Abstract: An injectate delivery device for expanding tissue is provided. The injectate delivery device comprises: at least one fluid delivery tube comprising a proximal end, a distal end and a lumen therebetween; at least one fluid delivery element in fluid communication with the at least one fluid delivery tube lumen; a radially expanding element comprising the at least one fluid delivery element; a supply of vacuum constructed and arranged to cause tissue to tend toward the at least one fluid delivery element; and at least one control constructed and arranged to perform a function. The at least one control can be constructed and arranged to expand the radially expandable element and activate the supply of vacuum. Systems and method of injectate delivery are also provided.

Abstract: A system for treating a patient comprises an elongate shaft, an expandable reservoir and a fluid delivery assembly. The elongate shaft comprises a distal portion and is constructed and arranged to be introduced into a gastrointestinal lumen. The expandable reservoir is positioned on the elongate shaft distal portion and is constructed and arranged to receive a first fixed amount of ablative fluid and to deliver a first thermal dose of energy to a first portion of target tissue. The fluid delivery assembly is in fluid communication with the expandable reservoir and is constructed and arranged to deliver the first fixed amount of ablative fluid to the expandable reservoir. Devices and methods for treating tissue of a patient are also provided.

Abstract: A system for treating a patient comprises a delivery device and injectate. The delivery device comprises an elongate shaft with a distal portion and at least one delivery element positioned on the elongate shaft distal portion. The delivery device is constructed and arranged to deliver the injectate through the at least one delivery element and into tissue to create a therapeutic restriction in the gastrointestinal tract. Methods of creating a therapeutic restriction are also provided.

Abstract: Methods, systems and devices for treating a patient include providing a tissue treatment element constructed and arranged to deliver energy to tissue and treating tissue of the gastrointestinal tract by causing the tissue treatment element to deliver energy to an energy delivery zone. Treatment results in a reduction in the luminal surface area of at least a portion of the gastrointestinal tract. In particular embodiments, the methods, systems and devices are used to treat diabetes.

Abstract: Methods, systems and devices for treating a patient include performing a first treatment to treat a first portion of tissue and performing a second treatment to treat a second portion of tissue. The second portion of tissue is treated at least twenty-four hours after the first portion of tissue is treated. In particular embodiments, the first portion of tissue includes duodenal tissue, and the second portion of tissue includes duodenal or other gastrointestinal tissue.

Abstract: A device for ablating target tissue of a patient with an ablative fluid is provided. An elongate shaft includes a proximal portion and a distal portion, and at least one fluid delivery element is attached to the distal portion. The device can be configured to ablate the duodenal mucosa of a patient while avoiding damage to the duodenal adventitial tissue. Systems and methods of treating target tissue are also provided.

Abstract: A device for ablating target tissue of a patient with electrical energy is provided. An elongate shaft includes a proximal portion and a distal portion, and a radially expandable element is attached to the distal portion. An ablation element for delivering electrical energy to target tissue is mounted to the radially expandable element. The device can be constructed and arranged to ablate the duodenal mucosa of a patient while avoiding damage to the duodenal adventitial tissue. Systems and methods of treating target tissue are also provided.

Abstract: A device for expanding tissue comprises at least one fluid delivery tube and at least one fluid delivery element in fluid communication with the at least one fluid delivery tube. The at least one fluid delivery tube comprises a proximal end, a distal end, and a lumen therebetween. The device is constructed and arranged to perform a near full circumferential expansion of luminal wall tissue. Systems and methods are also provided, including a system for expanding tissue layers and treating tissue proximate to the expanded tissue layers.

Abstract: A system for treatment target tissue comprises an ablation device and an energy delivery unit. The ablation device comprises an elongate tube with an expandable treatment element. The system delivers a thermal dose of energy to treat the target tissue. Methods of treating target tissue are also provided.

Abstract: Systems, methods and devices for the treatment of tissue are disclosed. A system includes an elongate tube with a distal portion. A treatment element is positioned on the elongate tube distal portion, the treatment element constructed and arranged to treat target tissue. In one embodiment, gastrointestinal tissue is modified for the treatment of diabetes.

Abstract: A spectroscope for detecting vulnerable plaque within a lumen defined by an intraluminal wall includes a probe through which an optical fiber extends. An coupler in optical communication with the fiber is configured to atraumatically contact the intraluminal wall. A light source provides light to the fiber for illuminating the wall and a detector coupled to the fiber receives light from within the wall.

