal elongated body portion. The balloon may be configured to receive a fluid to inflate the balloon such that an exterior balloon surface contacts a calcified lesion within a patient's vasculature. The medical device may include one or more pressure wave emitters positioned along the central longitudinal axis of the elongated body. The one or more pressure wave emitters may be configured to propagate at least one pressure wave through the fluid to fragment the calcified lesion. At least one pressure wave emitter may include an optical fiber configured to transmit laser energy into the balloon. The laser energy may be configured to create a cavitation bubble in the fluid.

A catheter system (100) for treating one or more treatment sites (106) within or adjacent to the heart valve (108) includes an energy source (124), a plurality of energy guides (122A), and a balloon assembly (104). The energy source (124) generates energy. The plurality of energy guides (122A) are configured to receive energy from the energy source (124). The balloon assembly (104) includes a plurality of balloons (104A) that are each positionable substantially adjacent to one or more treatment site(s) (106). Each of the plurality of balloons (104A) has a balloon wall (130) that defines a balloon interior (146). Each of the plurality of balloons (104A) is configured to retain a balloon fluid (132) within the balloon interior (146). A portion of at least one of the plurality of energy guides (122A) that receive the energy from the energy source (124) is positioned within the balloon interior (146) of each of the plurality of balloons (104A) so that plasma is formed in the balloon fluid (132) within the balloon interior (146).

A catheter system for imparting pressure to induce fractures at a treatment site within or adjacent a blood vessel wall includes a catheter, a fortified balloon inflation fluid and a first light guide. The catheter includes an elongate shaft and a balloon that is coupled to the elongate shaft. The balloon has a balloon wall and can expand to a first expanded configuration to anchor the catheter in position relative. The fortified balloon inflation fluid can expand the balloon to the first expanded configuration. The fortified balloon inflation fluid includes a base inflation fluid and a fortification component. The fortification component reduces a threshold for inducing plasma formation in the fortified balloon inflation fluid compared to the base inflation fluid. The fortification component can include at least one of carbon and iron. The first light guide is disposed along the elongate shaft and is positioned at least partially within the balloon. The first light guide is in optical communication with a light source and the fortified balloon inflation fluid. The light source provides sub-millisecond pulses of a light to the first light guide so that plasma formation and rapid bubble formation occur in the fortified balloon inflation fluid, thereby imparting pressure waves upon the treatment site.

A catheter system (100) includes a light guide (122A) and a light source (124). The light guide (122A) is configured to selectively receive light energy. The light source (124) generates the light energy. The light source (124) is in optical communication with the light guide (122A). The light source can include (i) a seed source (260) that outputs the light energy, (ii) a pre-amplifier (262) that receives the light energy from the seed source (260), the pre-amplifier (262) being in optical communication with the seed source (260), and (iii) an amplifier (264) that receives the light energy from the pre-amplifier (262), the amplifier (264) being in optical communication with the pre-amplifier (262) and the light guide (122A).

A method for manufacturing a catheter (102) including a rapid exchange port (157). The method can include the steps of creating a port (258) in a catheter shaft (210), inserting a port tube (360) into the port (358), skiving the port tube (360) so that it is flush with the catheter shaft (310), inserting a guidewire lumen (718) into the port tube (760), coupling the guidewire lumen (718) to the port tube (760), and skiving the guidewire lumen (718) so that it is flush with the catheter shaft. The method can also include the steps of inserting a port mandrel (462) into the port tube (460), inserting a catheter mandrel (464) into the catheter shaft (410), positioning a heat shrink (465) over a portion of the catheter shaft (410), applying heat to the heat shrink (465), removing the port mandrel (462) from the port tube (460), removing the catheter mandrel from (464) the catheter shaft (410), and sealing a gap between the guidewire lumen (718) and the port tube (760).

The present invention provides a catheter for treating occlusions in body lumens. The catheter includes a catheter body that is fillable with fluid. An impactor is connected to the distal end of the catheter body and has a proximal end inside the catheter body and a distal end outside the catheter body. The catheter also includes a shock wave source configured to generate a shock wave, and a deflector coupled to the proximal end of the impactor in between the shock wave source and distal end of the catheter body. When the shock wave source generates a shock wave, the shock wave impinges on the deflector causing the deflector to advance in a forward direction in conjunction with the impactor such that the distal end of the impactor delivers a mechanical force to the occlusion to restore flow to the body lumen.

An interventional system with real-time ablation thermal dose monitoring includes an interventional tool, an ultrasound transmitter at least one of attached to or integral with the interventional tool, an ultrasound receiver configured to receive ultrasound signals from the ultrasound transmitter after at least one of transmission through or reflection from a region of tissue while under an ablation procedure and to provide detection signals, and a signal processing system configured to communicate with the ultrasound receiver to receive the detection signals and to calculate, based on the detections signals, a thermal dose delivered to the region of tissue in real time during the ablation procedure.

A method of treating a mobile target tissue with a laser beam includes: providing a laser device for generating a laser beam and providing an optical fiber having a delivery end for guiding the laser beam to the target tissue; a controller causes the laser device to generate one or more laser pulses substantially along the same longitudinal axis. The controller causes the laser device to provide one or more laser pulses. The one or more pulses are selected to allow a vapor bubble formed by the one or more pulse to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the delivery end of the fiber and the target tissue. The one or more pulses are delivered to the target tissue through the vapor bubble after the vapor bubble has reached its maximum extent and has begun to collapse to reduce retropulsion of the mobile target tissue.

A medical instrument is disclosed that includes an elongate flexible shaft, a plurality of optical fibers extending along the length, and a laser control module coupled with the optical fibers. The instrument is configured for insertion into a patient body and/or into a working channel of an endoscope (e.g., ureteroscope). The instrument is configured for ablation of body tissue and/or a foreign substance within the body. The optical fibers can define a cross-sectional diameter within a range of 50 ?m to 150 ?m. Three or more of the optical fibers can be bundled together defining a circumscribed circle having a cross-sectional diameter less than 500 ?m. Some optical fibers are peripherally disposed along the shaft and are configured to direct light radially outward. A lumen extending along the length of the shaft is coupled with fluid port coupled with the shaft.