Abstract: A deflectable interstitial ablation device includes an elongated housing, an electrode mounted within the elongated housing, a driver coupled to the electrode, an imaging device integrally mounted within the elongated housing and a deflection system disposed within the elongated housing. The elongated housing has a proximal end, a distal end, and a deflectable segment. The electrode is deployable from a first position within the elongated housing to a second position a predetermined distance beyond the distal end of the elongated housing. The electrode further has a flexible portion capable of deflecting with the deflectable segment of the elongated housing, and can be deployed by the driver with a sufficient force such that penetration of the urethral wall occurs in a single motion. The imaging device further has a flexible portion capable of deflecting with the deflectable segment of the elongated housing.

Abstract: A deflectable interstitial ablation device includes an elongated housing, an electrode mounted within the elongated housing, a driver coupled to the electrode, an imaging device integrally mounted within the elongated housing and a deflection system disposed within the elongated housing. The elongated housing has a proximal end, a distal end, and a deflectable segment. The electrode is deployable from a first position within the elongated housing to a second position a predetermined distance beyond the distal end of the elongated housing. The electrode further has a flexible portion capable of deflecting with the deflectable segment of the elongated housing, and can be deployed by the driver with a sufficient force such that penetration of the urethral wall occurs in a single motion. The imaging device further has a flexible portion capable of deflecting with the deflectable segment of the elongated housing.

Abstract: Medical devices including a substrate that are expandable from a compressed state to an expanded state; a coating on the substrate, the coating having a drug agent incorporated therein; and a sheath over the coating. The sheath is expandable from a compressed state to an expanded state and has at least one perforation therein. The medical devices are configured such that when the substrate is in a compressed state, the sheath is also in a compressed state and the perforation is substantially closed. When the substrate is in an expanded state, the sheath is also in an expanded state and the perforation is substantially open. The invention also includes a method of using the medical devices for the controlled, localized delivery of a drug agent to a target location within a mammalian body.

Abstract: Medical devices including a substrate that are expandable from a compressed state to an expanded state; a coating on the substrate, the coating having a drug agent incorporated therein; and a sheath over the coating. The sheath is expandable from a compressed state to an expanded state and has at least one perforation therein. The medical devices are configured such that when the substrate is in a compressed state, the sheath is also in a compressed state and the perforation is substantially closed. When the substrate is in an expanded state, the sheath is also in an expanded state and the perforation is substantially open. The invention also includes a method of using the medical devices for the controlled, localized delivery of a drug agent to a target location within a mammalian body.

Abstract: A deflectable interstitial ablation device includes an elongated housing, an electrode mounted within the elongated housing, a driver coupled to the electrode, an imaging device integrally mounted within the elongated housing and a deflection system disposed within the elongated housing. The elongated housing has a proximal end, a distal end, and a deflectable segment. The electrode is deployable from a first position within the elongated housing to a second position a predetermined distance beyond the distal end of the elongated housing. The electrode further has a flexible portion capable of deflecting with the deflectable segment of the elongated housing, and can be deployed by the driver with a sufficient force such that penetration of the urethral wall occurs in a single motion. The imaging device further has a flexible portion capable of deflecting with the deflectable segment of the elongated housing.

Abstract: An implantable cancer therapy device includes adjacent segments of a radioactive therapeutic and an adjunctive therapeutic. The segments of radioactive therapeutic and adjunctive therapeutic can be alternatively disposed in a predetermined spatial array. The implantation can be permanent or temporary. The device can be a substantially cylindrical filament or plurality of spaced radioactive seed overlaid with an adjunctive therapeutic. The device can also be a monofilament comprising an adjunctive therapeutic, the monofilament having spaced depressions for indicating length and facilitating cutting.

Abstract: This invention provides for an apparatus and method to cause a stricture in a body passageway. For example, urinary incontinence and vesicoureteral reflux can be treated by inserting an energy-delivering probe into the body passageway of the urinary tract and applying energy to an arcuate segment of the wall of the body passageway to cause injury to the wall, hyperplasia of the tissue surrounding the wall, and stricture of the body passageway. Other applications for the apparatus and method of the present invention includes treatment of gastro-esophageal reflux and fecal incontinence.

