Abstract: An electrophysiology (EP) device suitable for ablating tissue within a patient's body lumen. The EP device of the invention generally comprises an elongated shaft having a distal shaft section with a helical shape and at least one electrode on an exterior portion thereof. One aspect of the invention comprises a method of performing a medical procedure, such as treating a patient for atrial arrhythmia, by forming a lesion using an EP device embodying features of the invention.

Abstract: A method and apparatus for creating a virtual electrode to ablate bodily tissue. The apparatus includes an outer tube, a first electrode, an inner tube and a second electrode. The outer tube is fluidly connected to a source of conductive fluid and defines a proximal end and a distal end. The distal end includes an opening for delivering conductive fluid from the outer tube. The first electrode is disposed at the distal end of the outer tube for applying a current to conductive fluid delivered from the outer tube. The inner tube is coaxially received within the outer tube and is connected to a source of conductive fluid. The inner tube defines a proximal end and a distal end, with the distal end forming an opening for delivering conductive fluid from the inner tube. Finally, the second electrode is disposed at the distal end of the inner tube for applying a current to conductive fluid delivered from the inner tube.

Abstract: Systems for phase-change particulate slurry cooling equipment and methods to induce hypothermia in a patient through internal and external cooling are provided. Subcutaneous, intravascular, intraperitoneal, gastrointestinal, and lung methods of cooling are carried out using saline ice slurries or other phase-change slurries compatible with human tissue. Perfluorocarbon slurries or other slurry types compatible with human tissue are used for pulmonary cooling. And traditional external cooling methods are improved by utilizing phase-change slurry materials in cooling caps and torso blankets.

Abstract: An ablation catheter used for treatment of, for example, atrial fibrillation by electrically isolating a vessel, such as a pulmonary vein, from a chamber, such as the left atrium. The ablation catheter has a virtual electrode and a catheter shaft. The virtual electrode comprises a porous conductor. The catheter shaft includes a proximal portion and a distal portion. The distal portion includes an active region, which is either a looped structure transverse to the longitudinal axis of the catheter shaft, or a linear structure that extends parallel to the longitudinal axis of the catheter shaft. During use, the active region is directed into contact with, for example, the wall of a pulmonary vein and, upon energization, the virtual electrode creates a continuous lesion at or near the ostium of the pulmonary vein, thereby electrically isolating the pulmonary vein from the left atrium.

Abstract: A catheter body of a catheter assembly includes a proximal portion, an intermediate portion extending from the proximal portion, a distal portion extending from the intermediate portion, and a locating device including a distal tip extending from the distal portion of the catheter body. The intermediate portion defines a longitudinal axis and the distal portion forms a loop including one or more loop segments formed around a central loop axis. The central loop axis is substantially parallel with the longitudinal axis and the one or more loop segments include at least one ablation electrode coupled thereto and adapted to create a lesion, the lesion electrically isolating a vessel from a chamber for treatment of a cardiac arrhythmia. The distal tip of the locating device is substantially parallel with the central loop axis.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to contract collagen fibers within the tissue structures. In one aspect of the invention, a system and method is provided for treating herniated or swollen discs within a patient's spine by applying sufficient electrical energy to the disc tissue to contract or shrink the collagen fibers within the nucleus pulposis. This causes the pulposis to shrink and withdraw from its impingement on the spinal nerve.

Abstract: A device for thermally affecting tissue of a patient includes a housing defining an interior volume that is at least partially insertable into an exterior opening in a patient. A thermal member positioned within the interior volume of the housing includes a thermal input side and a thermal output side to impart a thermal change to the tissue.

Abstract: A method of treating cardiac arrhythmia, including guiding a distal end portion of a catheter, the distal end portion having a distal tip and accommodating an elongated configuration of ablation electrodes, from the inferior vena cava into the right atrium of a human heart, guiding the distal end portion from the right atrium into the right ventricle of the heart, deflecting the distal tip into a hook configuration, pulling the catheter towards the inferior vena cava until the hook configuration engages the tricuspid annulus of the heart and the configuration of electrodes engages the isthmus of tissue between the tricuspid annulus and the inferior vena cava of the heart, and activating the configuration of electrodes to produce a substantially continuous lesion on the isthmus of tissue.