Abstract: A catheter includes a longitudinally extending catheter body having proximal and distal ends. The catheter body defines a lumen extending longitudinally from a first port defined at the proximal end, through the body, to a second port defined at the distal end. The catheter includes a valve for controlling fluid flow through the second port.

Abstract: An optical catheter system comprising an intraluminal catheter that provides optical signals to a patient and carries optical signals from the patient, an outer housing, and an inner carriage that moves longitudinally relative to the outer housing and rotates relative to the outer housing during operation when the catheter system is being driven by a pullback and rotation system. The optical catheter system has an interlock system that prevents rotation and longitudinal movement of the inner carriage in the outer housing until attached to the pullback and rotation system. The pullback and rotation system comprises a frame and a catheter system interface, attached to the frame, to which the catheter system is coupled. A carriage drive system is further provided that moves longitudinally and rotates relative to the frame to provide rotation and longitudinal drive to the catheter system.

Abstract: The invention features an apparatus and an associated method for illuminating a target area. The apparatus includes reflectors defining a first optical cavity. The first optical cavity defines a first set of longitudinal modes. The apparatus includes a first gain medium defining a first gain band. The first gain medium is configured to cause a plurality of the longitudinal modes of the first set to oscillate over an oscillation band within the first gain band when the first gain medium is pumped at an operative level. The apparatus includes a first optical waveguide positioned within the first optical cavity. The first optical waveguide has a length selected to cause a temporal coherence length of light emitted from the first optical cavity to be shorter than a scattering distance associated with the target area.

Abstract: The invention features an apparatus and an associated method for illuminating a target area. The apparatus includes reflectors defining a first optical cavity. The first optical cavity defines a first set of longitudinal modes. The apparatus includes a first gain medium defining a first gain band. The first gain medium is configured to cause a plurality of the longitudinal modes of the first set to oscillate over an oscillation band within the first gain band when the first gain medium is pumped at an operative level. The apparatus includes a first optical waveguide positioned within the first optical cavity. The first optical waveguide has a length selected to cause a temporal coherence length of light emitted from the first optical cavity to be shorter than a scattering distance associated with the target area.

Abstract: An intravascular probe includes a sheath with a distal portion and a proximal portion. The intravascular probe includes a first optical waveguide extending along the sheath, the first optical waveguide being configured to carry optical radiation between the distal and proximal portions, and a first beam redirector disposed at the distal portion in optical communication with the first optical waveguide. The intravascular probe also includes an optical detector configured to receive optical radiation from the first optical waveguide, and an ultrasound transducer disposed at the distal portion. The ultrasound transducer is configured to couple ultrasound energy between the intravascular probe and a transmission medium. A wire extends along the sheath in electrical communication with the ultrasound transducer.

Abstract: An apparatus for detecting vulnerable plaque within a lumen defined by an intraluminal wall includes a probe through which an optical fiber extends. An coupler in optical communication with the fiber is configured to atraumatically contact the intraluminal wall. A light source provides light to the fiber for illuminating the wall and a detector coupled to the fiber receives light from within the wall.

Abstract: An intravascular probe includes a sheath with a distal portion and a proximal portion. The intravascular probe includes a first optical waveguide extending along the sheath, the first optical waveguide being configured to carry optical radiation between the distal and proximal portions, and a first beam redirector disposed at the distal portion in optical communication with the first optical waveguide. The intravascular probe also includes an optical detector configured to receive optical radiation from the first optical waveguide, and an ultrasound transducer disposed at the distal portion. The ultrasound transducer is configured to couple ultrasound energy between the intravascular probe and a transmission medium. A wire extends along the sheath in electrical communication with the ultrasound transducer.

Abstract: A method for improving the treatment and/or examination of vessel walls through fluid, such as blood, functions by identifying the points in time when the catheter is closest to the vessel wall or farthest from the vessel wall. Identification of this relative location enables improved spectral readings in larger vessels. In short, instead of trying to overcome motion (e.g., by centering the catheter), this approach takes advantage of motion by identify times when the catheter is closer to the vessel wall, in order to gather more useful spectral information or improve the efficacy of the treatment of the vessel walls. In the specific example, the invention is used for near infrared (NIR) spectroscopy. In some embodiments, the catheter head is designed to induce relative movement between the head and the vessel walls.