Abstract: Devices and methods are disclosed for widening a channel in a treatment site, the channel containing a guide-wire. The channel is widened by advancing an elongated dilation device, which is configured to fit tightly over the guide-wire at the distal tip of the dilation device and to provide a distal dilating surface, over the guide-wire and at least partially through the treatment site. The dilation device comprises a tubular metallic shaft, typically a metal inner tube, for providing sufficient stiffness and column strength for the dilator to be advanced at least partially through the channel, and a flexible sleeve providing a tapered distal tip. The distal end of the dilator defines a leading surface that is shaped to force away portions of a lesion surrounding the guide-wire away from the guide-wire as the distal end is advanced over the guide-wire through the lesion, whereby a channel through the lesion is at least partially dilated.

Abstract: Described herein is a method for creating a channel through a foreign material located in a body of a patient. The foreign material defines a material first surface and a substantially opposed material second surface and the channel extends through the foreign material between the material first and second surfaces. The method uses an apparatus including an electrode, and includes the steps of: positioning the electrode substantially adjacent to the material first surface; energizing the electrode with a radiofrequency current; and using the electrode energized with the radiofrequency current to deliver energy into the foreign material to create the channel. In some embodiments, the patient's body includes a heart defining a septum, the septum defines an aperture extending there-through and the foreign material extends across the aperture to cover the aperture.

Abstract: Described herein is a method for creating a channel through a foreign material located in a septum of a heart at the site of a septal defect. The foreign material defines a material first surface and a substantially opposed material second surface, and the channel extends through the foreign material at least partially between the material first and second surfaces. The method uses an apparatus including an electrode and includes the steps of: positioning the electrode substantially adjacent to the material first surface; energizing the electrode with a radiofrequency current; and using the electrode energized with the radiofrequency current to deliver energy into the foreign material to create the channel.

Abstract: A radiofrequency perforation apparatus for creating a channel at a target location in a body of a patient, the radiofrequency perforation apparatus comprising: a substantially tubular member defining a tubular member lumen; an end member partially positioned within the tubular member lumen at a distal end of the tubular member, the end member including an electrode; and an electrical insulator extending along the substantially tubular member.

Abstract: A method and apparatus are disclosed for a medical device, including a means for enhancing visibility under imaging which, while reducing the local mechanical strength, avoids compromising the overall device effectiveness or safety. Visibility under imaging is increased by a non-uniform distribution of visibility-enhancing features as a function of the local stresses expected during use. One embodiment is for a medical device comprising an elongate member having proximal and distal regions, wherein the distal region comprises: a first echogenic region including a plurality of circumferential first region cuts, each of the first region cuts having a first region cut volume; and a second echogenic region, distal of the first echogenic region, including a plurality of circumferential second region cuts, wherein each of the second region cuts has a second region cut volume greater than said first region cut volume.

Abstract: A method is disclosed for creating a channel through an occlusion located in a vein that drains the central nervous system of a patient. The method utilizes a channel creating apparatus, including an energy delivery component operatively coupled to a distal end portion of the channel creating apparatus, to create a channel through the occlusion by delivering energy using the energy delivery component, in order to substantially increase blood flow through said vein to treat chronic cerebrospinal venous insufficiency (CCSVI).

Abstract: A method for creating a channel through a foreign material located in a body of a patient, the foreign material defining a material first surface and a substantially opposed material second surface, the channel extending through the foreign material between the material first and second surfaces, the method using an apparatus including an electrode, the method comprising: positioning the electrode substantially adjacent to the material first surface; energizing the electrode with a radiofrequency current; and using the electrode energized with the radiofrequency current to deliver energy into the foreign material to create the channel, wherein the foreign material is included in a stent graft.

Abstract: An electrosurgical bipolar probe with internal cooling for use in systems and methods for lesioning in bone and other tissue is disclosed. The bipolar probe includes tubular electrodes configured such that the inner surface of the electrodes are cooled, directly or indirectly, while keeping the electrodes electrically isolated. An exemplary disclosed method of using a bipolar probe having an active tip having at least two electrodes for delivering energy includes the steps of: advancing the active tip into a bone tissue; delivering energy substantially between the electrodes in a bipolar manner; and supplying cooling fluid to the active tip for internal cooling of the electrodes. Some versions of the method further include the steps of monitoring the temperature of tissue to which the energy is being delivered; and controlling the delivery of energy in response to the temperature of the tissue.

Abstract: Devices and methods are disclosed for providing access to the pericardial cavity while reducing risk of myocardial damage. The methods include maintaining the positions of a puncture device and of a portion of a parietal pericardium relative to one other while delivering energy from the puncture device to create a channel through the pericardium. Additional embodiments disclosed include delivering a pulse or pulses of energy to the parietal pericardium and attempting to advance the puncture device through the parietal pericardium between deliveries of energy pulses.

Abstract: An electrosurgical probe with internal cooling for use in systems and methods for lesioning in bone and other tissue is disclosed. The probe includes tubular electrodes configured such that the inner surface of the lesioning electrodes are cooled, directly or indirectly, while keeping the electrodes electrically isolated. One embodiment includes an electrosurgical probe having at least two electrically isolated electrical conductors, including an inner electrical conductor and an outer electrical conductor. The inner electrical conductor defines a lumen for the circulation of a cooling fluid therein. An inner electrical insulator is disposed between the electrical conductors to electrically isolate the electrical conductors. The electrical insulator has sufficient thermal conductivity to allow for cooling of the inner and outer electrical conductors when the cooling fluid is circulating within the lumen of the inner electrical conductor.

Abstract: A method of accessing a pericardial cavity of a heart is disclosed, comprising delivering electrical energy to a pericardium in a manner which creates a channel substantially through a parietal pericardium and does not substantially affect myocardial tissue.

Abstract: A radiofrequency perforation apparatus for creating a channel at a target location in a body of a patient, the radiofrequency perforation apparatus comprising: a substantially tubular member defining a tubular member lumen; an end member partially positioned within the tubular member lumen at a distal end of the tubular member, the end member including an electrode; and an electrical insulator extending along the substantially tubular member.

Abstract: A method is disclosed for delivering energy to a region of tissue within a patient's body using a medical treatment system. The medical treatment system comprises an energy delivery device coupled to an energy source. Energy is delivered through the energy delivery device positioned within the patient's body. An energy delivery parameter associated with the delivery of energy by the medical treatment system is monitored and if one or more values of the energy delivery parameter exceed a predetermined magnitude threshold, one or more errors are detected. The extent of the detected errors is determined or assessed and the delivery of energy is controlled if the extent of the errors detected exceeds a sensitivity threshold before the expiry of a predetermined time period.

Abstract: A radiofrequency perforation apparatus for creating a channel at a target location in a body of a patient, the radiofrequency perforation apparatus being usable by an intended user having a hand, the radiofrequency perforation apparatus comprising: a handle graspable by the hand; a distal portion, the distal portion defining a distal portion length, the distal portion including an electrode and an electrical insulator extending from the electrode; and a force transmitting portion extending between the distal portion and the handle, the force transmitting portion defining a force transmitting portion length, the force transmitting portion length being larger than the distal portion length, the force transmitting portion having a force transmitting portion flexural rigidity of at least about 0.