Abstract: An endovascular near critical fluid based cryoablation catheter for creating an elongated lengthwise-continuous lesion in tissue can comprise an elongated shaft, a flexible distal tissue treatment section, and a distal tip. A plurality of flexible tubes can extend through the distal treatment section to transport a near critical fluid to and from the distal tip. The distal treatment section can also include a flexible fluid-sealed cover or barrier layer surrounding the delivery tubes. The cover and tubes can collectively define a space which is filled with a fluidic thermally conductive media. The thermally conductive media, fluid delivery tubes, and the cover can be arranged such that a flow of the near critical fluid through the tube bundle transfers heat between a target tissue and the distal treatment section of the catheter thereby creating the elongated lengthwise-continuous lesion in the tissue.

Abstract: An endovascular near critical fluid based cryoablation catheter for creating an elongated lengthwise-continuous lesion in tissue can comprise an elongated shaft, a flexible distal tissue treatment section, and a distal tip. A plurality of flexible tubes can extend through the distal treatment section to transport a near critical fluid to and from the distal tip. The distal treatment section can also include a flexible fluid-sealed cover or barrier layer surrounding the delivery tubes. The cover and tubes can collectively define a space which is filled with a fluidic thermally conductive media. The thermally conductive media, fluid delivery tubes, and the cover can be arranged such that a flow of the near critical fluid through the tube bundle transfers heat between a target tissue and the distal treatment section of the catheter thereby creating the elongated lengthwise-continuous lesion in the tissue.

Abstract: An ablation apparatus for creating a lesion in target tissue, the ablation apparatus including a handle, an elongate shaft extending from the handle to a distal tip, where the shaft includes a first portion, an ablation portion distal to the first portion and having an outer sheath, and at least one ablation energy element disposed within the outer sheath, where a space is formed between the at least one ablation energy element and the outer sheath. The ablation apparatus further includes a thermally conductive liner disposed within the space.

Abstract: An ablation apparatus for creating a lesion in target tissue, the ablation apparatus including a handle, an elongate shaft extending from the handle to a distal tip, where the shaft includes a first portion, an ablation portion distal to the first portion and having an outer sheath, and at least one ablation energy element disposed within the outer sheath, where a space is formed between the at least one ablation energy element and the outer sheath. The ablation apparatus further includes a thermally conductive liner disposed within the space.

Abstract: An endovascular near critical fluid based cryoablation catheter for creating an elongated lengthwise-continuous lesion in tissue can comprise an elongated shaft, a flexible distal tissue treatment section, and a distal tip. A plurality of flexible tubes can extend through the distal treatment section to transport a near critical fluid to and from the distal tip. The distal treatment section can also include a flexible fluid-sealed cover or barrier layer surrounding the delivery tubes. The cover and tubes can collectively define a space which is filled with a fluidic thermally conductive media. The thermally conductive media, fluid delivery tubes, and the cover can be arranged such that a flow of the near critical fluid through the tube bundle transfers heat between a target tissue and the distal treatment section of the catheter thereby creating the elongated lengthwise-continuous lesion in the tissue.

Abstract: An ablation apparatus for creating a lesion in target tissue has a handle, an elongate shaft extending from the handle and a distal ablation portion. The distal ablation portion includes a cryogen flow manifold defining a plurality of fluid pathways between an insert body and a sleeve. Cryogen is circulated through the plurality of fluid pathways to create the lesion in the target tissue.

Abstract: An endovascular near critical fluid based cryoablation catheter for creating an elongated lengthwise-continuous lesion in tissue can comprise an elongated shaft, a flexible distal tissue treatment section, and a distal tip. A plurality of flexible tubes can extend through the distal treatment section to transport a near critical fluid to and from the distal tip. The distal treatment section can also include a flexible fluid-sealed cover or barrier layer surrounding the delivery tubes. The cover and tubes can collectively define a space which is filled with a fluidic thermally conductive media. The thermally conductive media, fluid delivery tubes, and the cover can be arranged such that a flow of the near critical fluid through the tube bundle transfers heat between a target tissue and the distal treatment section of the catheter thereby creating the elongated lengthwise-continuous lesion in the tissue.

