Abstract: The present disclosure provides catheter systems, electrode assemblies, and methods for electrically stimulating one or more points about the circumference of the renal artery to provide real time intraprocedural operational feedback to the operator of a renal denervation procedure to allow for more precise and thorough ablation of the renal artery and better patient outcomes. In many embodiments, an electrode assembly is provided that includes multiple splines that extend from an insulated proximal hub to an insulated distal hub and are interconnected to an electrical wire to allow the splines to independently function as electrical stimulation electrodes. The electrically active splines can then be energized at one or more desired points during a renal denervation procedure to provide operational feedback.

Abstract: The present disclosure provides catheter systems, electrode assemblies, and methods for electrically stimulating one or more points about the circumference of the renal artery to provide real time intraprocedural operational feedback to the operator of a renal denervation procedure to allow for more precise and thorough ablation of the renal artery and better patient outcomes. In many embodiments, an electrode assembly is provided that includes multiple splines that extend from an insulated proximal hub to an insulated distal hub and are interconnected to an electrical wire to allow the splines to independently function as electrical stimulation electrodes. The electrically active splines can then be energized at one or more desired points during a renal denervation procedure to provide operational feedback.

Abstract: An ablation catheter comprises: an elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis; a distal member disposed adjacent the distal end, the distal member including an ablation element to ablate a biological member; one or more acoustic transducers disposed in the distal member and each configured to direct an acoustic signal toward a respective target ablation region and receive reflection echoes therefrom; and an acoustic redirection member disposed in the distal member to at least partially redirect the acoustic signal from at least one of the acoustic transducers toward a tissue target. The distal member includes a most-distal portion, a proximal portion, and a deflectable portion between the most-distal portion and proximal portion to permit deflection between the most-distal portion and proximal portion of the distal member. The transducers and redirection member are mounted on opposite sides of the deflectable portion.

Abstract: A method for performing elastographic deformation mapping of tissues and plaques comprises: introducing a distal portion of a catheter to an interior of an interior body of a patient; applying, from a palpator in the distal portion, one of a directed fluid or a mechanical indenter to produce a surface-applied palpation force to a target area of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface and subsurface tissues and plaques; and directing and delivering an OCT (optical coherence tomography) beam, from an OCT imaging sensor in the distal portion, for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area.

Abstract: A method for performing elastographic deformation mapping of tissues and plaques comprises: introducing a distal portion of a catheter to an interior of an interior body of a patient; applying, from a palpator in the distal portion, one of a directed fluid or a mechanical indenter to produce a surface-applied palpation force to a target area of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface and subsurface tissues and plaques; and directing and delivering an OCT (optical coherence tomography) beam, from an OCT imaging sensor in the distal portion, for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area.

Abstract: An ablation catheter comprises an elongated catheter body; at least one ablation element disposed in a distal portion which is adjacent the distal end of the catheter body; an illumination optical element disposed in the distal portion, the illumination optical element being light-transmissive to emit light from the illumination optical element to the targeted tissue region; and a collection optical element disposed in the distal portion, the collection optical element being light-transmissive to collect one or more of returned, backscattered or newly excited light from the targeted tissue region. The illumination or excitation optical element and the collection optical element are axially spaced from one another and axially optically isolated from one another within the distal portion to substantially prevent light from traveling between the illumination optical element and the collection optical element along a path within the distal portion.

Abstract: An ablation catheter comprises: an elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis; a distal member disposed adjacent the distal end, the distal member including an ablation element to ablate a biological member; one or more acoustic transducers disposed in the distal member and each configured to direct an acoustic signal toward a respective target ablation region and receive reflection echoes therefrom; and an acoustic redirection member disposed in the distal member to at least partially redirect the acoustic signal from at least one of the acoustic transducers toward a tissue target. The distal member includes a most-distal portion, a proximal portion, and a deflectable portion between the most-distal portion and proximal portion to permit deflection between the most-distal portion and proximal portion of the distal member. The transducers and redirection member are mounted on opposite sides of the deflectable portion.

