Abstract: Described herein are devices, systems and methods for cutting tissue in a patient. In some embodiments, a tissue modification region of a device includes a pair of flexible elongate cutting members extending along the length of the tissue modification region. Each elongate cutting member may be configured to cut a discrete trough into tissue to a depth that is greater than the thickness of the cutting member. In some embodiments, the device includes a spacer. The spacer may be sized and configured to operate in one of two modes. A first mode, in which the spacer is coupled to the cutting members such that it holds a portion of each of the two cutting members a distance from one another, and a second mode, in which at least a portion of the spacer is moved away from a cutting member to allow the cutting members to cut further into tissue.

Abstract: Described herein are devices and methods for cutting tissue in a patient. In some embodiments, a bimanually controlled device may include a tissue modification region; at least two flexible elongate lengths of cable that extend substantially adjacent to each other proximally to distally; a plurality of rungs extending between the lengths of cable; and a pair of flexible elongate cutting members extending along the length of the tissue modification region of the device. Each elongate cutting member has a thickness cuts a discrete trough into tissue to a depth that is greater than the thickness of the cutting member. The device may further include a substrate sized and configured to releasably hold the cutting members a distance from one another and a pair of couplers positioned toward an outer edge region of the substrate and configured to releasably secure a cutting member to the outer edge region of the substrate.

Abstract: Described herein are pullwire handle devices for securing to a tissue-penetrating pullwire. In some embodiments, the device includes a handle body, a pullwire lock configured to removably lock the pullwire handle device onto a pullwire within the handle body, and a tip containment element configured to retain the distal tip of the pullwire. In some embodiments, the handle body further comprises a storage chamber configured to store a distal portion of the pullwire. Also described herein are methods for capturing a pullwire using a pullwire handle device. In some embodiments, the method includes the steps of inserting the distal end of a pullwire into the pullwire handle device, advancing the pullwire further into the pullwire handle device while the distal portion of the pullwire is contained within the pullwire handle device, and locking the distal portion of the pullwire within the pullwire handle device.

Abstract: An apparatus for treating tissue within a lumen may include a therapeutic or diagnostic instrument. A cleaning device may also be supported by the instrument. The cleaning device has a portion of a cleaning surface positioned proximal to the distal end of the cleaning device.

Abstract: In one embodiment, a device is provided including an expandable support member having a first portion and a second portion is provided. The first portion is adapted to have a smaller expansion index than the second portion. A therapeutic or diagnostic instrument is supported, at least in part, by the expandable support member first portion. In another embodiment, the support member is adapted for non-uniform expansion of the first and second portions. There are also described methods of forming therapeutic devices. There are also described methods of providing therapy to tissue in a body by positioning a device in proximity to tissue in a body selected to receive therapy. Next, the expandable support member second portion is expanded until the instrument is at a therapeutic position relative to the tissue in a body selected to receive therapy. Thereafter, therapy or diagnosis is provided to the selected tissue using the device.

Abstract: A medical device for delivering RF energy to a target tissue region includes an elongate delivery cannula having a lumen in communication with a distal opening. A deployment member is positioned and longitudinally movable in the lumen. An array of electrode elements are secured to a distal end of the deployment member, the deployment member being movable from a delivery position, in which the electrode elements are positioned within the lumen, to a deployed position, in which the electrode elements extend distally out of the cannula distal opening. A sealing member formed from a bio-compatible material sufficiently rigid to penetrate solid body tissue partially extends from, and substantially seals, the distal cannula opening when the deployment member is in the delivery position.

Abstract: Described herein are bimanually controlled neural localization devices capable of determining if a nerve is nearby a region of the device. In general, the device may include at least two electrodes including an anode in electrical communication with a anodal conductor and a cathode in electrical communication with a cathodal conductor. The device may further include a flexible elongate body, wherein the flexible elongate body has an axial length, a width and a thickness, wherein the axial length is greater than the width, and the width is greater than the thickness and is greater than a width of the at least two electrodes. The at least two electrodes may be disposed substantially in-line and centered along the length of the elongate body. In some embodiments, the device may further include a guidewire coupler at the distal end region of the elongate body.

Abstract: An apparatus for delivering electrical energy includes a tubular member having a pair of opposing members extendable from the distal end of the tubular member, the opposing members being directable towards one another for engaging tissue between inner surfaces of the opposing members, the opposing members having one or more electrodes for delivering electrical energy to tissue engaged between the opposing members. One or more hollow needles extend from an inner surface of at least one opposing member, the hollow needles configured to deliver conductive fluid from a lumen into tissue penetrated by the needles.

Abstract: A catheter section comprising an elongate tubular member having a proximal end, a distal end, and a passageway defining a lumen extending between the proximal and distal ends. The elongate tubular member includes a knit tubular member and an inner tubular liner in coaxial relationship with the knit tubular member. The catheter section is for use as a distal section in a catheter having a relatively stiff proximal section.

Abstract: Described herein are devices and methods for cutting tissue in a patient. In some embodiments, a bimanually controlled device may include a tissue modification region; at least two flexible elongate lengths of cable that extend substantially adjacent to each other proximally to distally; a plurality of rungs extending between the lengths of cable; and a pair of flexible elongate cutting members extending along the length of the tissue modification region of the device. Each elongate cutting member has a thickness cuts a discrete trough into tissue to a depth that is greater than the thickness of the cutting member. The device may further include a substrate sized and configured to releasably hold the cutting members a distance from one another and a pair of couplers positioned toward an outer edge region of the substrate and configured to releasably secure a cutting member to the outer edge region of the substrate.