Abstract: Devices and methods are provided for creating lesions in endocardial tissues surrounding a vessel opening to thereby isolate focal arrhythmia substrates, including an invasive catheter assembly comprising an elongate body having a longitudinal axis and first and second lumens, a first catheter having a distally mounted expandable anchor body disposed in the first lumen, and a second catheter having a distally mounted electrode disposed in the second lumen, the elongate body having a first distal opening accessing the first lumen through which the first catheter may be extended axially relative to the longitudinal axis of the elongate body and a second distal opening accessing the second lumen through which the second catheter may be extended at an angle relative to the longitudinal axis of the elongate body.

Abstract: A cryosurgical system including a housing having a front portion and a rear portion. The front portion and rear portion are connectable to support a fluid supply. A control unit attached to the front portion, and has a regulator assembly connecting the fluid supply to the control unit. A medical device is connected to the control unit, the medical device including a handle, a shaft, and a thermally-transmissive region. The handle, the shaft, and the thermally-transmissive region defining a fluid pathway through the handle, shaft, and thermally-transmissive region. The shaft is malleable to retain a first shape until manipulated to a second shape.

Abstract: An apparatus for transmural ablation using an instrument containing two electrodes. The electrodes extend along the surfaces of mating jaw members which are moveable between open and clamped positions. The electrodes are connected to an RF energy source so that, when activated, they are of opposite polarity. An EKG sensor is located on one of the jaw members and spaced from the electrode so that, when the electrodes are activated to form a line of ablation, the EKG sensor contacts the tissue outside the line of ablation. A pacing electrode is located on one of the jaw members so as to be on the opposite side of the line of ablation from the EKG sensor. Thus, if the line of ablation is not transmural, the EKG sensor will be able to detect signals generated by the pacing electrode.

Abstract: A probe that may be used to create circumferential lesions in body tissue and, in some implementations, may also be used to perform mapping functions. The probe includes a collapsible/expandable structure that supports electrodes or other operative elements against the body tissue.

Abstract: A catheter assembly and method for treatment of cardiac arrhythmia, for example, atrial fibrillation, by electrically isolating a vessel, such as a pulmonary vein, from a chamber, such as the left atrium. The catheter assembly includes a catheter body and at least one electrode. The catheter body includes a proximal portion, an intermediate portion and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and forms a substantially closed loop transverse to the longitudinal axis. The at least one electrode is disposed along the loop. With this configuration, the loop is axially directed into contact with the chamber wall about the vessel ostium. Upon energization, the electrode ablates a continuous lesion pattern about the vessel ostium, thereby electrically isolating the vessel from the chamber.

Abstract: A method and expandable device for thermally affecting tissue in which there is a fluid conduit. The fluid conduit defining a spiral-shaped element. The fluid conduit includes a wall defining an inner volume. The inner volume being configured to pass thermally transmissive fluid. Optionally, the tissue contact region is operable to have a first contact surface area and a second contact surface area in which the second contact surface area is larger than the first contact surface area. A method of use of the device is provided.

Abstract: Methods and apparatus for resecting and ablating tissue at a target site of a patient, the apparatus including a probe having an elongate shaft. The shaft includes a shaft distal end portion and a shaft proximal end portion, and a resection unit located at the shaft distal end portion. The resection unit includes a resection electrode support and at least one resection electrode arranged on the resection electrode support. The at least one resection electrode includes a resection electrode head. The probe and resection electrode head are adapted for concurrent electrical ablation and mechanical resection of target tissue. The shaft may include at least one digestion electrode capable of aggressively ablating resected tissue fragments. At least one fluid delivery port on the shaft distal end portion may provide an electrically conductive fluid to the resection unit or to the target site.

Abstract: A closed loop heat exchange catheter can be placed in the rectum of a patient to cool or warm the patient.

Abstract: Systems and methods are disclosed for therapeutically heating a target zone of a collagenous support tissue within a patient body. In exemplary embodiments, the present invention provides electronically determining an acceptable or unacceptable contact condition between an energy source and a first tissue layer disposed proximally to the target zone. Upon determining an acceptable contact condition, the target zone is irradiated or otherwise heated for a finite time period with energy. A determination of an unacceptable contact condition causes cessation of irradiating.

