Abstract: A microwave ablation catheter assembly is provided. A coaxial cable configured to connect to a microwave energy source at its proximal end and at its distal end to a distal radiating section. The coaxial cable includes inner and outer conductors and a dielectric positioned therebetween. An extended working channel is configured to receive the coaxial cable for positioning the coaxial cable adjacent target tissue. At least a portion of an inner surface of the extended working channel is electrically conductive. The electrically conductive inner surface of the extended working channel may function as a balun to maintain a balanced signal between the inner and outer conductors of the coaxial cable when the distal radiating section of the coaxial cable is energized.

Abstract: The ultrasonic surgical device includes a power source configured to generate power, an ultrasonic transducer having a first resonant frequency, the ultrasonic transducer electrically coupled to the power source and configured to generate ultrasonic motion in response to the generated power, an ultrasonic probe configured to be mechanically couplable to the ultrasonic transducer, the ultrasonic transducer and the ultrasonic probe having a second resonant frequency when the ultrasonic probe is coupled to the ultrasonic transducer, and a controller configured to determine whether the ultrasonic probe is properly coupled to the ultrasonic transducer based on the first resonant frequency and the second resonant frequency.

Abstract: An electrosurgical instrument capable of performing both thermal ablation and electroporation in a minimally invasive manner. The instrument is dimensioned to fit within an instrument channel of an endoscope to enable non-percutaneous insertion. The instrument comprises a radiating tip mounted at a distal end of a coaxial transmission line to receive microwave EM energy from the coaxial transmission line and emit it as a field around the radiating tip. The instrument further comprises an auxiliary transmission line arranged to convey electromagnetic energy having an electroporation waveform to a microelectrode array mounted on the radiating tip. The electroporation waveform may be a radiofrequency or low frequency electromagnetic (EM) signal. The microelectrode array may comprise a plurality of nanoscale conductive electrode elements.

Abstract: This document describes methods and devices for treating ventricular fibrillation. For example, this document describes methods of performing electroporation of a ventricle and electroporation catheters. The methods can include inserting a distal end portion of a catheter into a ventricle of a heart of a patient, inflating a balloon coupled to the distal end portion of the catheter, occluding a valve of the heart associated with the ventricle with the balloon, injecting a fluid into the ventricle via an aperture defined by the distal end portion of the catheter, and generating an electrical current via an electrode on the distal end portion of the catheter.

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 cryogenic medical device for delivery of subcooled liquid cryogen to various configurations of cryoprobes is designed for the treatment of damaged, diseased, cancerous or other unwanted tissues. The device is a closed or semi-closed system in which the liquid cryogen is contained in both the supply and return stages. The device is capable of generating cryogen to a supercritical state and may be utilized in any rapid cooling systems. As designed, the device comprises a number of parts including a vacuum insulated outer dewar, submersible cryogen pump, baffled linear heat exchanger, multiple pressurization cartridges, a return chamber, and a series of valves to control the flow of the liquid cryogen. The cryogenic medical device promotes the subcooling to any external cryogenic instrument.

Abstract: Disclosed are systems, devices, and methods for operating an electrosurgical generator, comprising an RF output stage configured to output an electrosurgical waveform through at least one pair of electrodes, sensing circuitry configured to measure an impedance between the at least one pair of electrodes configured to grasp tissue, and a controller configured to determine whether the impedance of the tissue disposed between the at least one pair of electrodes exceeds an impedance threshold, determine whether a change in the impedance is greater than an upper change in impedance threshold, and output an alarm indicative of the at least one pair of electrodes being at least partially open based on at least one of the impedance exceeding the impedance threshold or the change in impedance exceeding the change in impedance threshold.

Abstract: Devices, systems, and methods for removing obstructions from body lumens are disclosed herein. In some embodiments, a system for removing a thrombus includes an interventional element configured to be disposed proximate to or adjacent to a thrombus within a blood vessel. The system can include a signal generator in electrical communication with the interventional element. The signal generator can be configured to deliver an electrical signal to the interventional element. The electrical signal can include a waveform having a positive phase having a peak positive current and a first duration, and a negative phase having a peak negative current and a second duration. A magnitude of the peak positive current can be greater than a magnitude of the peak negative current, and the first duration can be greater than the second duration.

Abstract: The present invention relates to systems and devices for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In particular, the present invention relates to systems and devices for the delivery of energy with heat transfer ability. In some embodiments, the systems and devices also have variable characteristic impedance as a result of the use of heat transfer materials. In certain embodiments, methods are provided for treating a tissue region (e.g., a tumor) through application of energy with the systems and devices of the present invention.

Abstract: To provide a catheter having electrodes to be subjected to application of voltages different from each other in polarity. An outer tube member (3) having a lumen (2); a handle provided on a proximal side of the outer tube member (3); a plurality of electrodes (5) provided on the outer tube member (3); conducting wires (6) connected to one or more of the electrodes (5) and disposed in the lumen (2), the conducting wires (6); and an operating wire (7) having a distal end portion fixed to a distal end portion of the outer tube member (3), wherein one of the electrodes (5a) is connected to a conducting wire (6a) at a connection point, which is different from a connecting point, where another electrode (5b) is connected to another conducting wire (6b), in a circumferential direction of the outer tube member (3).

