Apparatus, consisting of a probe, containing a lumen and having a distal end configured to contact tissue of a living subject. A temperature sensor is located at the distal end, and a pump, having a pump motor, is coupled to deliver a cryogenic fluid through the lumen to the distal end of the probe and to receive the cryogenic fluid returning from the probe. There is a separator, coupled to separate the returning cryogenic fluid into a returning cryogenic liquid and a returning cryogenic gas, and a flow meter, coupled to measure a rate of flow of the returning cryogenic gas. A processor is configured to control a rate of pumping of the pump motor in response to a temperature measured by the temperature sensor and the rate of flow of the returning cryogenic gas.

A device for therapeutic neuromodulation in a nasal region can include, for example, a shaft and a therapeutic element at a distal portion of the shaft. The shaft can locate the distal portion intraluminally at a target site inferior to a patient's sphenopalatine foramen. The therapeutic element can include an energy delivery element configured to therapeutically modulate postganglionic parasympathetic nerves at microforamina of a palatine bone of the human patient for the treatment of rhinitis or other indications. In other embodiments, the therapeutic element can be configured to therapeutically modulate nerves that innervate the frontal, ethmoidal, sphenoidal, and maxillary sinuses for the treatment of chronic sinusitis.

The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to devices and methods to guide delivery devices and instruments. Exemplary instrument guides, including for endoscopes as delivery devices for cryogen delivery catheters and to guide cryogen decompression tubes as instruments, and methods for use of such instrument guides for use in body lumens at treatment sites, are disclosed.

An intravascular catheter for nerve activity ablation and/or sensing includes one or more needles advanced through supported guide tubes (needle guiding elements) which expand to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the extra-luminal tissue including the media, adventitia and periadvential space. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. Electrodes at the distal ends of the guide tubes allow sensing of nerve activity before and after attempted renal denervation. In a combination embodiment ablative energy or fluid is delivered to ablate nerves outside of the media.

A refrigerant dispenser for tick removal can include a main body, an actuator structure, and a cage. A main body can include a proximal end, a distal end, and a cavity that extends from the proximate end to the distal end, with the proximate end having an intake opening in communication with the cavity and being configured to receive a refrigerant canister therein. An actuator structure can be connected to the distal end and can be in communication with the cavity. A cage can include an upper portion connected to the actuator structure and in communication with the cavity, and a lower portion terminating at an exhaust opening. The lower portion can be configured to at least partially surround a tick, and the exhaust opening can be in communication with the cavity.

A cryosurgical instrument includes a feed line for conveying fluid into an expansion chamber. The feed line has a capillary line section that terminates in the expansion chamber and forms an aperture for the fluid to undergo the Joule-Thomson effect. The flow cross-section of the feed line decreases in at least one transition section of the feed line in the form of a funnel. Following each transition section there preferably follows a step section, in which latter section the flow cross-section is preferably largely constant. The last step section is preferably formed by the capillary line section. Due to the acceleration of the fluid in the transition sections and the abating of pressure fluctuations in the capillary tube section and, optionally in the additional step sections, the expansion range in the expansion chamber is increased, without impeding the backflow of the expanded gas out of the expansion chamber.

Provided herein are new compositions, methods, and devices to treat cancer through a combination of immunologic chemotherapeutic agents and ablation techniques. These compositions can include immune checkpoint inhibitors, cytokines and nucleic acid drugs that aid in eliciting an immune response to treat the tumor. The administration of these compositions in addition to various ablating techniques provides a presentation of the cancer cell antigens to the immune system and the immunologic targeting of the cancer.

An apparatus for cooling tissues which are treated with an energy-based device, such as a laser, is disclosed. The apparatus comprises a spray nozzle which generates an atomized liquid spray for the treatment area, wherein the atomized liquid spray is based on a mixture of liquid and gas. Further, the spray nozzle comprises at least one liquid outlet which ejects a liquid, and at least one gas outlet which ejects a gas stream. Besides, the apparatus for cooling comprises at least one delivery means for delivering pressurized gas to the spray nozzle; and a pumping means for the liquid, wherein the pumping means is configured to operate in pulses.

Provided herein are new compositions, methods, and devices to treat cancer through a combination of immunologic chemotherapeutic agents and ablation techniques. These compositions can include immune checkpoint inhibitors, cytokines and nucleic acid drugs that aid in eliciting an immune response to treat the tumor. The administration of these compositions in addition to various ablating techniques provides a presentation of the cancer cell antigens to the immune system and the immunologic targeting of the cancer.

A cryo formulation-based microneedle device for ocular delivery of bioactive therapeutic agents. The microneedle device includes: one or more microneedle patches each including an array of miniaturized needles, wherein each miniaturized needle defining a base end and a tip; and a substrate to which the base end of the array of miniaturized needles is attached or integrated thereto; wherein the microneedle patch is in a cryo status; wherein each of the one or more microneedle patch is adapted to be applied on cornea of an eye, in which the miniaturized needles penetrates into the eye; and wherein the miniaturized needles is further arranged to melt so as to release one or more bioactive therapeutic agents into the eye to achieve a targeted therapeutic effect.