Abstract: Methods and apparatus are provided for thermally affecting tissue via either a closed or open device. In each of the closed device embodiments, thermally transmissive fluid is circulated and distributed through into a device, an outer surface of which is in direct thermal contact with a region of tissue to thermally affect the tissue. In each of the open device embodiments, thermally transmissive fluid is circulated through a device and systematically deployed directly onto a region of tissue to irrigate, and, therefore, thermally affect the tissue.

Abstract: The present invention provides a method and apparatus for controlling the internal body temperature of a patient. According to the present invention, a catheter is inserted through an incision into a large blood vessel of a patient. By selectively heating or cooling a portion of the catheter lying within the blood vessel, heat may be transferred to or from blood flowing within the vessel and the patient's body temperature may thereby be increased or decreased as desired. The invention will find use in treating undesirable conditions of hypothermia and hyperthermia, or for inducing a condition of artificial hypothermia when desired. The method and system further provide for the cooling of initially hypothermic patients whose blood or body temperature has been warmed above the desired target level and the warming of initially hyperthermic patients whose blood or body temperature has been cooled below the desired target temperature.

Abstract: A device and method for providing body cooling. The cooling device applies cooling to blood flowing in a vena cavae that is then distributed throughout the body. The cooling can be assisted by use of thermoregulatory drugs or warming devices to prevent shivering and vasoconstriction.

Abstract: Embodiments of the invention provide a system for temperature control of the human body. The system includes an indwelling catheter with a tip-mounted heat transfer element. The catheter is fluidically coupled to a console that provides a heated or cooled heat transfer working fluid to exchange heat with the heat transfer element, thereby heating or cooling blood. The heated or cooled blood then heats or cools the patient's body or a selected portion thereof. In particular, methods and devices, including software, are provided for administering cooling or rewarming and controlling the same based on a projected control temperature measured by a temperature sensor within the catheter.

Abstract: A medical device has a structure deployable from its distal end to cool a target tissue region inside the body, such as tissue within a chamber of the heart. Also, a method of cooling a target tissue region inside a body includes introducing a distal portion of a catheter having a deployable structure at a distal end into the body. The method also includes positioning the distal catheter portion near a target tissue region, deploying the deployable structure, and placing the deployed structure in contact with the target tissue region to cool the target tissue region.

Abstract: Methods, systems and computer program products include modular single-use disposable catheter assemblies with cassettes configured to matably engage with a console to circulate liquid to a treatment balloon in a closed loop circulation system. The console is portable, compact, and can be programmed to administer a plurality of different therapy types and to engage with different catheter configurations via the cassette body.

Abstract: Instruments for thermally-mediated treatment of a patient's lower esophageal sphincter (LES) to induce an injury healing response to thereby populate the extracellular compartment of walls of the LES with collagen matrices to altere the biomechanics of the LES to provide an increased intra-esophageal pressure for preventing acid reflux. A preferred embodiment is a bougie-type device for trans-esophageal introduction that carries conductive electrodes for delivering Rf energy to walls of the LES (i) to induce the injury healing response or (ii) to “model” collagenous tissues of the LES by shrinking collagen fibers therein. Typically, an Rf source is connected to at least one conductive electrode that may be operated in a mono-polar or bi-polar fashion. A sensor array of individual sensors is provided in the working end.

Abstract: A catheter includes a first plurality of expandable leads and a second plurality of expandable leads separate and longitudinally spaced-apart from the first plurality to deliver energy to a hollow anatomical structure, such as vein, fallopian tube, hemorrhoid, esophageal varix, to effectively ligate that structure. Each of the leads includes an electrode located at the distal end of the respective electrode lead. Polarizations of the leads may be selected to achieve the power distribution desired. Each electrode lead includes an outward bend such that when a movable sheath is moved out of contact with the leads, they expand outwardly into apposition with an inner wall of the structure to be ligated. High frequency energy can be applied from the leads to create a heating effect in the surrounding tissue of the anatomical structure.

Abstract: Combination catheters/stents includes matable female and male members which, when engaged, deliver the desired therapy, typically a thermal therapy, to the targeted tissue in the body. At the conclusion of the delivery of the therapy regimen, the female and male matable members disengage allowing one member (the stent portion) to remain in the body proximate the treatment site of the subject while the other member (primarily the catheter portion which with the stent portion allows delivery of desired treatment) can be removed from the body of the subject. The combination catheter/stent requires only a single insertion procedure reducing the trauma potentially introduced to tissue (either along the lumen or at the targeted treatment site) in the body.