Abstract: An endoesophageal balloon and catheter for operation with a transesophageal echocardiography (TEE) probe includes an inflatable balloon body disposed over the ultrasound element of the TEE probe, a liquid inflow lumen in fluid communication with the balloon, and a liquid outflow lumen in fluid communication with the balloon. The balloon is inflated with an acoustically transmitting liquid.

Abstract: An ablation apparatus for creating a lesion in target tissue, the ablation apparatus including a handle, an elongate shaft extending from the handle to a distal tip, where the shaft includes a first portion, an ablation portion distal to the first portion and having an outer sheath, and at least one ablation energy element disposed within the outer sheath, where a space is formed between the at least one ablation energy element and the outer sheath. The ablation apparatus further includes a thermally conductive liner disposed within the space.

Abstract: A method of creating a lesion in cardiac tissue where the method includes deploying a distal treatment section of an ablation catheter into a heart chamber and manipulating the distal treatment section against the cardiac tissue and into a curved shape that encloses a plurality of vessel entries in the heart chamber. The method further includes commencing a first application of ablation energy from the distal treatment section to the cardiac tissue and halting the first application of ablation energy to the cardiac tissue. The first application of ablation energy causes formation of a first continuous lesion in the cardiac tissue that encloses the plurality of vessel entries.

Abstract: An endovascular near critical fluid based cryoablation catheter for creating an elongated lengthwise-continuous lesion in tissue can comprise an elongated shaft, a flexible distal tissue treatment section, and a distal tip. A plurality of flexible tubes can extend through the distal treatment section to transport a near critical fluid to and from the distal tip. The distal treatment section can also include a flexible fluid-sealed cover or barrier layer surrounding the delivery tubes. The cover and tubes can collectively define a space which is filled with a fluidic thermally conductive media. The thermally conductive media, fluid delivery tubes, and the cover can be arranged such that a flow of the near critical fluid through the tube bundle transfers heat between a target tissue and the distal treatment section of the catheter thereby creating the elongated lengthwise-continuous lesion in the tissue.

Abstract: An endovascular near critical fluid based cryoablation catheter for creating an elongated lengthwise-continuous lesion in tissue can comprise an elongated shaft, a flexible distal tissue treatment section, and a distal tip. A plurality of flexible tubes can extend through the distal treatment section to transport a near critical fluid to and from the distal tip. The distal treatment section can also include a flexible fluid-sealed cover or barrier layer surrounding the delivery tubes. The cover and tubes can collectively define a space which is filled with a fluidic thermally conductive media. The thermally conductive media, fluid delivery tubes, and the cover can be arranged such that a flow of the near critical fluid through the tube bundle transfers heat between a target tissue and the distal treatment section of the catheter thereby creating the elongated lengthwise-continuous lesion in the tissue.

Abstract: A method of creating a lesion in cardiac tissue where the method includes deploying a distal treatment section of an ablation catheter into a heart chamber and manipulating the distal treatment section against the cardiac tissue and into a curved shape that encloses a plurality of vessel entries in the heart chamber. The method further includes commencing a first application of ablation energy from the distal treatment section to the cardiac tissue and halting the first application of ablation energy to the cardiac tissue. The first application of ablation energy causes formation of a first continuous lesion in the cardiac tissue that encloses the plurality of vessel entries.

Abstract: An endovascular near critical fluid based cryoablation catheter for creating an elongated lengthwise-continuous lesion in tissue comprises an elongated shaft, a flexible distal tissue treatment section, and a distal tip. A plurality of flexible tubes extend through the distal treatment section to transport a near critical fluid to and from the distal tip. The distal treatment section is controllably articulated to match the contour of an anatomical region to be treated. In embodiments the distal treatment section includes a superelastic material and assumes a pre-set shape when released from an outer sleeve member. When the catheter is activated, heat is transferred between a target tissue and the distal treatment section of the catheter thereby creating the elongated lengthwise-continuous lesion in the tissue.