Abstract: Apparatus for treating an aneurysm in a vessel that isolates a volume around the aneurysm, evacuates that volume and heats the aneurysmal wall. A catheter includes one or more inflatable balloons for defining the isolated volume and occluding and preventing any blood flow through the volume. Suction applied through the catheter to the isolated volume withdraws any blood in the isolated volume and displaces the tissue for contact with a thermal source that heats the aneurysmal wall. When the treatment is completed, the balloons are deflated and the catheter is removed from the vessel.

Abstract: An acoustic imaging system for use within a heart has a catheter (6), an ultrasound device (10) incorporated into the catheter (6), and an electrode (300, 304, 334, 394) mounted on the catheter (6). The ultrasound device (10) directs ultrasonic signals toward an internal structure in the heart to create an ultrasonic image, and the electrode (300, 304, 334, 394) is arranged for electrical contact with the internal structure. A chemical ablation device (55, 86, 314, 396) mounted on the catheter (6) ablates at least a portion of the internal structure by delivery of fluid to the internal structure. The ablation device (55) may include a material that vibrates in response to electrical excitation, the ablation being at least assisted by vibration of the material. The ablation device may alternatively be a transducer (414) incorporated into the catheter (6), arranged to convert electrical signals into radiation and to direct the radiation toward the internal structure.

Abstract: The invention features a bipolar electro-surgical apparatus having a first electrode that has a relatively large surface area for creating a diffuse current sufficient to heat a region of tissue to coagulation temperatures and a second electrode that has a relatively small surface area for creating a concentrated current region sufficient to heat tissue adjacent to the second electrode to resection temperatures. The first and second electrodes are relatively positioned along a treatment path, such that tissue is coagulated and resected as the electro-surgical apparatus is disposed along the path. The invention also features a method for bipolar electro-surgical tissue removal including positioning a pair of bipolar electrodes along a treatment path, flushing the treatment path with an ionic fluid, and imposing a voltage differential to cause current to flow through tissue between the electrodes, where the current flowing through the tissue is sufficient to heat and cause coagulation of the tissue.

Abstract: The invention relates to quickly and efficiently removing coagulated tissue within a body lumen without affecting the normal, healthy, untreated tissue, to minimize post-operative complications such as bleeding or edema formation. For example, in an aspect, the invention features a surgical resecting brush assembly. The assembly includes an elongated catheter sized and constructed for delivery through an extended body lumen to a site that is occluded with body matter that has been effected by heat treatment and a brush formation near the distal end of the catheter. The brush formation includes a bristle structure of sufficient stiffness to resect and remove the effected bodily matter without substantially damaging adjacent healthy tissue when the brush formation is actuated relative to the occluded site.

Abstract: A balloon catheter is provided that includes a catheter shaft constructed for insertion into a blood vessel, an inflatable balloon mounted on a distal portion of the catheter shaft, a heating device mounted on the distal portion of the catheter arranged for heating tissue in contact with the balloon while the balloon is inflated, and an ablation electrode. The catheter shaft and the balloon are sized and constructed to permit the distal portion of the catheter shaft to be inserted into an atrium or ventricle of a heart while the balloon is deflated. The distal portion of the catheter is positioned within the atrium or ventricle and adjacent to a wall of the atrium or ventricle. The balloon is inflated with fluid while the balloon is within the atrium or ventricle, and while the balloon is inflated it is engaged in direct contact with a wall of the atrium or ventricle. Tissue surrounding the balloon is heated through use of the heating device while the balloon is inflated.

Abstract: A balloon catheter is provided that includes a catheter shaft constructed for insertion into a blood vessel, an inflatable balloon mounted on a distal portion of the catheter shaft, a heating device mounted on the distal portion of the catheter arranged for heating tissue in contact with the balloon while the balloon is inflated, and an ablation electrode. The catheter shaft and the balloon are sized and constructed to permit the distal portion of the catheter shaft to be inserted into an atrium or ventricle of a heart while the balloon is deflated. The distal portion of the catheter is positioned within the atrium or ventricle and adjacent to a wall of the atrium or ventricle. The balloon is inflated with fluid while the balloon is within the atrium or ventricle, and while the balloon is inflated it is engaged in direct contact with a wall of the atrium or ventricle. Tissue surrounding the balloon is heated through use of the heating device while the balloon is inflated.

