Abstract: An electrosurgical wand for treating tissue at a target site within or on a patient's body is described, having an elongate shaft with a handle and a distal end portion. The distal end portion has an active electrode, an insulative spacer body and a return electrode; the active electrode supported by the insulative spacer body and spaced away from the return electrode. The active electrode has both lateral and medial edge surfaces. The insulative spacer body has an aspiration cavity fluidly connected with an aspiration lumen, and at least one tapered aperture extending beyond at least one of the electrode medial edge surfaces and directed to the aspiration cavity.

Abstract: Described here are devices, systems, and methods for forming a fistula between two blood vessels. The systems may comprise a first catheter including a housing and an electrode having a proximal end and a distal end. The proximal end is fixed relative to the housing and the distal end is longitudinally slidable within the housing.

Abstract: Described here are devices, systems, and methods for forming a fistula between two blood vessels. The systems may comprise a first catheter including a housing and an electrode having a proximal end and a distal end. The proximal end is fixed relative to the housing and the distal end is longitudinally slidable within the housing.

Abstract: Systems and methods for positioning a wire for advancement through a vessel wall, and advancing it through one or more vessel walls, generally include a delivery catheter and an alignment catheter or a receiving catheter, and a guidewire. In some variations, the systems and methods may be used to bypass an occlusion or other barrier that may prevent advancement of a wire or tools through an endoluminal space. In these variations, the systems and methods include a delivery catheter, a bypass catheter, a receiving catheter, and a guidewire. The delivery and receiving catheters each generally include a side aperture, a deflection surface, and an alignment element, and the bypass catheter generally includes two side apertures, two deflectors, and two alignment elements. In some variations, the systems and methods may assist in treatment of a patient suffering from critical limb ischemia.

Abstract: Described here are methods of treating a patient having hypertension comprising advancing a catheter into a deep ulnar vein or an artery, wherein the catheter comprises an electrode. The methods further comprise forming a fistula between the deep ulnar vein and the artery with the electrode to reduce a blood pressure of the patient.

Abstract: Described here are devices and methods for treating hypertension by forming a fistula between two blood vessels to reduce blood pressure of a patient. The fistula may be formed using a catheter having an electrode that is placed in a first blood vessel. In some instances, a desired amount of blood pressure is determined. In other instances, the hypertension is drug resistant hypertension.

Abstract: Described here are devices, systems, and methods for forming a fistula between two blood vessels. The systems may comprise a first catheter including a housing and an electrode having a proximal end and a distal end. The proximal end is fixed relative to the housing and the distal end is longitudinally slidable within the housing.

Abstract: Described here are devices, systems, and methods for forming a fistula between two blood vessels. The systems may comprise a first catheter including a housing and an electrode having a proximal end and a distal end. The proximal end is fixed relative to the housing and the distal end is longitudinally slidable within the housing.

Abstract: A method comprising sealing a vessel residing within tissue between jaws of forceps by sensing an amount of tissue held within the forceps, the sensing by passing electrical current through the tissue by way of the forceps. The method comprises heating the tissue using electrical current, the heating such that impedance of the tissue changes at a first predetermined rate, the first predetermined rate selected based on the sensing. The method comprises desiccating the tissue using electrical current, such that the impedance of the tissue changes at a second predetermined rate different than the first predetermined rate. The method comprises ceasing application of the electrical current to the tissue when impedance of the tissue reaches a predetermined value. Sensing the amount of tissue held within the forceps comprises varying electrical current flowing through the tissue through the forceps such that impedance of the tissue changes at a third predetermined rate.

Abstract: Described here are devices, systems, and methods for improving blood flow in a vessel. Generally, the method may comprise advancing a catheter into a first vessel proximal to an occlusion in the first vessel and forming a fistula between the first vessel and a second vessel. This may deliver blood flow around an occlusion to ischemic tissues located in the peripheral vasculature.

Abstract: Electrosurgical wands. At least some of the illustrative embodiments are electrosurgical wands having features that reduce contact of tissue with an active electrode of a wand, decrease the likelihood of clogging, and/or increase the visibility within surgical field. For example, wands in accordance with at least some embodiments may comprise standoffs, either along the outer perimeter of the active electrode, or through the main aperture in the active electrode, to reduce tissue contact. Wands in accordance with at least some embodiments may implement slots on the active electrodes to increase bubble aspiration to help keep the visual field at the surgical site clear. Wands in accordance with at least some embodiments may implement aspiration flow pathways within the wand that increase in cross-sectional area to reduce the likelihood of clogging.