Abstract: An ablation catheter comprises: an elongated catheter body extending along a longitudinal axis; at least one ablation element disposed in a distal portion which is adjacent the distal end of the catheter body to ablate a targeted tissue region outside the catheter body; a single pulse-echo ultrasonic transducer disposed in the distal portion and arranged to emit and receive an acoustic beam along a centroid in a beam direction, at a transducer angle of about 30-60 degrees relative to a distal direction of the longitudinal axis at a location of intersection between the longitudinal axis and the beam direction of the centroid of the acoustic beam; and a mechanism to manipulate the distal portion in movement including rotation of at least the distal portion around the longitudinal axis. The single ultrasonic transducer emits and receives acoustic pulses to provide lesion information in the targeted tissue region being ablated.

Abstract: An ablation catheter with acoustic monitoring comprises an elongated catheter body; a distal member disposed adjacent a distal end and including an ablation element to ablate a biological member at a target region outside the catheter body; and one or more acoustic transducers each configured to direct an acoustic beam toward a respective target ablation region and receive reflection echoes therefrom. The distal member includes a transducer housing in which the acoustic transducers are disposed, the transducer housing including at least one transducer window which is the only portion in the distal member through which the acoustic beam passes, at least the at least one transducer window portion of the distal member being made of a material comprising at least 50% carbon by volume, the transducer window material having an acoustic impedance between that of the acoustic transducers and that of the biological member.

Abstract: An ablation system comprises a catheter including a pulse-echo ultrasonic transducer disposed in a distal portion and arranged to emit and receive an acoustic beam. The transducer emits and receives acoustic pulses to provide transducer detected information regarding the targeted tissue region being ablated. A rotation mechanism rotates at least the distal portion around a longitudinal axis of the catheter. A control and interface system processes the transducer detected information and provides feedback to a user via a user interface and/or the control and interface system to be used to control ablation. The transducer detected information includes a detected lesion depth along a beam emanation direction. The control and interface system includes a lesion depth correction module which converts the detected lesion depth along the beam direction to a corrected lesion depth in a normal direction which is perpendicular to the tissue surface in contact with the ablation element.

Abstract: A system for ablation with acoustic feedback comprises: a catheter which includes an elongated catheter body; at least one ablation element to ablate a targeted tissue region; and a pulse-echo ultrasonic transducer arranged to emit and receive an acoustic beam along a centroid in a beam direction, at a transducer beam angle of between about 30 degrees and about 60 degrees relative to a distal direction of the longitudinal axis at a location of intersection between the longitudinal axis and the beam direction of the centroid of the acoustic beam of the ultrasonic transducer, wherein the transducer transmits and receives acoustic pulses to provide lesion information in the targeted tissue region; an ablation power subsystem; an ultrasonic transmit and receive subsystem to operate the ultrasonic transducer; a control subsystem to control operation of the ablation power subsystem and the ultrasonic transmit and receive subsystem; and a display.

Abstract: A method for denervation comprises: introducing a distal portion of a catheter to an interior of a vessel of patient, the catheter including an elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis, the catheter body including the distal portion at the distal end and a catheter lumen from the proximal end to the distal end; delivering optical energy via the catheter lumen to the distal portion of the catheter body; emitting an optical beam outwardly from the distal portion, through an optical emission port disposed in the distal portion of the catheter body; and forming at least one trench using the emitted optical beam with sufficient intensity to a depth into a vessel wall of the vessel sufficient to cause tissue removal and physically sever at least one nerve associated with the vessel wall at the depth within that depth range.

Abstract: An ablation system comprises a catheter including a pulse-echo ultrasonic transducer disposed in a distal portion and arranged to emit and receive an acoustic beam. The transducer emits and receives acoustic pulses to provide transducer detected information regarding the targeted tissue region being ablated. A rotation mechanism rotates at least the distal portion around a longitudinal axis of the catheter. A control and interface system processes the transducer detected information and provides feedback to a user via a user interface and/or the control and interface system to be used to control ablation. The transducer detected information includes a detected lesion depth along a beam emanation direction. The control and interface system includes a lesion depth correction module which converts the detected lesion depth along the beam direction to a corrected lesion depth in a normal direction which is perpendicular to the tissue surface in contact with the ablation element.

