Abstract: A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.

Abstract: A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.

Abstract: A method of treating a perforator vein comprises applying ultrasound to the perforator vein and occluding the perforator vein with the ultrasound. An apparatus for treating blood vessels comprises an ultrasound emitter, wherein the ultrasound emitter is configured to emit ultrasound at multiple therapeutic ultrasound frequencies during a treatment cycle. The apparatus further comprises an acoustic coupler in sonic communication with the emitter, wherein the acoustic coupler has an acoustic coupling surface configured to contact a patient and facilitate delivery of ultrasound to the patient and wherein the acoustic coupler provides a conduction path for ultrasound from the emitter to the acoustic coupling surface. The apparatus further comprises an acoustic coupler containing a displaceable acoustic coupling material.

Abstract: A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.

Abstract: A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.

Abstract: A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.

Abstract: A catheter includes multiple primary leads to deliver energy for ligating a hollow anatomical structure. Each of the primary leads includes a resistive element located at the working end of the catheter. Separation is maintained between the leads such that each lead can individually receive power. The catheter can include a lumen to accommodate a guide wire or to allow fluid delivery. Energy is applied until the diameter of the hollow anatomical structure is reduced to the point where occlusion is achieved. In one embodiment, a balloon is inflated to place the resistive elements into apposition with a hollow anatomical structure and to occlude the structure before the application of energy. The inflated balloon impairs blood flow and facilitates the infusion of saline, or medication, to the hollow anatomical structure in order to reduce the occurrence of coagulation and to improve the heating of the structure by the catheter.

Abstract: A catheter is usable to treat a hollow anatomical structure (HAS). The catheter comprises one or more shafts which extend away from a proximal end of the catheter toward a distal end thereof. The catheter further comprises an HAS constriction energy source located at or near the distal end of the catheter. The catheter further comprises at least one radially expandable transmural fluid delivery channel located in the catheter near the HAS constriction energy source.

Abstract: An energy delivering probe is used for thermally coagulating and/or constricting hollow anatomical structures (HAS) including, but not limited to, blood vessels such as perforator veins. The probe includes a shaft and at least two electrodes where at least one of the electrodes has a perimeter that increases as it extends proximally.

Abstract: The present invention provides an apparatus and method for induction of therapeutic hypothermia of the heart by selective hypothermic perfusion of the myocardium through the patient's coronary arteries. The apparatus consists of a guiding catheter into which blood is drawn from the aorta, directed over a heat exchanger and expelled directly into a coronary artery.

Abstract: An apparatus and method are described for quickly inducing therapeutic hypothermia of the heart by perfusing the myocardium with hypothermic fluid in alternatingly antegrade and retrograde directions. The apparatus and method provide rapid cooling of the affected myocardium to achieve optimal myocardial salvage in a patient experiencing acute myocardial infarction. The therapeutic hypothermia system includes one or more coronary artery perfusion catheters, a coronary sinus perfusion catheter and a fluid source for delivering a hypothermically-cooled physiologically-acceptable fluid, such as saline solution, oxygenated venous blood, autologously-oxygenated arterial blood and/or an oxygenated blood substitute. The system may also include one or more guidewires, subselective catheters and/or interventional catheters introduced through a lumen in one or more of the perfusion catheters.

Abstract: An apparatus and method are described for efficiently cooling the myocardium while minimizing blood dilution as well as volume buildup within the patient. A flow of cooled fluid is conducted through a percutaneously introduced catheter into the aorta where only a portion thereof is discharged while the remainder is withdrawn from the patient. The much greater flow rate through the catheter that can thereby be maintained without adverse physiological effect serves to minimize the heat gained by the fluid as a result of the catheter's immersion in blood at body temperature. By arranging the catheter such that the return flow surrounds and thereby insulates the supply flow, even colder fluid can be delivered to the myocardium.

Abstract: The present invention relates to catheters for selectively cooling or warming tissue within a patient's vasculature. The present invention utilizes novel heat exchanging devices, which reside inside the catheter body for selectively altering the temperature of fluid that flows through the catheter shaft. In addition, the present invention utilizes novel pumping devices, which reside within a patient's vasculature for withdrawing oxygenated blood into the catheter body where heat exchange occurs across a heat transfer interface for selective cooling or warming of the blood occurs. The present invention can be used in a multiplicity of medical disciplines where it is advantageous to selectively alter the temperature of tissue, including beating heart applications, as well as stopped heart medical interventions.

