Abstract: Methods, apparatus, and systems for occluding a left atrial appendage are provided. One embodiment includes an elongate body having a tissue apposition member extendably positioned within a lumen of the elongate body to appose tissue of the LAA. An energy emitting device coupled to the elongate body can be used for emitting high intensity focused ultrasound to the tissues to fuse the tissues.

Abstract: A method of assessing lesion quality of an ablated tissue region comprising ablating at least a portion of the tissue region. The reactance of the ablated tissue region is measured. The lesion quality of the ablated tissue region is determined based on the measured reactance.

Abstract: An applicator for cryoablating tissue to form linear (i.e. straight line and curvilinear) lesions in targeted tissue includes a fluid refrigerant delivery system having a source of a fluid refrigerant and a tubular cryoablation segment. Structurally, the segment has an open proximal end and a distal end, and is formed with a lumen. Also, the segment is formed with at least one distal port and at least one proximal port, with each port connected in fluid communication with the segment's lumen. The proximal end of the tubular segment is operably connected in fluid communication with the source of fluid refrigerant. For the system, the ports can be selectively sized to outflow liquid refrigerant through the distal and proximal ports at a substantially same mass flow rate.

Abstract: The present invention relates to methods and devices for carrying out cryogenic therapy, particularly on the whole body of a patient, wherein the patient is exposed to gases cooled to cryogenic temperature. The process is performed by introducing the patient into the interior of a treatment cabin and exposing the body to cold air deposited into the cabin space.

Abstract: A new non-invasive approach is proposed that contemplates a method and apparatus to utilize two- or three-dimensional treatment patterns with a reverse thermal gradient to non-invasively heat a subjacent soft tissue structure through an intact tissue surface or an intact surface epithelium for clinical applications. For most clinical applications, an electromagnetic energy source with surface cooling is employed to heat the treatment patterns. Without limitation, the clinical applications include but are not limited to the treatment of post partum vaginal laxity, female incontinence, cervical incompetence with preterm labor, gastro-esophageal reflux, reduction of gastric reservoir capacity (for weight management), sleep apnea, snoring, pain management and the treatment of orthopedic injuries such as joint laxity and tennis elbow.

Abstract: A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen.

Abstract: In some implementations, a method of ablating body tissue includes (a) locating an inflatable balloon portion of a cryotherapy balloon catheter at a treatment site internal to a patient's body, and inflating the inflatable balloon portion; (b) employing electrodes that are disposed on an expandable surface of the inflatable balloon portion to electrically characterize body tissue at the treatment site; (c) ablating the body tissue by supplying a cryotherapy agent to the inflatable balloon portion to cool the body tissue to a therapeutic temperature; (d) employing the electrodes to determine whether the ablating caused desired electrical changes in the body tissue; and (e) repeating (c) and (d) when it is determined that the ablating did not cause the desired electrical changes.

Abstract: A device for the sealing connection of a pressure hose with a grip element of a surgical instrument. The device comprising at least one sealing element that, in an assembled state, is interposed between the grip element and the pressure hose in a connecting region to create a seal. A support element is provided and arranged in the connecting region in the interior of the pressure hose such that the sealing element is clamped, or can be clamped, between the support element and the pressure hose on one side and the grip element on the other side. In addition, a handle for a surgical device, in particular a cryogenic surgical instrument, comprising a grip element for holding the surgical instrument and comprising at least one pressure hose that is connected, or can be connected, with the grip element via the device for the sealing connection.

Abstract: A device for the fluid-conveying connection of at least one application probe. The device comprising at least two coaxially extending application line elements, with a supply tubing set, said tubing set comprising at least two parallel-extending supply line elements, in a grip element of a surgical instrument such as a cryosurgical instrument, such that, in a connected state, each supply line element is in fluid communication with at least one associated application line element. A fluid-diverting element is provided and arranged, or can be arranged, in the grip element in fluid communication with an application line connecting region for the connection of the application line elements and with a supply line connecting region for the connection of the supply line elements. At least two transfer line elements designed as an integral part of the fluid-diverting element are in fluid communication with the application line connecting region via the application line connecting region.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: The system of the preferred embodiments includes a first rotational element, a second rotational element, and a therapeutic source coupled to the rotational elements. The system permits simultaneous attachment to and movement around a surface of tissue, preferably during an ablation procedure (either during lesion creation or between lesion creation events), or during any other suitable procedure. The therapeutic source functions to translate along the path of tissue and deliver therapy as the first and second rotational elements rotate and roll along the path of tissue. The therapeutic source preferably delivers contiguous doses of therapy along the path of tissue. The system is preferably designed for delivering therapy to tissue and, more specifically, for delivering therapy to cardiac tissue. The system, however, may be alternatively used in any suitable environment and for any suitable reason.

