Abstract: An atherectomy system includes a drive mechanism that is adapted to rotatably actuate an atherectomy burr and a controller that is adapted to regulate operation of the drive mechanism. In some cases, the drive mechanism includes a drive cable that is coupled with the atherectomy burr and a drive motor that is adapted to rotate the drive cable. The controller is adapted to receive an indication of an increase in torque experienced at the atherectomy burr and is further adapted to, in response, regulate operation of the drive mechanism such that the increase in torque results in a noticeable reduction in speed of the drive mechanism such that a user of the atherectomy system notices the reduction in speed and is alerted to the increase in torque.

Abstract: Embodiments herein relate to systems and methods for intravascular lesion disruption. In an embodiment, a catheter system for imparting pressure to induce fractures upon a vascular lesion within or adjacent a blood vessel wall is included. The system includes a catheter configured to advance to a vascular lesion, the catheter including an elongate shaft that defines at least a first orifice for fluid flow; a balloon, coupled to the elongate shaft, that surrounds the first orifice where the balloon can expand from a collapsed configuration suitable for advancing the catheter through a patient's vasculature to a first expanded configuration suitable for anchoring the catheter in position relative to a treatment site; and a propulsion system configured to propel a fluid from the first orifice toward the balloon wall to create an inertial impulse in a vessel wall to transfer momentum to the vascular lesion. Other embodiments are also included herein.

Abstract: An atherectomy system includes a drive mechanism adapted to rotatably actuate an atherectomy burr and a controller that is adapted to regulate operation of the drive mechanism. A guidewire motion detector is adapted to detect movement of the guidewire. The controller is further adapted to take action when the guidewire motion detector detects movement of the guidewire relative to the drive mechanism while the drive mechanism is operating.

Abstract: Embodiments herein relate to systems and methods for intravascular lesion disruption. In an embodiment, a catheter system for imparting pressure to induce fractures upon a vascular lesion within or adjacent a blood vessel wall is included. The system includes a catheter configured to advance to a vascular lesion, the catheter including an elongate shaft that defines at least a first orifice for fluid flow; a balloon, coupled to the elongate shaft, that surrounds the first orifice where the balloon can expand from a collapsed configuration suitable for advancing the catheter through a patient's vasculature to a first expanded configuration suitable for anchoring the catheter in position relative to a treatment site; and a propulsion system configured to propel a fluid from the first orifice toward the balloon wall to create an inertial impulse in a vessel wall to transfer momentum to the vascular lesion. Other embodiments are also included herein.

Abstract: An atherectomy system includes a drive mechanism adapted to rotatably actuate an atherectomy burr and a controller that is adapted to operate the drive mechanism in a first operating mode in which the atherectomy burr is operated at a speed reference and with a predetermined torque limit. The controller is adapted to determine when the atherectomy burr becomes stuck while in the first operating mode and is further adapted to, when the atherectomy burr becomes stuck, operate the drive mechanism in a second operating mode that is different from the first operating mode.

Abstract: An atherectomy system includes a drive mechanism adapted to rotatably actuate an atherectomy burr and a controller that is adapted to operate the drive mechanism in a first operating mode in which the atherectomy burr is operated at a speed reference and with a predetermined torque limit. The controller is adapted to determine when the atherectomy burr becomes stuck while in the first operating mode and is further adapted to, when the atherectomy burr becomes stuck, operate the drive mechanism in a second operating mode that is different from the first operating mode.

Abstract: A catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (208A) or a heart valve within a body (107) of a patient (109) includes an energy source (124), a balloon (104), an energy guide (122A), and a tissue identification system (142). The energy source (124) generates energy. The balloon (104) is positionable substantially adjacent to the treatment site (106). The balloon (104) includes a balloon wall (130) that defines a balloon interior (146). The balloon (104) can be configured to retain a balloon fluid (132) within the balloon interior (146). The energy guide (122A) is configured to receive energy from the energy source (124) and guide the energy into the balloon interior (146) so that plasma bubbles (134) are formed in the balloon fluid (132) within the balloon interior (146). The tissue identification system (142) can be configured to acoustically analyze tissue within the treatment site (106).