Abstract: A system for ablation with acoustic feedback comprises: a catheter which includes an elongated catheter body; at least one ablation element to ablate a targeted tissue region; and a pulse-echo ultrasonic transducer arranged to emit and receive an acoustic beam along a centroid in a beam direction, at a transducer beam angle of between about 30 degrees and about 60 degrees relative to a distal direction of the longitudinal axis at a location of intersection between the longitudinal axis and the beam direction of the centroid of the acoustic beam of the ultrasonic transducer, wherein the transducer transmits and receives acoustic pulses to provide lesion information in the targeted tissue region; an ablation power subsystem; an ultrasonic transmit and receive subsystem to operate the ultrasonic transducer; a control subsystem to control operation of the ablation power subsystem and the ultrasonic transmit and receive subsystem; and a display.

Abstract: An ablation catheter comprises: an elongated catheter body extending along a longitudinal axis; at least one ablation element disposed in a distal portion which is adjacent the distal end of the catheter body to ablate a targeted tissue region outside the catheter body; a single pulse-echo ultrasonic transducer disposed in the distal portion and arranged to emit and receive an acoustic beam along a centroid in a beam direction, at a transducer angle of about 30-60 degrees relative to a distal direction of the longitudinal axis at a location of intersection between the longitudinal axis and the beam direction of the centroid of the acoustic beam; and a mechanism to manipulate the distal portion in movement including rotation of at least the distal portion around the longitudinal axis. The single ultrasonic transducer emits and receives acoustic pulses to provide lesion information in the targeted tissue region being ablated.

Abstract: An ablation catheter comprises an elongated catheter body; at least one ablation element disposed in a distal portion which is adjacent the distal end of the catheter body; an illumination optical element disposed in the distal portion, the illumination optical element being light-transmissive to emit light from the illumination optical element to the targeted tissue region; and a collection optical element disposed in the distal portion, the collection optical element being light-transmissive to collect one or more of returned, backscattered or newly excited light from the targeted tissue region. The illumination or excitation optical element and the collection optical element are axially spaced from one another and axially optically isolated from one another within the distal portion to substantially prevent light from traveling between the illumination optical element and the collection optical element along a path within the distal portion.

Abstract: An ablation catheter with acoustic monitoring comprises an elongated catheter body; a distal member disposed adjacent a distal end and including an ablation element to ablate a biological member at a target region outside the catheter body; and one or more acoustic transducers each configured to direct an acoustic beam toward a respective target ablation region and receive reflection echoes therefrom. The distal member includes a transducer housing in which the acoustic transducers are disposed, the transducer housing including at least one transducer window which is the only portion in the distal member through which the acoustic beam passes, at least the at least one transducer window portion of the distal member being made of a material comprising at least 50% carbon by volume, the transducer window material having an acoustic impedance between that of the acoustic transducers and that of the biological member.

Abstract: A method for performing elastographic deformation mapping of tissues and plaques comprises: introducing a distal portion of a catheter to an interior of an interior body of a patient; applying, from a palpator in the distal portion, one of a directed fluid or a mechanical indenter to produce a surface-applied palpation force to a target area of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface and subsurface tissues and plaques; and directing and delivering an OCT (optical coherence tomography) beam, from an OCT imaging sensor in the distal portion, for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area.

Abstract: An optical coherence tomography (OCT) catheter, for performing high performance elastographic deformation mapping of tissues and plaques, comprises: a catheter having elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis, the catheter body including a distal portion at the distal end and a catheter lumen; a palpator, disposed in the distal portion, to apply one of a directed fluid or a mechanical indenter to produce a surface-applied palpation force to a target area of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface and subsurface tissues and plaques; and OCT imaging sensor, disposed in the distal portion, to direct and deliver OCT beam for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area.

Abstract: A control system alters one or more characteristics of an ablating element to ablate tissue. In one aspect, the control system delivers energy nearer to the surface of the tissue by changing the frequency or power. In another aspect, the ablating element delivers focused ultrasound which is focused in at least one dimension. The ablating device may also have a number of ablating elements with different characteristics such as focal length.