Abstract: A cryoplasty catheter and method for preventing or slowing reclosure of a lesion following angioplasty. The cryoplasty catheter includes a shaft having proximal and distal ends and a dilatation balloon disposed at the distal end. An intake lumen and exhaust lumen are defined by the shaft to deliver coolant to the balloon and to exhaust or drain coolant from the balloon. The method in accordance with the present invention includes cooling a lesion to aid in remodeling the lesion through dilatation and/or freezing a portion of the lesion adjacent the dilatation balloon to kill cells within the lesion to prevent or retard restenosis.

Abstract: A physiological thermal stimulation probe, comprising: (a) an electrically controlled heat control element with a relatively low thermal capacity and adapted for contact with tissue on one side thereof; (b) a thermal sink/source with a relatively high effective thermal capacity and a relatively low thermal impedance, such that said thermal sink/source sink can rapidly change a temperature of said heat control element, at a rate above 10 degrees Celsius per second, from a temperature of below 100 degrees Celsius; and (c) circuitry which activates said heat control element to achieve a desired temperature stimulation profile of said tissue.

Abstract: A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen.

Abstract: A cryosurgical instrument features a cryogen in liquid or liquid-gaseous (mist) form being supplied by a feeding lumen into the internal space of a cryotip at the distal end of the cryosurgical instrument. The distal section of the feeding lumen is helically coiled, so that an outer diameter of the helically coiled distal section fits an inner diameter of a cylindrical envelope of said cryotip, and said helically coiled distal section and said cylindrical envelope are in thermal contact.

Abstract: The invention relates to a coolant dosing device for the application of cryogenic gas for producing low temperatures as required e.g. in cryosurgery. The invention aims to ensure a disturbance-free operation in spite of often dirty gas and to exclude possible operating errors in the connection of capsules of the prior art. According to the invention, the coolant dosing device comprises a capillary tube that receives gas that has been filtered in the capsule and directly supplies it to the dispenser, thereby ensuring a disturbance-free operation. The low force connection between the capsule and the metering device by means of O-rings that are slipped over ensures a tight seal and an error-free operation.

Abstract: Exemplary embodiments of the present disclosure provide method and apparatus for effecting (e.g., lightening) an appearance of skin by cooling or freezing small separated surface regions of the skin to produce regions of local hypopigmentation. The width of the regions can be, for example, smaller than about 1 mm or 0.5 mm, and a distance between these frozen regions can be greater than about 3 times the width of the regions. An exemplary apparatus can be provided that includes a plurality of spatially-separated thermally conductive arrangements that can be affixed or otherwise coupled to a base. For example, the conductive arrangements can be regions of conductive material provided in or proximal to a thermal insulator, or thermally conductive protrusions affixed to the base. The conductive arrangements can be cooled and then contacted with the skin surface to produce the small regions of hypopigmentation.

Abstract: The present invention relates generally to devices for performing targeted tissue ablation in a subject. In particular, the present invention provides devices configured to deliver energy to a targeted tissue region without causing damage to untargeted tissue.

Abstract: A cryosurgery apparatus is disclosed. The cryosurgery apparatus an introducer having a hollow and a distal portion, the distal portion being sufficiently sharp so as to penetrate into a body, the hollow of the introducer being designed and constructed for containing a plurality of cryoprobes each of the cryoprobes being for effecting cryoablation, such that each of the plurality of cryoprobes is deployable through the distal portion of the introducer when the distal portion is positioned with respect to a tissue to be cryoablated.

Abstract: An ablative apparatus that can be used to treat atrial fibrillation and other cardiac arrhythmias by ablating cardiac tissue is disclosed. When the distal end of the apparatus reaches the tissue to be ablated, an ablation probe driven by a transducer is vibrated. Scratching the tissue with abrasive members, the vibrating ablation probe is capable of mechanically ablating tissues. This mechanical ablation may be utilized to penetrate epicardial fat, thereby exposing the underlying myocardium. The ablative apparatus may then be used subject the exposed myocardium to mechanical ablation, cryoablation, ultrasonic ablation, and/or any combination thereof.