Abstract: A catheter system (100) for placement within a treatment site (106) at a vessel wall (208A) or a heart valve includes an energy source (124), a balloon (104), an energy guide (122A), and a tissue identification system (142). The energy source (124) generates energy. The balloon (104) is positionable substantially adjacent to the treatment site (106). The balloon (104) has a balloon wall (130) that defines a balloon interior (146). The balloon (104) is configured to retain a balloon fluid (132) within the balloon interior (146). The energy guide (122A) is configured to receive energy from the energy source (124) and guide the energy into the balloon interior (146) so that plasma is formed in the balloon fluid (132) within the balloon interior (146). The tissue identification system (142) is configured to spectroscopically analyze tissue within the treatment site (106).

Abstract: A catheter system (100) for treating a treatment site (106) within or adjacent to the vessel wall of a blood vessel (108), or the heart valve, includes an energy source (124), a balloon (104), an energy guide (122A), and a balloon integrity protection system (142). The energy source (124) generates energy. The balloon (104) is positionable substantially adjacent to the treatment site (106). The balloon (104) has a balloon wall (130) that defines a balloon interior (146). The balloon (104) is configured to retain a balloon fluid (132) within the balloon interior (146). The energy guide (122A) is configured to receive energy from the energy source (124) and guide the energy into the balloon interior (146) so that plasma is formed in the balloon fluid (132) within the balloon interior (146). The balloon integrity protection system (142) is operatively coupled to the balloon (104).

Abstract: An ultrasound catheter may be adapted for placement within a blood vessel having a vessel wall for treating a vascular lesion within or adjacent the vessel wall. The ultrasound catheter includes an elongate shaft extending from a distal region to a proximal region and an ultrasound transducer that is disposed relative to the distal region of the elongate shaft and is adapted to impart near-field acoustic pressure waves upon the vascular lesion in order to mechanically modify the vascular lesion. An inflatable balloon is disposed about the ultrasound transducer and is coupled to the elongate shaft, the inflatable balloon having a collapsed configuration suitable for advancing the ultrasound catheter through a patient's vasculature and an expanded configuration suitable for anchoring the ultrasound catheter in position relative to a treatment site.

Abstract: An atherectomy system includes a drive mechanism adapted to rotatably actuate an atherectomy burr and a control system that is adapted to regulate operation of the drive mechanism. The drive mechanism may include a drive cable that is coupled with the atherectomy burr and a drive motor that is adapted to rotate the drive cable. The control system includes a drive module adapted to provide an operational signal to operate the drive mechanism, a monitoring module adapted to monitor operation of the drive mechanism and to determine if the drive mechanism is operating within a predetermined range and an excitation module that is operably coupled to the drive mechanism and is adapted to provide haptic feedback to a user of the drive mechanism if the monitoring module determines that the drive mechanism is not operating within a predetermined range.

Abstract: An atherectomy system includes a handle and a drive motor that is adapted to rotate a drive cable extending through the handle and operably coupled to an atherectomy burr. A control system is adapted to regulate operation of the drive motor, including providing the drive motor with a high frequency pulse width modulation (PWM) drive signal in order to operate the drive motor. The control system monitors a motor performance parameter such as motor speed or motor torque, and when the motor performance parameter approaches a limit of a performance range, the control system adds a low frequency PWM signal to the high frequency PWM drive signal, thereby causing the drive motor to produce a tactile signal that signals to the user that the motor performance parameter is approaching the limit of the performance range.

Abstract: An atherectomy system includes a handle and a drive motor that is adapted to rotate a drive cable extending through the handle and operably coupled to an atherectomy burr. A control system is adapted to regulate operation of the drive motor, including providing the drive motor with a high frequency pulse width modulation (PWM) drive signal in order to operate the drive motor. The control system monitors a motor performance parameter such as motor speed or motor torque, and when the motor performance parameter approaches a limit of a performance range, the control system adds a low frequency PWM signal to the high frequency PWM drive signal, thereby causing the drive motor to produce a tactile signal that signals to the user that the motor performance parameter is approaching the limit of the performance range.