Abstract: An invasive medical device for delivery radio frequency energy to a target tissue region includes an elongate delivery cannula having a lumen in communication with a distal opening. A deployment member is positioned and longitudinally movable in the lumen. An array of electrode elements are secured to a distal end of the deployment member, the deployment member being movable from a delivery position, in which the electrode elements are positioned within the lumen, to a deployed position, in which the electrode elements extend distally out of the cannula distal opening. A sealing member formed from a biocompatible material sufficiently rigid to penetrate solid body tissue partially extends from, and substantially seals, the distal cannula opening when the deployment member is in the delivery position. By way of examples, the sealing member may be carried on a distal end of the deployment member, or on a separately movable deployment member, or frictionally fit in the cannula distal opening.

Abstract: Methods of ablating tissue in an alimentary tract are provided. The methods include advancing an ablation structure into an alimentary tract while supporting the ablation structure with an endoscope. The methods further include a step of moving at least part of the ablation structure with respect to the endoscope and toward a tissue surface, before activating the ablation structure to ablate a tissue surface.

Abstract: Methods of ablating tissue in an alimentary tract are provided. The methods include advancing an ablation structure into an alimentary tract while supporting the ablation structure with an endoscope. The methods further include a step of moving at least part of the ablation structure with respect to the endoscope and toward a tissue surface, before activating the ablation structure to ablate a tissue surface.

Abstract: Ablation probes are provided for perfusing the tissue, while the tissue is ablated. The ablation probe comprises an elongated shaft and an ablative element, such as a needle electrode. The ablation probe further comprises a lumen that extends through the probe shaft, which will be used to deliver an fluid to the distal end of the probe shaft for perfusion into the surrounding tissue. The ablation probe further comprises a porous structure that is associated with the distal end of the shaft in fluid communication with the lumen. For example, the distal end of the shaft, or the entirety of the shaft, can be composed of the porous structure. Or, if the ablative element is an electrode, the electrode can be composed of the porous structure. Because the pores within the porous structure are pervasive, the fluid will freely flow out into the tissue notwithstanding that some of the pores may become clogged.

Abstract: Apparatus for treating abnormal mucosa in an alimentary tract are provided. The apparatus include an ablation structure configured to be removably coupled to an endoscope and a deflection mechanism adapted to move the ablation structure with respect to the endoscope and toward a tissue surface.

Abstract: Described herein are elongate devices for modifying tissue having a plurality of flexibly connected and rungs or links, and methods of using them, including methods of using them to decompress stenotic spinal tissue. These devices may be included as part of a system for modifying tissue. In general, these devices include a plurality of blades positioned on for formed from) rungs that are flexibly connected and may be separated by one or more spacers. The rungs are typically wider than they are long (e.g., rectangular). The rungs may be arranged, ladder like, and may be connected by a flexible connector substrate or between two or more cables. Different sized rungs may be used, or rungs with different cutting properties. In some variations the tissue modification devices may have a non-linear axial shape, or may be converted from a first axial shape to a second axial shape.

Abstract: Described herein are devices, systems and methods for treating target tissue in a patient's spine. In general, the methods include the steps of advancing a wire into the patient from a first location, through a neural foramen, and out of the patient from a second location; connecting a tissue modification device to the wire; positioning the tissue modification device through the neural foramen using the wire; modifying target tissue in the spine by moving the tissue modification device against the target tissue; and delivering an agent to modified target tissue, wherein the agent is configured to inhibit blood flow from the modified target tissue. In some embodiments, the step of modifying target tissue comprises removing target tissue located ventral to the superior articular process while avoiding non-target tissue located lateral to the superior articular process.

Abstract: A catheter section comprising an elongate tubular member having a proximal end, a distal end, and a passageway defining a lumen extending between the proximal and distal ends. The elongate tubular member includes a knit tubular member and an inner tubular liner in coaxial relationship with the knit tubular member. The catheter section is for use as a distal section in a catheter having a relatively stiff proximal section.

Abstract: Described herein are pullwire handle devices for securing to a tissue-penetrating pullwire. In some embodiments, the device includes a handle body, a pullwire lock configured to removably lock the pullwire handle device onto a pullwire within the handle body, and a tip containment element configured to retain the distal tip of the pullwire. In some embodiments, the handle body further comprises a storage chamber configured to store a distal portion of the pullwire. Also described herein are methods for capturing a pullwire using a pullwire handle device. In some embodiments, the method includes the steps of inserting the distal end of a pullwire into the pullwire handle device, advancing the pullwire further into the pullwire handle device while the distal portion of the pullwire is contained within the pullwire handle device, and locking the distal portion of the pullwire within the pullwire handle device.

Abstract: Described herein are devices, systems and methods for cutting tissue in a patient. In some embodiments, a tissue modification region of a device includes a pair of flexible elongate cutting members extending along the length of the tissue modification region. Each elongate cutting member may be configured to cut a discrete trough into tissue to a depth that is greater than the thickness of the cutting member. In some embodiments, the device includes a spacer. The spacer may be sized and configured to operate in one of two modes. A first mode, in which the spacer is coupled to the cutting members such that it holds a portion of each of the two cutting members a distance from one another, and a second mode, in which at least a portion of the spacer is moved away from a cutting member to allow the cutting members to cut further into tissue.