Abstract: A medical method is provided, including a medical device having a distal assembly including at least one electrode and at least one treatment element, the medical device generating information regarding at least one of a physiological measurement and an operational parameter of the medical device; a plurality of surface electrodes affixable to a skin of the patient, wherein the surface electrodes are in electrical communication with the distal assembly to obtain position information of the medical device; and a processor pairing the position information and the at least one of a physiological measurement and an operational parameter of the medical device.

Abstract: A treatment method is disclosed for treating a bodily tissue utilizing one or more steps of removal of material as well as one or more steps of energy delivery in order to effectively treat the bodily tissue. These mechanisms of treatment may beneficially be used to induce separate treatment effects, for example to treat both the symptoms and the underlying cause of a specific pathological condition. In addition, a specific application of the inventive method is described for using the inventive method to treat an intervertebral disc.

Abstract: The present invention provides an enhanced method and device to inhibit or reduce the rate of restenosis following angioplasty or stent placement. The invention involves placing a balloon tipped catheter in the area treated or opened through balloon angioplasty immediately following angioplasty. The balloon, which can have a dual balloon structure, may be delivered through a guiding catheter and over a guidewire already in place from a balloon angioplasty. A fluid such as a perfluorocarbon may be flowed into the balloon to freeze the tissue adjacent the balloon, this cooling being associated with reduction of restenosis. The catheter may also be used to reduce atrial fibrillation by inserting and inflating the balloon such that an exterior surface of the balloon is in contact with at least a partial circumference of the portion of the pulmonary vein adjacent the left atrium.

Abstract: This invention provides a relatively fast and safe method of producing a permanent or nearly permanent skin image, design, or tattoo similar in appearance to that of a solar tattoo. A protective design template is placed on the skin and a cryogenic agent applied to freeze exposed portions of the skin, producing hypopigmentation. An image is defined by the contrast between the treated (hypopigmented) skin and the adjacent untreated skin.

Abstract: A cryosurgery device for dispensing a liquid refrigerant from a container having a valve stem extending outwardly therefrom. The device includes an actuator adapted to seat on the valve stem of the container in order to depress the valve stem to release the refrigerant from the container. The actuator includes an inner passageway having opposed ends disposed therein, one of the ends of the passageway being in fluid communication with the valve stem. An applicator tube is mounted to the actuator at the other end of the inner passageway. A cap is disposed on the top of the container. The actuator is movably positioned on the cap and a shield is attached to the cap to completely receiving the applicator tube. Liquid refrigerant can only be dispensed when the actuator is positioned properly and the applicator tube is disposed within the shield means.

Abstract: Epicatechins, Epicatechin Oligomers, or Thiolated Epicatechins are applied (A) directly to a genital wart in the form of a cream, ointment, paste or solution, (B) directly to the genital wart wherein such cream, ointment, paste or solution contains as an additional active ingredient a skin permeabilizing agent, (C) following electrosurgical resection or removal of the genital wart in such form of a cream, ointment, paste or solution, (D) following chemical resection or extirpation of the genital wart in such form, (E) following surgical resection or removal of the genital wart in such form, wherein said Epicatechins, Epicatechin Oligomers, or Thiolated Epicatechins both provide antiviral activity against multiple strains of human papilloma virus (HPV) and promote healing following resection polymers contained in a vehicle. Disclosed are the compositions, therapeutical kits containing such composition, methods of treatment using such composition, and methods of enhancing the stability of such composition.

Abstract: Devices and methods for cooling vessel walls to inhibit restenosis in conjunction with medical procedures such as coronary artery angioplasty. Stenosed vessel walls can be cooled prior to angioplasty, after angioplasty, or both. The invention is believed to inhibit restenosis through cooling to a temperature near freezing, preferably without causing substantial vessel wall cell death.

Abstract: Methods for therapeutic renal denervation are disclosed herein. One aspect of the present application, for example, is directed to methods that block, reduce and/or inhibit renal sympathetic nerve activity to achieve a reduction in central sympathetic tone. Renal sympathetic nerve activity may be altered or modulated along the afferent and/or efferent pathway. The achieved reduction in central sympathetic tone may carry several therapeutic benefits across many disease states.

