A catheter system (100) for treating a vascular lesion (106A) within or adjacent to a vessel wall (108A) of a blood vessel (108) within a body (107) of a patient (109) includes a catheter shaft (210); a handle assembly (228); and a source manifold (236). The handle assembly (228) is coupled to the catheter shaft (210). The handle assembly (228) includes an assembly housing (266). The handle assembly (228) is usable by a user to selectively position the catheter shaft (210) near the vascular lesion (106A). The source manifold (236) is coupled to the assembly housing (266). The source manifold (236) includes a manifold housing (282) having a catheter shaft port (264) that is configured to receive a portion of the catheter shaft (210) so that the catheter shaft (210) is coupled to the manifold housing (282).

The presently disclosed subject matter provides techniques for inducing collagen cross-linking in human tissue, such as cartilage, by inducing ionization of the water contained in the tissue to produce free radicals that induce chemical cross-linking in the human tissue. In an embodiment, a femtosecond laser operates at sufficiently low laser pulse energy to avoid optical breakdown of the tissue being treated. In an embodiment, the femtosecond laser operates in the infrared frequency range.

An instrument for endoscopic applications, including urology. The instrument may include both irrigation and aspiration channels, effective attraction and suction of tissue and body stone fragments, enhanced viewing clarity of the operational area, illumination fibers with steering function for flexible version of the scopes. In some embodiments, a distal head is configured to locate a mouth of the working channel within a viewing angle of the visualization system. In some embodiments, a transparent cap is disposed at the distal end of endoscope to provide an enhanced view of the operational area. Irrigation and aspiration channels may be arranged so that consistent water flow will attract tissue and body stone particles and remove heated liquid. Illumination fibers may be utilized as pull linkages or push-pull linkages for deflection and steering of flexible embodiments of the scope.

A catheter system for treating a treatment site within or adjacent to a blood vessel includes a power source, a light guide and a plasma target. In various embodiments, the light guide receives power from the power source. The light guide has a distal tip, and the light guide emits light energy in a direction away from the distal tip. The plasma target is spaced apart from the distal tip of the light guide by a target gap distance. The plasma target is configured to receive light energy from the light guide so that a plasma bubble is generated at the plasma target. The power source can be a laser and the light guide can be an optical fiber. In certain embodiments, the catheter system can also an inflatable balloon that encircles the distal tip of the light guide. The plasma target can be positioned within the inflatable balloon. The target gap distance can be greater than 1 μm. The plasma target can have a target face that receives the light energy from the light guide. The target face can be angled relative to a direction the light energy is emitted to the plasma target. The plasma target can be formed from one or more of tungsten, tantalum, platinum, molybdenum, niobium, iridium, magnesium oxide, beryllium oxide, tungsten carbide, titanium nitride, titanium carbonitride and titanium carbide.

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 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 catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (108) or heart valve includes a first light source (124), a plurality of light guides (122A), a multiplexer (128) and a multiplexer alignment system (142). The first light source (124) generates light energy. The plurality of light guides (122A) are each configured to alternatingly receive light energy from the first light source (124). Each light guide (122A) has a guide proximal end (122P). The multiplexer (128) receives the light energy from the first light source (124). The multiplexer (128) alternatingly directs the light energy from the first light source (124) to each of the plurality of light guides (122A). The multiplexer alignment system (142) is operatively coupled to the multiplexer (128). The multiplexer alignment system (142) includes a second light source (270) that generates a probe source beam (270A) that scans the guide proximal end (122P) of each of the plurality of light guides (122A).

A catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (208A) or a heart valve within a body (107) of a patient (109) includes an energy source (124), a balloon (104), an energy guide (122A), and a tissue identification system (142). The energy source (124) generates energy. The balloon (104) is positionable substantially adjacent to the treatment site (106). The balloon (104) includes a balloon wall (130) that defines a balloon interior (146). The balloon (104) can be configured to retain a balloon fluid (132) within the balloon interior (146). The energy guide (122A) is configured to receive energy from the energy source (124) and guide the energy into the balloon interior (146) so that plasma bubbles (134) are formed in the balloon fluid (132) within the balloon interior (146). The tissue identification system (142) can be configured to acoustically analyze tissue within the treatment site (106).

A balloon aortic lithotripsy assembly for placement adjacent an aortic valve. The balloon aortic lithotripsy assembly includes multiple balloon chambers, a shell, and a shock wave generator. The balloon chambers are arranged to establish an open interior residing inboard of the balloon chambers. The shell is located around the balloon chambers. The shock wave generator can be situated on one or more of the balloon chambers, the shell, or both of the balloon chamber(s) and shell. In use, blood is free to travel through the open interior, and the shock wave generator can produce shock waves that are intended to impinge calcified tissues residing at the aortic valve.

A method for treating a treatment site (106) within or adjacent to a heart valve (108) within a body of a patient includes the steps of generating energy with an energy source (124); receiving energy from the energy source (124) with an energy guide (122A); positioning a balloon assembly (104) adjacent to the treatment site (106), the balloon assembly (104) including an outer balloon (104B) and an inner balloon (104A) that is positioned within and at least partially spaced-apart from the outer balloon (104B) to define an interstitial space (146A) therebetween that is configured to retain a balloon fluid (132); and positioning a portion of the energy guide (122A) that receives the energy from the energy source (124) within the interstitial space (146A) between the balloons (104A, 104B) so that a plasma-induced bubble (134) is formed in the balloon fluid (132) within the interstitial space (146A).