Abstract: A novel medical probe assembly, system, and methods for the use thereof to treat tissue are described. The system optionally comprises an energy source, two probe assemblies, and one or more cooling devices to provide cooling to at least one of the probe assemblies. The probe assemblies may be configured in a bipolar mode, whereby current flows preferentially between the probe assemblies. The probe assemblies and system described herein are particularly useful to deliver radio frequency energy to a patient's body. RF energy delivery may be used for various applications, including the treatment of pain, tumor ablation and cardiac ablation.

Abstract: A medical probe assembly, system, and methods for the use thereof to treat tissue are described. The system optionally comprises an energy source, two internally-cooled probe assemblies, and one or more cooling devices to provide cooling to at least one of the probe assemblies. The probe assemblies may be configured in a bipolar mode, whereby current flows preferentially between the probe assemblies. The probe assemblies and system described herein are particularly useful to deliver radio frequency energy to a patient's body. RF energy delivery may be used for various applications, including the treatment of pain, tumor ablation and cardiac ablation.

Abstract: A method and apparatus are disclosed for improving accuracy of placement of a cannula during delivery of electrical energy proximate to bodily tissue, e.g. neural structures. The apparatus optionally includes a cannula operable to deliver electrical current where a portion of the cannula is electrically insulated and a portion of the cannula is exposed and electrically conductive. The cannula further includes a radiopaque marker to identify a specific portion of the cannula, for example to differentiate the electrically insulated region from the electrically exposed region, by allowing it to be more clearly delineated using fluoroscopy or other radiographic imaging techniques. The radiopaque marker is optionally tapered in order to reduce the force required to insert a cannula comprising a radiopaque marker into the patient's body.

Abstract: A device with a functional tip containing at least one active electrode capable of creating a controlled perforation in body tissue through the application of energy (e.g. Radio Frequency (RF)) is described. The position of the tip of the device can be determined in response to ECG measured at the tip and determined by a monitor coupled to the device. The device is useful to remove or perforate unwanted tissue in a controlled manner in any location in the body, particularly in the atrial septum for controlled transseptal puncture. In this application, the device is introduced into the right atrium, and the functional tip is then positioned against the atrial septum. ECG is used to locate the region of the fossa ovalis on the atrial septum. Energy is applied to create the perforation and ECG is monitored to determine if the perforation was created in a desired location.

Abstract: An intradiscal device for treatment of a patient's intervertebral disc. The device has two elongate probes for insertion to two spaced apart treatment sites of the annulus fibrosus. The distal portions of each probe have energy delivery means for delivering energy between the distal portions of the probes through the annulus fibrosus adjacent the two treatment sites. The energy is preferably electrical energy the probes may be inserted surgically through respective elongate introducer tubes.

Abstract: A device for creating a surgical perforation with a functional distal tip for creating a controlled perforation. The functional tip may comprise at least one active electrode for creating the perforation through the application of Radio Frequency (RF) energy. The device is curved in order to decrease the likelihood of injury to structures of a patient such as inadvertent cardiac perforation when used in transseptal perforation procedures. The device is introduced into the right atrium, and the functional tip is then positioned against the atrial septum. Energy is applied to create the perforation. The tip is advanced toward the left atrium to create the perforation and as it advances into the left atrium, the device takes on its curved shape to direct the tip away from cardiac structures. The position of the tip of the device can be determined in response to pressure sensed at the tip and determined by a monitor.

Abstract: A method and apparatus are disclosed for improving accuracy of placement of needles during delivery of high frequency signals near a neural structure to form lesions. The apparatus includes a needle that can deliver electrical current where a portion of the needle is electrically insulated and a portion of the needle is exposed and electrically active, thereby causing lesions. The needle includes radiopaque marking to differentiate the electrically insulated region from the exposed region, allowing it to be better discerned in the body under fluoroscopy.