Abstract: An elongated, rigid implement having a sharp distal end is insertable into a solid mass within the body of a living being through a puncture site in the solid mass created by the sharp distal end. An elongated sleeve, which engages the elongated, rigid implement, is insertable into the solid mass through the puncture site in the solid mass. Fluid is provided to an expandable chamber located in the vicinity of a distal end of the elongated sleeve through at least one channel located within the elongated sleeve, to inflate the chamber while the chamber is positioned interstitially within the solid mass. A heating device located within the expandable chamber is powered, through at least one elongated conductor located within the elongated sleeve, to heat fluid within the chamber while the chamber is filled with the fluid and is positioned interstitially within the solid mass.

Abstract: Systems and methods for dilation of a body lumen, using an expandable dilatation catheter to simultaneously heat and apply pressure to tissue of the lumen and to expand and dilate the lumen including means constructed to produce and/or detect physiological response of the heated tissue to applied pressure.

Abstract: The invention features a treatment method of deeply seated tissue and a corresponding medical instrument. The medical instrument includes a light guide adapted to transmit light energy of a selected wavelength from a light source to a selected volume of tissue, a conduit constructed to deliver a flow of coolant from a source of coolant to a surface of the selected tissue volume through which the light energy passes in reaching the volume. The irradiation and cooling is governed by control means adapted to regulate the intensity of the light energy in respect of the flow of coolant delivered to the surface to prevent substantial damage of surface tissue while irradiating the tissue volume.

Abstract: Acoustic imaging balloon catheters formed by a disposable liquid-confining sheath supporting a high fidelity, flexible drive shaft which carries on its end an ultrasound transducer and includes an inflatable dilatation balloon. The shaft and transducer rotate with sufficient speed and fidelity to produce real time images on a T.V. screen. In preferred embodiments, special features that contribute to the high fidelity of the drive shaft include the particular multifilar construction of concentric, oppositely wound, interfering coils, a preloaded torque condition on the coils enhancing their interfering contact, and dynamic loading of the distal end of the probe, preferably with viscous drag. The coil rotating in the presence of liquid in the sheath is used to produce a desirable pressure in the region of the transducer.

Abstract: An apparatus and method for treating an aneurysm in a vessel that isolates a volume around the aneurysm, evacuates that volume and heats the aneurysmal wall. A catheter includes one or more inflatable balloons for defining the isolated volume and occluding and preventing any blood flow through the volume. Suction applied through the catheter to the isolated volume withdraws any blood in the isolated volume and displaces the tissue for contact with a thermal source that heats the aneurysmal wall. When the treatment is completed, the balloons are deflated and the catheter is removed from the vessel.

Abstract: Device and method for heating tissue, the device having a catheter shaft for insertion into a patient's body, a chamber formed by a collapsible balloon mounted on the catheter shaft and filled with an electrically conductive fluid, two or more electrical contacts enclosed within the chamber, a power supply for applying an electrical potential to the contacts, and a two or more conductors for connecting each of the contacts to the power supply. The fluid is heated on the basis of I.sup.2 R losses by a radio frequency electric current flowing between the electrodes, and the fluid in turn heats the surrounding tissue by heat transfer through the wall of the chamber. According to the method, the apparatus is inserted into the patient's body, the chamber is filled with an electrically conductive fluid, and an electrical potential is applied to the contacts. The apparatus functions as a temperature source.

Abstract: Device and method for heating tissue, the device having a catheter shaft for insertion into a patient's body, a chamber formed by a collapsible balloon mounted on the catheter shaft and filled with an electrically conductive fluid, two or more electrical contacts enclosed within the chamber, a power supply for applying an electrical potential to the contacts, and a two or more conductors for connecting each of the contacts to the power supply. The fluid is heated on the basis of I.sup.2 R losses by a radio frequency electric current flowing between the electrodes, and the fluid in turn heats the surrounding tissue by heat transfer through the wall of the chamber. According to the method, the apparatus is inserted into the patient's body, the chamber is filled with an electrically conductive fluid, and an electrical potential is applied to the contacts. The apparatus functions as a temperature source.