Abstract: A method and apparatus of treating tissue adjacent to a bodily conduit using thermotherapy, while preventing obstructions of the bodily conduit due to edema employs the circulation of warmed fluid to maintain the temperature of the bodily conduit walls and compresses the tissue to be treated to increase the effectiveness of the irradiated heat. An energy-emitting source containing catheter is inserted in a bodily conduit and is positioned in a region of the tissue to be treated so that the energy-emitting source radiates energy to the tissue to be treated. Fluid warmed to over 30° C. is circulated into and through the catheter to warm walls of the bodily conduit adjacent the catheter. The circulated fluid inflates a balloon to a pressure to compress the tissue to be treated. The combination of warmed fluid over 30° C.

Abstract: A device is disclosed for generating a high intensity localized heat. The device comprises a conduit defining a channel with a catalyst disposed near the end of the channel. The channel carries a gaseous mixture to the catalyst where the mixture reacts in the presence of the catalyst and generates heat.

Abstract: A heat transfer device has first and second elongated, articulated segments, each having a turbulence-inducing exterior surface. A flexible joint connects the first and second elongated, articulated segments. An inner coaxial lumen is disposed within the first and second elongated, articulated segments. The inner coaxial lumen is capable of transporting a pressurized working fluid to a distal end of the first elongated, articulated segment.

Abstract: An endovascular heat transfer device which can have a smooth exterior surface, or a surface with ridges and grooves. The device can have a plurality of elongated, articulated segments, with each having such a surface. A flexible joint connects adjacent elongated, articulated segments. The flexible joints can be bellows or flexible tubes. An inner lumen is disposed within the heat transfer segments. The inner lumen is capable of transporting a pressurized working fluid to a distal end of the heat transfer element.

Abstract: A catheter system for controlling the body temperature of a patient by modifying the temperature of blood flowing within a blood vessel of the patient. The catheter system comprises a catheter body having a heat exchange region in contact with the blood; and a mechanism for moving the heat exchange surface, thereby increasing heat exchange between the heat exchange surface and blood flowing past the heat exchange surface. Various methods of moving the heat exchange surface are disclosed.

Abstract: A catheter introduction apparatus provides a radially expandable helical coil as a radiofrequency emitter. In one application the emitter is introduced percutaneously, and transseptally advanced to the ostium of a pulmonary vein. The emitter is radially expanded, which can be accomplished by inflating an anchoring balloon about which the emitter is wrapped, in order to cause the emitter to make circumferential contact with the inner wall of the pulmonary vein. The coil is energized by a radiofrequency generator, and a circumferential ablation lesion is produced in the myocardial sleeve of the pulmonary vein, which effectively blocks electrical propagation between the pulmonary vein and the left atrium.

Abstract: Balloon catheters according to the present invention have surface contours with protrusions and grooves to make non-continuous lesions. There is a heating element inside the balloon. The balloon will be filled with a fluid before ablation to expand the balloon for tissue contact, and to transfer heating energy from the heating element to the tissue in contact with the balloon. Since the balloon surface has contours with grooves and protrusions, the tissue contact will not be continuous along the balloon surfaces, and therefore the ablation on the tissue will not be continuous. The energy transmitter can be ultrasound transducer, electrical resistant heater, and microwave antenna.

Abstract: A catheter system and method for selectively cooling or freezing target neuronal tissue to induce lesions along the neuroaxis and produce cryoanalgesia by impairing nerve conduction of the targeted neuronal tissue. The system includes a catheter that has cryogenic capability for variable cooling or freezing of neuronal tissue. The catheter also includes temperature sensing and electrodiagnostic capabilities. A pressurized fluid source is included for inflating a portion of the catheter body. The system includes electrodiagnostic equipment for stimulating and monitoring sensory evoked potentials in the patient. The method involves placement of the catheter tip in the subarachnoid space of the spinal canal and location of the tip on the neuronal target using imaging and electrodiagnostic techniques.