Abstract: A method comprising sealing a vessel residing within tissue between jaws of forceps by sensing an amount of tissue held within the forceps, the sensing by passing electrical current through the tissue by way of the forceps. The method comprises heating the tissue using electrical current, the heating such that impedance of the tissue changes at a first predetermined rate, the first predetermined rate selected based on the sensing. The method comprises desiccating the tissue using electrical current, such that the impedance of the tissue changes at a second predetermined rate different than the first predetermined rate. The method comprises ceasing application of the electrical current to the tissue when impedance of the tissue reaches a predetermined value. Sensing the amount of tissue held within the forceps comprises varying electrical current flowing through the tissue through the forceps such that impedance of the tissue changes at a third predetermined rate.

Abstract: Described here are devices, systems, and methods for improving blood flow in a vessel. Generally, the method may comprise advancing a catheter into a first vessel proximal to an occlusion in the first vessel and forming a fistula between the first vessel and a second vessel. This may deliver blood flow around an occlusion to ischemic tissues located in the peripheral vasculature.

Abstract: Described here are devices and methods for treating hypertension by forming a fistula between two blood vessels to reduce blood pressure of a patient. The fistula may be formed using a catheter having an electrode that is placed in a first blood vessel. In some instances, a desired amount of blood pressure is determined. In other instances, the hypertension is drug resistant hypertension.

Abstract: An electrosurgical wand for treating tissue at a target site within or on a patient's body is described, having an elongate shaft with a handle and a distal end portion. The distal end portion has an active electrode, an insulative spacer body and a return electrode; the active electrode supported by the insulative spacer body and spaced away from the return electrode. The active electrode has both lateral and medial edge surfaces. The insulative spacer body has an aspiration cavity fluidly connected with an aspiration lumen, and at least one tapered aperture extending beyond at least one of the electrode medial edge surfaces and directed to the aspiration cavity.

Abstract: Described here are devices and methods for treating hypertension by forming a fistula between two blood vessels to reduce blood pressure of a patient. The fistula may be formed using a catheter having an electrode that is placed in a first blood vessel. In some instances, a desired amount of blood pressure is determined. In other instances, the hypertension is drug resistant hypertension.

Abstract: An electrosurgical wand for treating tissue at a target site within or on a patient's body is described, having an elongate shaft with a handle and a distal end portion. The distal end portion has an active electrode, an insulative spacer body and a return electrode; the active electrode supported by the insulative spacer body and spaced away from the return electrode. The active electrode has both lateral and medial edge surfaces. The insulative spacer body has an aspiration cavity fluidly connected with an aspiration lumen, and at least one tapered aperture extending beyond at least one of the electrode medial edge surfaces and directed to the aspiration cavity.

Abstract: Electrosurgical systems and methods include a generator which is operable to connect to an electrosurgical device and to identify the electrosurgical device. The generator automatically determines at least one device specific operational parameter for carrying out the electrosurgical procedure. In an exemplary embodiment, a generator includes a fluid pump and the generator automatically determines a candidate flowrate at which to operate the pump based on the type of device. The device specific operational parameter may be selected or modified by the operator prior to commencing the procedure.

Abstract: Electrosurgical systems and methods include a generator which is operable to connect to an electrosurgical device and to identify the electrosurgical device. The generator automatically determines at least one device specific operational parameter for carrying out the electrosurgical procedure. In an exemplary embodiment, a generator includes a fluid pump and the generator automatically determines a candidate flowrate at which to operate the pump based on the type of device. The device specific operational parameter may be selected or modified by the operator prior to commencing the procedure.

Abstract: Electrosurgical system with selective control of active and return electrodes. At least some of the illustrative embodiments are systems comprising an electrosurgical wand and an electrosurgical controller. The wand comprises a non-conductive outer surface, at least three electrodes disposed on a distal end of the wand, and at least three electrical leads extending from a proximal end of the wand (one electrical lead electrically coupled to each electrode). The controller comprises a voltage generator and a control circuit coupled between the voltage generator and the electrodes of the wand. The control circuit is configured to: selectively electrically couple the active terminal singly and in combination to the electrodes of the wand; and selectively electrically couple the return terminal singly and in combination to electrodes of the wand.