Abstract: An endoesophageal balloon and catheter for operation with a transesophageal echocardiography (TEE) probe includes an inflatable balloon body disposed over the ultrasound element of the TEE probe, a liquid inflow lumen in fluid communication with the balloon, and a liquid outflow lumen in fluid communication with the balloon. The balloon is inflated with an acoustically transmitting liquid.

Abstract: An endovascular near critical fluid based cryoablation catheter for creating an elongated lengthwise-continuous lesion in tissue can comprise an elongated shaft, a flexible distal tissue treatment section, and a distal tip. A plurality of flexible tubes can extend through the distal treatment section to transport a near critical fluid to and from the distal tip. The distal treatment section can also include a flexible fluid-sealed cover or barrier layer surrounding the delivery tubes. The cover and tubes can collectively define a space which is filled with a fluidic thermally conductive media. The thermally conductive media, fluid delivery tubes, and the cover can be arranged such that a flow of the near critical fluid through the tube bundle transfers heat between a target tissue and the distal treatment section of the catheter thereby creating the elongated lengthwise-continuous lesion in the tissue.

Abstract: A high-intensity pulsed electric field (HIPEF) vitrectomy apparatus is disclosed. An exemplary apparatus includes a HIPEF probe comprising at least one electrode disposed at a distal end of the HIPEF probe, such that the distal end is configured for insertion into an eye. Various embodiments include a probe shaft assembled from a modular end segment and one or more additional modular shaft segments, each of the modular end segment and one or more modular shaft segments in turn comprising at least two longitudinal channels adapted to accommodate an electrode unit. In some of these probe shafts, each of the modular end segment and one or more modular shaft segments has a central longitudinal channel, and the probe shaft further comprises an aspiration tube disposed within the central longitudinal channel.

Abstract: A high-intensity pulsed-electrical-field (HIPEF) apparatus removes ocular tissue from a localized portion of an eye by delivering one or more focused shockwaves to that tissue. In one embodiment, for example, the apparatus generates one or more electrical pulses, delivers the one or more focused shockwaves to ocular tissue by applying the generated electrical pulses to a HIPEF probe, and then removes the ocular tissue disrupted by the one or more focused shockwaves via aspiration. To mitigate risk of damage to adjacent ocular tissue, the apparatus delivers the one or more focused shockwaves with energy substantially limited to the tissue being removed. The HIPEF apparatus is, therefore, especially advantageous in the context of cataract surgery where cataract tissue need be broken apart and removed without damaging adjacent tissue associated with the lens capsule required to implant an intraocular lens.

Abstract: A high-intensity pulsed-electrical-field (HIPEF) apparatus treats ocular tissue within a localized portion of an eye with a pharmacological solution. To mitigate risk of damage to adjacent, healthy ocular tissue, the apparatus delivers the solution to only a portion of the eye and then alters the effectiveness of at least some of the solution delivered by applying a HIPEF. In some embodiments, for example, the apparatus delivers an inactive pharmacological solution and then activates at least some of the solution by applying a HIPEF to that solution. As the apparatus applies the HIPEF with high precision, the HIPEF only activates solution within select portions of the eye. In other embodiments, the apparatus delivers a pharmacological carrier encapsulating an active pharmacological solution and then penetrates the carrier by applying a HIPEF. Delivered with a high concentration, but low dose, the solution diffuses only to tissue within a localized portion of the eye.

Abstract: A high-intensity pulsed-electrical-field (HIPEF) apparatus chemically induces lysis of ocular tissue within a localized portion of an eye. Instead of broadly applying a lysis affecting solution (e.g., plasmin) to the eye, the apparatus delivers solution to only a portion of the eye. The apparatus then alters the effectiveness of at least some of the solution delivered by applying a HIPEF to that solution. In some embodiments, for example, the apparatus delivers a solution that does not substantially affect lysis of ocular tissue and then enhances the solution's effectiveness by applying a HIPEF. As the apparatus applies the HIPEF with high precision, the HIPEF only enhances the effectiveness of the solution within select and localized portions of the eye. The apparatus is especially advantageous for vitreoretinal surgery, whereby the apparatus may selectively induce lysis of vitreous tissue within a localized portion of the vitreous cavity, without significantly affecting adjacent retinal tissue.