Abstract: Embodiments herein relate to devices for delivering fluid-based therapies into a target vessel of a patient. In an embodiment, an apparatus is included having a microcatheter. The microcatheter can include a catheter shaft having a lumen therein. The microcatheter can have an open end that is at a distal end of the catheter shaft. The microcatheter can have a plurality of side apertures disposed within a side wall of the catheter shaft. The plurality of side apertures allow for a fluid to pass from the lumen to the outside of the catheter shaft. The apparatus further includes a seal element configured to pass through the lumen of the microcatheter. The seal element can include a shaft and an occlusion member configured to at least partially occlude the open end of the microcatheter directing fluid flow through the plurality of side apertures. Other embodiments are also included herein.

Abstract: Electrosurgical generators having improved functionality and a user interface. In an example, the user may modify therapy output parameters without interrupting therapy delivery within a therapy regimen by accessing a change tool on the user interface, with the change tool operable to change a stack selector configuration. In an example, the display shows both therapy amplitudes and encountered impedances for a plurality of therapy pulses in different portions of a display.

Abstract: A pulse field ablation system may include a first elongate shaft, a second elongate shaft, one or more electrodes, a wave generator, and a treatment control module. The first elongate shaft may include one or more lumens with a first lumen configured to pass a fluid to treat a thrombus in a vessel of a subject. The second elongate shaft may be configured to extend in a distal direction beyond a distal end of the first shaft. The one or more electrodes may be disposed at a distal portion of the second elongate shaft. The wave generator may be configured to be in electrical communication with the one or more electrodes. The treatment control module may selectively cause the wave generator to deliver energy to an electrode of the one or more electrodes, where the energy may be configured to lyse red blood cells of the thrombus.

Abstract: Methods and devices for performing ablation. In some examples an ablation delivery system is configured to allow separate voltage levels of a capacitor stack to be accessed for use in therapy delivery. Ablation therapy systems switchable between current and voltage controlled output are described. Methods of treating a patient using adjustable interphase or interpulse delay are disclosed as well.

Abstract: Methods and devices for performing ablation using spatially multiplexed waveforms are disclosed. The increased efficacy of monophasic waveforms is combined with the reduced side effects of biphasic waveforms by distributing components of the waveform across multiple electrodes. Charge balancing occurs upon completion of therapy delivery within a time period that avoids muscle stimulation, while allowing unbalanced waveforms to be delivered during stimulation.

Abstract: Methods and devices for performing ablation. In some examples an ablation delivery system is configured to allow separate voltage levels of a capacitor stack to be accessed for use in therapy delivery. Ablation therapy systems switchable between current and voltage controlled output are described. Methods of treating a patient using adjustable interphase or interpulse delay are disclosed as well.

Abstract: Disclosed herein are devices, systems, and methods for monitoring a formation of an iceball at a cryoablation needle. An example method includes receiving an impedance from at least one electrode in an electrode arrangement that is disposed at a cryoablation needle distal portion. The electrode arrangement is configured to engage the iceball as the iceball is formed over the cryoablation needle distal portion so as to cause a change in the impedance. The example method includes determining one or more physical attributes of the iceball based on a rate of the change in the impedance.

Abstract: A system includes a device, a radioactive deliverable and a pressure source. The device includes a shaft and a needle received therein. The needle extends longitudinally from a proximal end to a distal end and is slidably received within a channel of the shaft. The needle is movable between an insertion configuration, in which a tip at the distal end thereof is housed within the channel of the shaft, and a piercing configuration, in which the needle is moved distally relative to the shaft so that the tip extends distally from the channel of the shaft to pierce a target tumor. The deliverable is inserted into a channel of the needle. The source is coupled to the proximal end of the needle to apply a pressure through the channel of the needle that is sufficient to inject the deliverable through the channel and into the tumor.

Abstract: Disclosed herein are devices, systems, and methods for monitoring a formation of an iceball at a cryoablation needle. An example method includes receiving an impedance from at least one electrode in an electrode arrangement that is disposed at a cryoablation needle distal portion. The electrode arrangement is configured to engage the iceball as the iceball is formed over the cryoablation needle distal portion so as to cause a change in the impedance. The example method includes determining one or more physical attributes of the iceball based on a rate of the change in the impedance.

Abstract: An example medical device is disclosed. The medical device includes a catheter shaft including a distal end portion, wherein the distal end portion includes an ablation assembly. The ablation assembly includes an expandable frame including a base, an end region and a plurality of struts extending between the base and the end region, the struts defining a plurality of apertures along the frame. The ablation assembly also includes an electrical circuit coupled to an inner surface of the second end region of the frame, the electrical circuit including a plurality of ablation electrodes coupled thereto. Further, the expandable frame is designed to shift from a delivery configuration in which the ablation electrodes face inward from the inner surface of the expandable frame to an expanded configuration in which the ablation electrodes face away from the base of the expandable frame.

