Neuromodulation catheter systems with controlled irrigation capabilities and methods for using such systems are disclosed herein. One such method includes, for example, positioning an irrigated neuromodulation catheter at a treatment site within a renal blood vessel of a human patient, delivering neuromodulation energy at the treatment site, and delivering irrigation fluid to the treatment site having characteristics coordinated with the delivered energy. The characteristics can be adjusted to maintain an energy delivery element and/or tissue of the blood vessel at a constant temperature as power is increased. The method can further include monitoring at least one parameter of the tissue and/or of the energy delivery element, and adjusting the neuromodulation energy and/or the characteristics of the irrigation fluid if the at least one parameter falls outside of a treatment range of values.

A system is provided including an intravascular catheter or guidewire and a processor circuit. The processor circuit determines a metric corresponding to the state of the sympathetic nervous system. The processor circuit then controls the intravascular catheter to alter the blood flow within the vessel. The processor circuit then determines another metric corresponding to the state of the sympathetic nervous system while the blood flow is altered. The processor circuit then provides an output based on the metrics obtained while the blood flow was not altered and while the blood flow was altered.

A system includes a processor circuit in communication with an anatomical measurement device. The anatomical measurement device receives a metric associated with a sympathetic response of a patient. The sympathetic nervous system of the patient is then stimulated. The anatomical measurement device then receives another metric associated with a sympathetic response of the patient while the sympathetic nervous system is stimulated. The processor circuit then provides an output based on the comparison.

A method for treating the kidney with focused extracorporeal shockwaves in a noninvasive manner. The method configured to restore blood flow velocity in the interlobular renal arteries, the method using non-invasive focused extracorporeal shockwave therapy (‘ESWT’), the method comprising applying between 1 and 2400 non-invasive focused shockwaves having a repetition rate above one shockwave per second, and energy density of about 0.02 to 0.18 mJ/mm.sup.2. The non-invasive shockwave treatment is applied to various focal zones encompassing renal structures.

Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a catheter shaft. An expandable member may be coupled to the catheter shaft. The expandable member may be capable of shifting between a folded configuration and an expanded configuration. A plurality of flexible elements may be attached to the expandable member, with a plurality of electrode assemblies disposed on the flexible elements. The flexible elements may have a grooved substrate.

A catheter comprises a catheter shaft having a fluid channel, an ultrasound transducer and a compliant balloon mounted on the catheter shaft and having an interior in fluid communication with the fluid channel and containing the ultrasound transducer. The compliant balloon includes a balloon wall having a working section radially surrounding the ultrasound transducer. The working section has a predetermined straightness when the working section has a first diameter and when the working section has a second diameter that is at least 2 mm greater than the first diameter. Other embodiments are also described and claimed.

A catheter has at least a first transducer located in an interior of at least a first balloon, the first transducer configured to be operated at an operational frequency. The first transducer transmits an acoustic signal that provides a first acoustic field with multiple lobes along a longitudinal axis of the first transducer, each of the lobes has a spatial intensity maximum in a spatial intensity distribution of the first acoustic field, the spatial intensity distribution being at a surface of the first balloon and parallel to a surface of the first transducer, the spatial intensity distribution of the first acoustic field having one or more reduced spatial acoustic intensity locations where the spatial intensity of the acoustic field of the first transducer is 50% or less of a value of one of the spatial intensity maxima of the first transducer, each of the reduced spatial acoustic intensity locations being between the spatial intensity maxima for lobes that are adjacent to one another along the longitudinal axis of the first transducer, and each of the reduced spatial acoustic intensity locations being on the surface of the first balloon between the spatial intensity maxima that are adjacent to one another along the longitudinal axis of the first transducer. The catheter further comprises at least a first electrode configured to transmit an electromagnetic signal, the first electrode being positioned on the first balloon at one of the reduced spatial acoustic intensity location of the first transducer.

A system includes a processor circuit configured to receive an endovascular flow measurement obtained by an endovascular flow measurement positioned within a blood vessel of a patient. The system controls a nerve stimulation device to stimulate a nerve of the patient and receives an additional endovascular flow measurement while the nerve is stimulated. The processor circuit then performs a comparison of the two flow measurements received and provides an output based on the comparison.

A method and device for modulating the autonomic nervous system adjacent a pericardial space to treat cardiac arrhythmia includes a treatment source arranged to supply a treatment medium, a catheter having an end sized for insertion into the pericardial space, a medium delivery assembly having a distal end arranged to be positioned by the catheter into the pericardium, with the distal end of the delivery assembly comprising a delivery tip arranged to extend away from the distal end of the catheter into the pericardial space. A connector operatively couples the delivery tip of the medium delivery assembly to the treatment source, and the delivery tip of the medium delivery assembly including a plurality of delivery points for delivering the treatment medium at a plurality of treatment areas within the pericardial space. The device performs modulation or ablation of the autonomic nervous system at selected treatment areas within the pericardium.