Abstract: Devices and methods are provided for applying vacuum near to devices for delivering treatments to tissue adjacent a body cavity, effective to draw adjacent tissue near to such devices and to enhance treatment of the tissue. Body cavities include natural body cavities and cavities remaining after removal of tissue such as cancerous tissue. A device may include an inner balloon assembly with an inflation conduit. A sheath assembly having a fluid-permeable sheath wall may enclose the inner balloon assembly. Vacuum applied to the space between the sheath and the inner balloon is useful to draw tissue into contact with the device, improving treatment effectiveness. Methods for treating tissue with such devices and systems are also provided. Treatments may include providing radioactive material for radiation treatment, providing chemotherapeutic material for chemotherapy, providing thermal treatment, and combinations thereof. Systems may include devices of the invention and a vacuum source.

Abstract: Apparatus and methods for cooling selected regions within a body are described herein. An implantable cooling system is used to cool regions of the brain, spinal cord, fibrous nerve bodies, e.g., vagus nerve, etc. down to about 30° C. to diminish nerve impulses which control seizures or chronic pain. The system includes an implantable unit containing a pumping mechanism and/or various control electronics. It also has a heat exchanger attachable to a tubular body organ, such as the superior vena cava or the inferior vena cava, through which the heat is effectively dissipated. Also included is a heat pump such as a Peltier junction configured to be placed into contact with the region of tissue to be cooled. The heated portion of the Peltier junction is cooled by a liquid heat transfer medium which absorbs the heat from the junction and dissipates it into the tubular body organ.

Abstract: An intravascular heat transfer device is provided with a mixing-inducing surface formed by an easily manufacturable process. The device can have a plurality of elongated, articulated segments, each having a mixing-inducing exterior surface. A flexible joint connects adjacent elongated, articulated segments. The device may be conveniently formed, e.g., by vapor deposition or molding, and further lacks undercuts so that the same may be conveniently removed from, e.g., a two-part mold.

Abstract: A method and apparatus is provided for heating or cooling at least a selected portion of a patient's body. The method begins by inserting a catheter having a balloon into the colon or stomach of the patient. A heated or chilled fluid is conducted through a supply lumen of the catheter and into the balloon. The fluid is evacuated from the balloon through a return lumen of the catheter.

Abstract: Embodiments of the invention provide a system for temperature control of the human body. The system includes an indwelling catheter with a tip-mounted heat transfer element. The catheter is fluidically coupled to a console that provides a heated or cooled heat transfer working fluid to exchange heat with the heat transfer element, thereby heating or cooling blood. The heated or cooled blood then heats or cools the patient's body or a selected portion thereof. In particular, methods and devices are provided for control and determination of the pressure within the heat transfer element.

Abstract: Devices, systems, and methods can treat incontinence by heating between about 100 and about 800 cubic millimeters of endopelvic fascia for sufficient time to effect substantial collagenous tissue shrinkage. A probe body may directly engage the endopelvic fascia, or may be separated from the endopelvic fascia, heating through (for example) the vaginal wall. In either case, tissue-penetrating electrodes may be inserted from the probe body so as to heat the endopelvic fascia.

Abstract: Medical devices that are configured for insertion into a body lumen, such as the male urethra, are provided with one or more inflatable balloons having elastic sleeves, wherein each elastic sleeve is adapted to inflate in response to inflation of a respective balloon, and to deflate in response to deflation of the respective balloon. When a balloon is in a deflated condition, a respective elastic sleeve exerts a circumferentially compressive force against the balloon to cause a smooth, reduced cross-sectional profile of the balloon along an axial extent thereof. This smooth, reduced cross-sectional profile can facilitate passage of the medical device through a body lumen during both insertion and extraction of the medical device. A thin layer of fluid may be disposed between a treatment balloon and a respective elastic sleeve to facilitate heat transfer from a treatment balloon to a surrounding elastic sleeve or to administer a therapeutic agent to localized tissue.

Abstract: A method, device, and system for treatment of urinary tract disorders is provided. The device includes a catheter having multiple lumens for insertion into a urinary bladder and for providing fluid flow within the bladder and within the fluid reservoir within the urethra. The device further includes an anchor to be placed within the bladder. A port hub having multiple ports is connected at a proximal end of the catheter. A method of treatment includes providing heated fluid to a urinary bladder and to a fluid reservoir for insertion into an adjacent organ such as the urethra. Simultaneous treatment or separate treatment may be done. Optionally, a medicated solution may be added to the heated fluid. Additionally, pressure may be adjusted so as to optimize the therapeutic effect.