Abstract: A device with a functional tip containing at least one active electrode capable of creating a controlled perforation in body tissue through the application of Radio Frequency (RF) energy is described. The position of the tip of the device can be determined in response to pressure sensed at the tip and determined by a monitor. The device is useful to remove or perforate unwanted tissue in a controlled manner in any location in the body, particularly in the atrial septum for controlled transseptal puncture. In this application, the device is introduced into the right atrium, and the functional tip is then positioned against the atrial septum. Energy is applied to create the perforation and pressure is monitored to determine if the perforation was created in a desired location. Other possible applications include the removal of plaque or thrombotic occlusions from diseased vessels.

Abstract: A device with a functional tip containing at least one active electrode capable of creating a controlled perforation in body tissue through the application of Radio Frequency (RF) energy is described. The position of the tip of the device can be determined in response to pressure sensed at the tip and determined by a monitor. The device is useful to remove or perforate unwanted tissue in a controlled manner in any location in the body, particularly in the atrial septum for controlled transseptal puncture. In this application, the device is introduced into the right atrium, and the functional tip is then positioned against the atrial septum. Energy is applied to create the perforation and pressure is monitored to determine if the perforation was created in a desired location. Other possible applications include the removal of plaque or thrombotic occlusions from diseased vessels.

Abstract: A method and apparatus are disclosed for proximity detection and confirmation of treatment of a target nerve such as the facet nerve. The apparatus includes a probe that can deliver electrical current for stimulation of the facet nerve, and physiological sensors for transduction of multifidus muscle activity. A generator produces electrical current at physiological stimulation frequencies, and physiological sensor signals of muscle activity are displayed, analyzed and recorded with the use of a measuring device. A method using stimulation-induced multifidus activity to localize and confirm treatment of the facet nerve is disclosed.

Abstract: Apolipoprotein A-I (ApoA-I), preferably a variant form such as Apolipoprotein A-I Milano (ApoA-IM), alone or more preferably in combination with a lipid carrier such as phospholipids or other drug, can be administered locally before or during bypass surgery on diseased coronary, peripheral, and cerebral arteries, surgery to implant grafts or transplanted organs, or angioplasty, or to stabilize unstable plaques. In an alternative embodiment, the apolipoprotein is not provided directly, but the gene encoding the apolipoprotein is provided. The gene is introduced into the blood vessel in a manner similar to that used for the protein, where the protein is then expressed. The technique can also be used for delivery of genes for treatment or prevention or restenosis or other cardiovascular diseases.

Abstract: For creating a hole in body tissue and then enlarging the hole, a guidewire has a continuous diameter guidewire body having a proximal end and a distal end, a distal portion including an electrically conductive exposed tip for creating a perforation when RF current is applied and for preventing the creation of a perforation when RF current is not applied. For expanding the hole, a dilator region is provided between the distal end of the guidewire body and the distal portion for expanding the hole, and has a tapered profile. Also for expanding the hole, an inflatable balloon is located circumferentially on the guidewire body, and a catheter located on the guidewire body and in communication with the balloon for delivery of fluid to the balloon for its inflation.

Abstract: An intradiscal lesioning device for percutaneous treatment of a patient's intervertebral disc. An elongate introducer having a longitudinal hollow bore is surgically inserted from the patient's skin to extend through the annulus fibrosus thereby providing external surgical access to the nucleus pulposus through the introducer bore. An elongate probe slides through and flexibly conforms to the bore when longitudinally inserted through the bore of the introducer. The distal portion of the probe is capable of resiliently conforming to the bore in a longitudinally slidably confined configuration and resiliently rebounding to a deployed configuration when released within the nucleus pulposus. The distal portion houses lesioning devices for emitting energy toward the inner wall of the annulus fibrosus when the distal portion is in the deployed configuration.

Abstract: An intradiscal lesioning device for percutaneous treatment of a patient's intervertebral disc. An elongate introducer having a longitudinal hollow bore is surgically inserted from the patient's skin to extend through the annulus fibrosus thereby providing external surgical access to the nucleus pulposus through the introducer bore. An elongate probe slides through and flexibly conforms to the bore when longitudinally inserted through the bore of the introducer. The distal portion of the probe is capable of resiliently conforming to the bore in a longitudinally slidably confined configuration and resiliently rebounding to a deployed configuration when released within the nucleus pulposus. The distal portion houses lesioning devices for emitting energy toward the inner wall of the annulus fibrosus when the distal portion is in the deployed configuration.