Abstract: The present invention provides methods, systems and devices for performing cardipulmonary bypass (CPB), cardioplegic arrest, suction of fluid from the aorta to remove embolic or other fluid from the general circulation and the selective segmentation of the arterial system to perform differential perfusion eliminating hypoperfusion. An aortic catheter having an arch lumen which extends at least in part along the length of the catheter shaft has a proximal opening coupled to a CPB machine and a distal arch opening. A corporeal lumen extends at least in part along the length of the catheter shaft and has a proximal opening coupled to a CPB machine and a distal corporeal opening. A suction lumen extends at least in part along the length of the catheter shaft and has a proximal suction opening coupled to a suction source and a distal suction opening residing in the aortic lumen of a patient.

Abstract: A system for establishing differential perfusion without the use of an occlusion balloon or other flow separator devices. The flows through two lumens are controlled such that the blood flow issuing from one lumen terminating in the aortic arch supplies the entire demand of the cerebral subcirculation while the blood flow issuing from a second lumen terminating in the descending aorta supplies the entire demand of the corporeal subcirculation. When the two flows are properly balanced, an inversion layer forms therebetween and no intermixing of the two flows takes place.

Abstract: The cannula of the present invention is useful for standard gravity drainage or vacuum assisted/suction drainage. The cannula of the present invention has a flexible shaft composed of a tubular body and an expandable scaffolding. The expandable scaffolding has a contracted position, facilitating insertion into a vessel and an expanded condition configured to allow optimal drainage in a vessel. The cannula is inserted into a vessel and navigated into an operative position within the patient's venous system. Once the cannula is in the proper position, the scaffolding is expanded either through passive, active, mechanic, hydraulic, pneumatic, thermal or electrical actuation. The cannula of the present invention is capable of expanding a collapsed vein to its normal diameter and/or capable of supporting the vein when suction is applied to the cannula to help increase fluid flow through the cannula.

Abstract: The present invention relates to catheters for selectively cooling or warming tissue within a patient's vasculature. The present invention utilizes novel heat exchanging devices, which reside inside the catheter body for selectively altering the temperature of fluid that flows through the catheter shaft. In addition, the present invention utilizes novel pumping devices, which reside within a patient's vasculature for withdrawing oxygenated blood into the catheter body where heat exchange occurs across a heat transfer interface for selective cooling or warming of the blood occurs. The present invention can be used in a multiplicity of medical disciplines where it is advantageous to selectively alter the temperature of tissue, including beating heart applications, as well as stopped heart medical interventions.

Abstract: An apparatus and method are described for therapeutic hypothermia of the heart by selective hypothermic perfusion of the myocardium through the patient's coronary arteries. The apparatus and method provide rapid cooling of the affected myocardium to achieve optimal myocardial salvage in a patient experiencing acute myocardial infarction. The therapeutic hypothermia system includes one or more selective coronary perfusion catheters and a fluid source for delivering a hypothermically-cooled physiologically-acceptable fluid, such as saline solution, oxygenated venous blood, autologously-oxygenated arterial blood and/or an oxygenated blood substitute. The system may also include one or more guidewires, subselective catheters and/or interventional catheters introduced through a lumen in the selective coronary perfusion catheter.

Abstract: The present invention includes an apparatus and methods for differentially perfusing a patient undergoing cardiopulmonary bypass. A cardiopulmonary bypass machine is configured to provide hypothermic oxygenated blood and normothermic oxygenated blood to an aortic balloon catheter. The catheter has arch perfusion ports and corporeal perfusion ports and is introduced into a patient's aorta and navigated transluminally until the occlusion balloon is located in the descending aorta. The occlusion balloon is inflated and hypothermic oxygenated blood is perfused to the arch vessels while normothermic oxygenated blood is perfused to the corporeal circulation. This procedure offers the benefit of cerebral protection from embolic events during cardiopulmonary bypass surgery.

Abstract: The present invention includes an apparatus and methods for differentially perfusing a patient undergoing cardiopulmonary bypass. A cardiopulmonary bypass machine is configured to provide hypothermic oxygenated blood and normothermic oxygenated blood to an aortic balloon catheter. The catheter has arch perfusion ports and corporeal perfusion ports and is introduced into a patient's aorta and navigated transluminally until the occlusion balloon is located in the descending aorta. The occlusion balloon is inflated and hypothermic oxygenated blood is perfused to the arch vessels while normothermic oxygenated blood is perfused to the corporeal circulation. This procedure offers the benefit of cerebral protection from embolic events during cardiopulmonary bypass surgery.