Abstract: A catheter system for pressure wave and inertial impulse generation for intravascular lesion disruption at a treatment site includes a catheter including an elongate shaft and balloon coupled to the elongate shaft. The catheter system includes a light guide disposed along the elongate shaft and at least partially within the balloon, where the light guide is in optical communication with a light source and a balloon fluid. The catheter can include a first focusing element located at a distal portion of the light guide and in optical communication with the light source. The first focusing element can direct light from within the light guide to a first location at a first distance away from the distal portion of the light guide to initiate plasma formation in the balloon fluid away from the distal portion and to cause rapid bubble formation, thereby imparting pressure waves at the treatment site.

Abstract: A catheter system for imparting pressure to induce fractures at a treatment site within or adjacent a blood vessel wall includes a catheter, a fortified balloon inflation fluid and a first light guide. The catheter includes an elongate shaft and a balloon that is coupled to the elongate shaft. The balloon has a balloon wall and can expand to a first expanded configuration to anchor the catheter in position relative. The fortified balloon inflation fluid can expand the balloon to the first expanded configuration. The fortified balloon inflation fluid includes a base inflation fluid and a fortification component. The fortification component reduces a threshold for inducing plasma formation in the fortified balloon inflation fluid compared to the base inflation fluid. The fortification component can include at least one of carbon and iron. The first light guide is disposed along the elongate shaft and is positioned at least partially within the balloon.

Abstract: A catheter system for pressure wave and inertial impulse generation for intravascular lesion disruption includes a balloon coupled to an elongate shaft, and a first and second light guide disposed along the elongate shaft. The first and second light guides each include a diverting feature in optical communication with at least one light window to direct light to exit each light guide toward a side surface portion thereof and toward the balloon. A method includes expanding the balloon from a collapsed configuration to a first expanded configuration, and activating a light source in optical communication with each light guide to provide sub-millisecond pulses of light to the diverting features, thereby inducing plasma formation in a balloon fluid, causing rapid bubble formation, and imparting pressure waves upon the treatment site.

Abstract: A catheter system includes a catheter having an elongate shaft, a balloon and a light guide. The balloon expands from a collapsed configuration to a first expanded configuration. The light guide is disposed along the elongate shaft and is in optical communication with a light source and a balloon fluid. A first portion of the light guide extends into a recess defined by the elongate shaft. A protection structure is disposed within the recess and is in contact with the first portion of the light guide. The light source provides pulses of light to the balloon fluid, thereby initiating plasma formation and rapid bubble formation within the balloon, thereby imparting pressure waves upon a treatment site. The protection structure can provide structural protection from the pressure waves to the first portion of the light guide.

Abstract: A catheter system for imparting pressure to induce fractures in a vascular lesion within or adjacent a vessel wall, includes a catheter and a superheating system. The catheter can advance to the vascular lesion. The catheter includes an elongate shaft and a balloon coupled to the elongate shaft. The balloon includes a balloon wall. The balloon moves between a collapsed configuration and a first expanded configuration suitable for anchoring the catheter in position relative to a treatment site. The superheating system can heat a balloon fluid within the balloon rapidly enough to achieve spontaneous vaporization of the balloon fluid and to generate inertial bubbles and acoustic pressure waves. The superheating system can include a first light guide extending along the elongate shaft. The first light guide is in optical communication with a light source at a proximal portion of the first light guide. The first light guide can include a first light window at a distal portion of the first light guide.

Abstract: An atherectomy system includes a drive mechanism adapted to rotatably actuate an atherectomy burr and a controller that is adapted to regulate operation of the drive mechanism. A guidewire motion detector is adapted to detect movement of the guidewire. The controller is further adapted to take action when the guidewire motion detector detects movement of the guidewire relative to the drive mechanism while the drive mechanism is operating.

Abstract: Embodiments herein relate to systems and methods for intravascular lesion disruption. In an embodiment, a catheter system for imparting pressure to induce fractures upon a vascular lesion within or adjacent a blood vessel wall is included. The system includes a catheter configured to advance to a vascular lesion, the catheter including an elongate shaft that defines at least a first orifice for fluid flow; a balloon, coupled to the elongate shaft, that surrounds the first orifice where the balloon can expand from a collapsed configuration suitable for advancing the catheter through a patient's vasculature to a first expanded configuration suitable for anchoring the catheter in position relative to a treatment site; and a propulsion system configured to propel a fluid from the first orifice toward the balloon wall to create an inertial impulse in a vessel wall to transfer momentum to the vascular lesion. Other embodiments are also included herein.