Abstract: Methods and systems utilizing inferred maximum temperature monitoring for irrigated ablation therapy are described herein. In one embodiment, a method for ablating tissue includes positioning an elongate body proximate to tissue, where the elongate body includes an ablation element and at least one temperature sensor coupled thereto. The method can include simultaneously delivering ablative energy to the tissue through the ablation element and liquid through the elongate body. The method can further include pausing delivery of ablative energy and liquid, as well as sensing a temperature of the ablation element while delivery of ablative energy and liquid is paused. The method can further include any of terminating delivery of ablative energy and liquid and resuming delivery of ablative energy and liquid based on a comparison of the sensed temperature to a reference temperature.

Abstract: A medical apparatus includes a probe configured for insertion into a body of a patient and including a plurality of electrodes configured to contact tissue within the body. An electrical signal generator applies bipolar trains of pulses having a voltage amplitude of at least 200 V and having a duration of each of the bipolar pulses less than 20 ?s between at least one pair of the electrodes in contact with the tissue, thereby causing irreversible electroporation of the tissue between the at least one pair of the electrodes. One or more electrical sensors sense an energy dissipated between the at least one pair of the electrodes during the trains of the pulses. A controller controls electrical and temporal parameters of the trains of the pulses applied by the electrical signal generator, responsively to the one or more electrical sensors, so that the dissipated energy satisfies a predefined criterion.

Abstract: A medical probe includes a shaft and an expandable flexible distal-end assembly. The shaft is configured for insertion into a cavity of organ of a patient. The expandable flexible distal-end assembly, which is fitted at a distal-end of the shaft, includes a flat flexible backing sheet, including irrigation channels, and two flexible substrates having respective arrays of electrodes disposed thereon, the substrates attached one on either side of the backing sheet.

Abstract: A method for coagulating and dissecting tissue. The method includes measuring a tissue property and delivering multiple energy modalities to the tissue based on the tissue property. The energy modalities being delivered from a generator either alone or in combination.

Abstract: An endovascular near critical fluid based cryoablation catheter for creating an elongated lengthwise-continuous lesion in tissue can comprise an elongated shaft, a flexible distal tissue treatment section, and a distal tip. A plurality of flexible tubes can extend through the distal treatment section to transport a near critical fluid to and from the distal tip. The distal treatment section can also include a flexible fluid-sealed cover or barrier layer surrounding the delivery tubes. The cover and tubes can collectively define a space which is filled with a fluidic thermally conductive media. The thermally conductive media, fluid delivery tubes, and the cover can be arranged such that a flow of the near critical fluid through the tube bundle transfers heat between a target tissue and the distal treatment section of the catheter thereby creating the elongated lengthwise-continuous lesion in the tissue.

Abstract: A balloon catheter includes a flexible outer cylinder shaft, a holding member connected to a proximal end portion of the outer cylinder shaft, a sealing member that maintains liquid tightness incorporated in the holding member, a flexible inner cylinder shaft, a tube having a Rockwell hardness of R 115 or more, a flexural modulus of 3.0 to 4.5 GPa, and a thickness of 0.06 to 0.12 mm, a push-in member connected to a proximal end portion of the inner cylinder shaft, a pull-out prevention member connected to the push-in member, and a balloon composed of an elastic material and connected to each of the distal end portion of the outer cylinder shaft and the proximal end portion of the inner cylinder shaft, wherein the tube is inserted over the inner cylinder shaft over an area thereof except for a connecting portion between the balloon and the inner cylinder shaft.

Abstract: Examples herein describe a surgical instrument that deliver a first energy and a second energy configured to seal the tissue. The first energy may be operated by a first energy algorithm and second energy may be operated by a second energy algorithm. The surgical instrument may include an updatable memory that may store a default control algorithm that may control both the first energy algorithm and the second energy algorithm simultaneously. The surgical instrument may include a processor that may be configured to operate in a first mode at a first time, wherein in the first mode the processor may be configured to operate according to the default control algorithm. The processor may receive data at a second time that may cause the processor to operate in a second mode, wherein in the second mode the processor may be configured to operate according to an alternative control algorithm.

Abstract: A cryogenic needle of a cryogenic system is coupled to a heater. While the needle is inserted into target tissue beneath skin, the heater provides heat to protect the skin. Power supplied to the heater is used to interpolate performance of the needle and/or operating parameters of the cryogenic system.

Abstract: A vapor delivery system and method is provided that includes a number of features. In one embodiment, a method comprises inserting a vapor delivery needle into tissue of a patient, activating a flow of vapor from a vapor generator through vapor delivery ports of the vapor delivery needle to cause condensed liquid to exit vapor delivery ports of the vapor delivery needle, generating vapor in the vapor generator, delivering a dose of vapor through the vapor delivery ports of the vapor delivery needle into the tissue, and after the dose of vapor is delivered, re-activating the flow of vapor from the vapor generator through the vapor delivery ports of the vapor delivery needle to prevent a vacuum from forming in the vapor delivery needle. Vapor therapy systems are also provided.

Abstract: Systems, devices, and methods for transvascular ablation of target tissue are disclosed herein. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are method of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.