Abstract: A multi-purpose electrode mechanism for detection and control of changes in brain state includes a shaft portion and extendible elements structured for insertion into target tissue of the brain of a subject patient, cooling means configured to operatively apply cooling therapy to the target tissue, stimulation means having at least one electrical contact structured to operatively apply electrical stimulation therapy to the target tissue, sensing means including at least one sensor monitoring a biological signal of the subject patient, control means responsive to the sensing means wherein the control means is structured to, in response to signals from the sensing means that indicate the presence of a pre-determined physiological condition or occurrence of an undesirable state change, automatically cause the cooling means and/or the stimulation means to initiate or terminate the cooling therapy and/or the electrical stimulation therapy respectively and an energy source for powering the various components of the

Abstract: A method and device for treating nasal cavity irritation, such as symptoms of allergic rhinitis. The device includes a nasal suppository having a plug shape for placement within a nasal cavity. In an embodiment, the suppository is frozen saline solution in a therapeutic concentration. In another embodiment, the device includes a handle, frozen within a portion of the suppository and extending therefrom, to allow grasping and insertion of the suppository in an affected nasal cavity. In yet another embodiment, a leak-resistant molding package having a chamber for accepting a liquid and shaped to conform to the interior of a nasal passage, is provided. The method includes inserting an elongated, conformally shaped plug of a frozen liquid into a nasal cavity; removably lodging the frozen liquid in the nasal cavity, and allowing the frozen liquid to gradually melt within the nasal cavity.

Abstract: Methods, systems, and computer program products for providing thermal therapies or internal thermal massage therapy for treating prostatitis by expanding and contracting a treatment balloon with inflation media and currently applying heat to a portion of the prostatic urethra.

Abstract: A catheter for exchanging heat with a body fluid is disclosed. The catheter includes a main shaft and a heat exchange region having a plurality of heat exchange elements each having a length and opposed ends. Each of the elements is attached on at least one of its ends to the shaft and disposed so that when inserted in a fluid body cavity having body fluid therein, the body fluid may circumferentially surround each heat exchange element along a portion of the length of the heat exchange element. The catheter includes a fluid circulation path therein, which desirably includes the hollow lumen within each of heat exchange elements. The heat exchange elements may be connected at two points along the shaft using manifolds that are in fluid communication with fluid flow paths within the shaft. Alternatively, the heat exchange elements may be connected at only one point and be permitted to float in a proximal or distal direction with respect to the catheter.

Abstract: A catheter assembly and method for treatment of cardiac arrhythmia, for example, atrial fibrillation, by electrically isolating a vessel, such as a pulmonary vein, from a chamber, such as the left atrium. The catheter assembly includes a catheter body and at least one electrode. The catheter body includes a proximal portion, an intermediate portion and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and forms a substantially closed loop transverse to the longitudinal axis. The at least one electrode is disposed along the loop. With this configuration, the loop is axially directed into contact with the chamber wall about the vessel ostium. Upon energization, the electrode ablates a continuous lesion pattern about the vessel ostium, thereby electrically isolating the vessel from the chamber.

Abstract: A method of promoting blood vessel growth includes the steps of providing a cryocatheter having a thermally transmission region; placing the cryocatheter proximate an area of tissue to be treated; cooling the thermally transmissive region of the cryocatheter proximate the area of tissue to a temperature sufficient to injure the area of tissue; allowing the area of tissue to warm; and removing the cryocatheter from the area of tissue. Prior, during or after the cooling step, the area of tissue can be mechanically traumatized, and drugs can be injected into the tissue.

Abstract: Systems and methods for reducing or minimizing post-surgical complications are described. By applying energy to tissues under specifically controlled conditions, the formation of adhesions in response to cutting or other damage of those tissue may be eliminated or significantly reduced. According to an embodiment of the method of the invention, energy application is controlled to heat the tissue within a range of 61 to 100 degrees centigrade. In one embodiment, the system of the invention includes an easily manipulated applicator, having a scissor-like configuration and a controller for the energy application.

Abstract: An endovascular heat transfer device which can have a smooth exterior surface, or a surface with ridges and grooves. The device can have a plurality of elongated, articulated segments, with each having such a surface. A flexible joint connects adjacent elongated, articulated segments. The flexible joints can be bellows or flexible tubes. An inner lumen is disposed within the heat transfer segments. The inner lumen is capable of transporting a pressurized working fluid to a distal end of the heat transfer element.