Abstract: Methods for therapeutic renal neuromodulation are disclosed herein. One aspect of the present application, for example, is directed to methods that block, reduce and/or inhibit renal sympathetic nerve activity to achieve a reduction in central sympathetic tone. Renal sympathetic nerve activity may be altered or modulated along the afferent and/or efferent pathway. The achieved reduction in central sympathetic tone may carry several therapeutic benefits across many disease states, including, but without limitation, insulin resistance, diabetes and/or metabolic syndrome.

Abstract: Devices, systems, and methods treat cosmetic defects, and often apply cooling with at least one tissue-penetrating probe inserted through of the skin of a patient. The cooling may remodel one or more target tissue so as to effect a desired change in a composition of the target tissue and/or a change in its behavior. Exemplary embodiments of the cooling treatments will interfere with the nerve/muscle contractile function chain so as to mitigate wrinkles of the skin. Related treatments may be used therapeutically for treatment of back and other muscle spasms, chronic pain, and the like. Some embodiments may remodel subcutaneous adipose tissue so as to alter a shape or appearance of the skin surface.

Abstract: During cryotherapy, using an endoscope that extends within a patient to a cold treatment site, the device of the invention vacuums gas from the site through radial intake ports to a cylindrical space in an evacuation chamber held elastically circumferentially about the distal end of the endoscope tube that carries the cryoprobe to the site.

Abstract: The present invention provides a closed ultra-fast device for vitrification that reduces the risk of contamination; favors and increases the survival of human cells (e.g., oocytes, embryos, sperm, etc.) or non-human cells after thawing; and achieves ultra-fast cooling rates with a low concentration of cryo-protectors. The device of the present invention avoids risk of contamination, favors and increases the survival rate of human (oocytes, embryos or sperm, etc) or nonhuman cells after thawing, featuring ultra-rapid cooling rates and the use of low concentrations of cryo-protectors. The device comprises a protective sheath made of an inert, flexible and transparent material, inside of which a micro-capillary, preferably of quartz, is intended to house the cells that are to be vitrified.

Abstract: A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen.

Abstract: A method for tightening and rejuvenating skin utilizing a cryogenic applicator, which includes the steps of holding a handle of a barrel of the cryogenic applicator in a hand, fluidly communicating the barrel with a source of a biocompatible non-toxic cryogenic fluid to supply the biocompatible non-toxic cryogenic fluid through a hollow interior of the barrel, out through a plurality of openings in a distal portion of the barrel, and onto a head of the cryogenic applicator, rolling the head quickly, smoothly, and evenly over the skin being treated for a period of time in an order of hundredths or tenths of a second, and sparging the biocompatible non-toxic cryogenic fluid onto the skin quickly, evenly, and smoothly when the head is rolled on the skin, and thereby tightening and rejuvenating the skin.

Abstract: Low temperature lesion formation apparatus, systems and methods. The apparatus includes a base member and an inflatable element carried by the base member.

Abstract: An apparatus and methods for treating lesions on skin are presented. The apparatus collects information about a lesion and can automatically determine a course of treatment for the lesion. The device can include a controller that positions the nozzle proximate to a surface region of the lesion and automatically dispenses a pulse of the cryogenic fluid from the nozzle. The controller then positions the nozzle proximate to another surface region of the lesion and automatically dispenses a pulse of the cryogenic fluid from the nozzle.

Abstract: This invention relates to compositions and methods for immunotherapy of cancer. Specifically, a method of cancer immunotherapy is described which results in the systemic liquidation of both solid and metastatic tumors whereever they reside in the body. The compositions include activated allogeneic Th1 cells that when administered appropriately lead to liquidation of tumors. The method includes administering priming doses of the therapeutic composition, ablation of a selected tumor lesion along with intratumoral injection of the composition and then infusion of the therapeutic composition. These steps enable the systemic liquidation of tumors secondary to immune cell infiltration and leads to immune-mediated tumor eradication.

Abstract: Systems and methods stabilize corneal tissue after treatment of the corneal tissue. For example, thermokeratoplasty may be applied to the corneal tissue to address disorders associated with abnormal shaping of the cornea. To stabilize the desired structural changes caused by the treatment, embodiments apply ophthalmic formulations that help to inhibit wound healing. Wound healing may occur in response to the application of the treatment and may produce further structural changes that mitigate or alter the desired effects of the treatment.

