A catheter system for pressure wave and inertial impulse generation for intravascular lesion disruption at a treatment site includes a catheter including an elongate shaft and balloon coupled to the elongate shaft. The catheter system includes a light guide disposed along the elongate shaft and at least partially within the balloon, where the light guide is in optical communication with a light source and a balloon fluid. The catheter can include a first focusing element located at a distal portion of the light guide and in optical communication with the light source. The first focusing element can direct light from within the light guide to a first location at a first distance away from the distal portion of the light guide to initiate plasma formation in the balloon fluid away from the distal portion and to cause rapid bubble formation, thereby imparting pressure waves at the treatment site.

A catheter system for pressure wave and inertial impulse generation for intravascular lesion disruption includes a balloon coupled to an elongate shaft, and a first and second light guide disposed along the elongate shaft. The first and second light guides each include a diverting feature in optical communication with at least one light window to direct light to exit each light guide toward a side surface portion thereof and toward the balloon. A method includes expanding the balloon from a collapsed configuration to a first expanded configuration, and activating a light source in optical communication with each light guide to provide sub-millisecond pulses of light to the diverting features, thereby inducing plasma formation in a balloon fluid, causing rapid bubble formation, and imparting pressure waves upon the treatment site.

A photoacoustic catheter adapted for placement within a blood vessel having a vessel wall includes an elongate shaft, a balloon and a photoacoustic transducer. The elongate shaft can extend from a proximal region to a distal region. The elongate shaft can include a light guide that is configured to be placed in optical communication with a light source. The balloon is coupled to the elongate shaft, and can be configured to expand from a collapsed configuration suitable for advancing the photoacoustic catheter through a patient's vasculature to a first expanded configuration suitable for anchoring the photoacoustic catheter in position relative to a treatment site. The photoacoustic transducer can be disposed on a surface of the balloon and in optical communication with the light guide. The photoacoustic transducer can include a light-absorbing material and a thermal expansion material.

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.

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 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 device for plasma treatment of biological tissue can comprise a hollow needlelike tubular section with a distal end for applying a light-induced plasma to the tissue, wherein the tubular section comprises subsequent to the distal end an inner plasma chamber configured for generating therein a light-induced plasma. In one embodiment, the plasma chamber is communicatively coupled with a distal, central axial aperture in the distal end, and adjoins, within the tubular section, a light injection section for injecting light, in particular laser light pulses, into the plasma chamber for plasma generation.

The present disclosure relates to a system and method for providing laser energy through a catheter towards a second end portion of the catheter. Based on a characteristic of the laser energy multiple types of ablation therapy may be implemented. A first ablation therapy is directed at the target site when the laser energy at the second end portion of the laser energy delivery system has a first characteristic. A second ablation therapy is directed at the target site when the laser energy at the second end portion of the laser energy delivery system has a second characteristic. The first ablation therapy may be an optical ablation therapy wherein the laser energy is directed at the target site as optical energy and the second ablation therapy may be a pressure wave ablation therapy wherein pressure waves are directed at the target site as pressure wave energy.