Abstract: The present invention is of a system and method for accurate cryoablation, useable to enhance a surgeon's ability to accurately cryoablate a selected cryoablation target and to limit cryoablation to that selected target. Presented are apparatus and method for accurately delimiting a cryoablation volume, for minimizing damage to tissues surrounding a cryoablation volume, and for real-time visualization of a border of a cryoablation volume during cryoablation. Also presented are a method for mildly heating tissues during cryoablation, cryoprobes operable to simultaneously cool first tissues while heating second tissues, and cryoprobes operable to cool tissues extending in a first lateral direction from those probes while not substantially cooling tissues extending in a second lateral direction from those probes.

Abstract: A cryosurgical system featuring both cooling and heating utilizing a single type of cryogen but from two different sources. The liquid cryogen cools the tip of a cryosurgical instrument in the cryosurgical system, such as a cryoprobe or cryocatheter. The gaseous cryogen is further heated by a heating element, preferably an electrical heating element, supplying the heating needed for the thaw and release parts of the cryo treatment procedure. Thus, the cryosurgical system supports the freeze/thaw cycle of the operation of the cryosurgical instrument.

Abstract: The present invention is directed to an anti-cancer drug containing an anti-MFG-E8 antibody as an active ingredient, and to an anti-cancer drug which employs an anti-MFG-E8 antibody in combination with a cancer therapy employing an anti-cancer agent other than the anti-MFG-E8 antibody.

Abstract: A cryogenic catheter includes an outer flexible member having at least one cryogenic fluid path through the flexible member. The at least one fluid path is defined by a plurality of flexible members disposed within the outer flexible member.

Abstract: A catheter includes a cryoablation tip with an ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber and have an RF electrode at its distal end. The electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled in combination with an RF treatment regimen to enhance the lesion size, speed or placement of multi-lesion or single lesion cycles. In one embodiment a microwave energy source operates to extend beyond the thermal conduction depth, or penetrate the ice ball and be absorbed in tissue beyond an ice boundary, thus extending a dimension of treatment. Also, the cooling and application of RF energy can be controlled to position the ablation region away from the surface contacted by the electrode thereby leaving surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth.

Abstract: The subject matter described herein includes methods, systems, and computer readable media for image guided ablation. One system for image guided ablation includes an ultrasound transducer for producing a real-time ultrasound image of a target volume and of surrounding tissue. The system further includes an ablation probe for ablating the target volume. The system further includes a display for displaying an image to guide positioning of the ablation probe during ablation of the target volume. The system further includes at least one tracker for tracking position and orientation of the ablation probe during the ablation of the target volume. The system further includes a rendering and display module for receiving a pre-ablation image of the target volume and for displaying a combined image on the display, where the combined image includes a motion tracked, rendered image of the ablation probe and an equally motion tracked real-time ultrasound image registered with the pre-ablation image.

Abstract: Medical devices can be positioned within a patient by use of apparatus and methods according to the invention. The apparatus and methods permit insertion of the medical devices into various locations of the patient's body without requiring removal and reinsertion of already-inserted medical devices. The apparatus and methods are typically used to place medical devices into a male patient's urinary system to treat a disease or condition. The medical devices can be cryoablation probes that are inserted into the prostate gland to treat prostate cancer, for example.

Abstract: Devices, systems, and methods treat cosmetic defects, and often apply cooling with at least one tissue-penetrating probe inserted through of the skin of a patient. The cooling may remodel one or more target tissue so as to effect a desired change in a composition of the target tissue and/or a change in its behavior. Exemplary embodiments of the cooling treatments will interfere with the nerve/muscle contractile function chain so as to mitigate wrinkles of the skin. Related treatments may be used therapeutically for treatment of back and other muscle spasms, chronic pain, and the like. Some embodiments may remodel subcutaneous adipose tissue so as to alter a shape or appearance of the skin surface.

Abstract: A laser treatment device and process with controlled cooling. The device contains a cooling element with high heat conduction properties, which is transparent to the laser beam. A surface of the cooling element is held in contact with the tissue being treated while at least one other surface of the cooling element is cooled by the evaporation of a cryogenic fluid. The cooling is coordinated with the application of the laser beam so as to control the temperatures of all affected layers of tissues. In a preferred embodiment useful for removal of wrinkles and spider veins, the cooling element is a sapphire plate. A cryogenic spray cools the top surface of the plate and the bottom surface of the plate is in contact with the skin. In preferred embodiments the wavelength of the laser beam is chosen so that absorption in targeted tissue is low enough so that substantial absorption occurs throughout the targeted tissue. In a preferred embodiment for treating large spider veins with diameters in the range of 1.