Abstract: An example medical device is disclosed. The medical device includes a catheter shaft including a distal end portion, wherein the distal end portion includes an ablation assembly. The ablation assembly includes an expandable frame including a base, an end region and a plurality of struts extending between the base and the end region, the struts defining a plurality of apertures along the frame. The ablation assembly also includes an electrical circuit coupled to an inner surface of the second end region of the frame, the electrical circuit including a plurality of ablation electrodes coupled thereto. Further, the expandable frame is designed to shift from a delivery configuration in which the ablation electrodes face inward from the inner surface of the expandable frame to an expanded configuration in which the ablation electrodes face away from the base of the expandable frame.

Abstract: In an embodiment, a cryoablation system includes a pre-cooler gas circuit, a working gas circuit isolated from the pre-cooler gas circuit, and a vacuum chamber isolated from the pre-cooler gas circuit and the working gas circuit. The cryoablation system can include a shaft having an insulated zone and a working gas expansion chamber distal to the insulated zone. The cryoablation system can further include a handle and a shaft-handle connector, wherein a proximal end of the shaft connects to the shaft-handle connector, wherein the shaft-handle connector is configured to removably attach the proximal end of the shaft to a distal end of the handle.

Abstract: A multi-electrode energy-delivering assembly configured to be delivered in a generally elongate delivery configuration. The multi-electrode energy-delivering assembly includes one or more spaced apart electrodes of a first polarity. The electrodes may be spaced apart axially and/or may be expanded apart from one another upon deployment. In some aspects, the electrodes may be electrically activated independently of one another.

Abstract: Bipolar or monopolar adjustable energy-delivering assemblies. The assemblies are configured for transluminal (e.g., endoscopic) delivery within a patient. A first energy-delivering member defines a first electrode portion formed of an electrically-conductive material so that energy may be delivered to the first energy-delivering member to create an energy field along the first electrode portion to apply to a target site within a patient. The first energy-delivering member may define a lumen therethrough allowing delivery of materials distally therethrough to a target site and/or allows materials from the target site to be aspirated proximally therethrough. Optionally, a second energy-delivering member and a second insulation member form a second electrode portion. Optionally, either or both electrode portions may be adjustable. Additionally or alternatively, the first electrode portion and the second electrode portion are adjustable with respect to each other.

Abstract: In an embodiment, a method for detecting leaks in a shaft of a cryoablation system includes placing a vacuum pump in fluid communication with a return tube and a supply tube; pulling a vacuum within the supply tube and the return tube; after pulling the vacuum for a predetermined amount of time, measuring a vacuum pressure within the supply tube and the return tube; and analysis of the vacuum pressure to assist with identifying leaks in the system.

Abstract: In an embodiment, a cryoablation shaft is included having a working fluid circuit; a vacuum circuit; an insulated portion, wherein the vacuum circuit runs through the insulated portion; and an expansion chamber; a supply tube having a distal outlet in the expansion chamber, wherein fluid from the working fluid circuit travels distally down the cryoablation shaft through supply tube and expands in the expansion chamber; and a guidewire lumen including a metallic tube and a polymer sleeve configured to surround at least a portion of the metallic tube.

Abstract: Embodiments herein relate to a cryoablation probe including a pre-cooler fluid circuit; a working fluid circuit; a vacuum circuit; and a shaft. The shaft includes a supply tube and a return tube surrounding the supply tube. The return tube includes a first polymer layer, wherein the first polymer layer is configured to contain fluid from the working fluid circuit; a reinforcement layer, and a second polymer layer. Other embodiments are also included herein.

Abstract: An energy-delivering assembly probes formed from an elongated energy-delivering member have one or more electrodes defined along an energy-delivering region of the energy-delivering member. An electrode-defining insulation member is provided over the energy-delivering member to define and space apart at least a first electrode from a second electrode. One or more of the electrodes and/or insulation members are configured and/or have characteristics or properties which reduce/minimize/eliminate arcing between/across electrodes of the energy-delivering assembly.

Abstract: Methods and devices for performing ablation using time multiplexed waveforms are disclosed. The increased efficacy of monophasic waveforms is combined with the reduced side effects of biphasic waveforms by distributing components of the waveform across over a broader time interval than that typically used in a conventional biphasic waveform. Charge balancing occurs upon completion of therapy delivery within a time period that avoids muscle stimulation, while allowing unbalanced waveforms to be delivered during stimulation.

Abstract: A system for ablation is described herein including an inner electrode assembly with an inner elongate shaft and a distal electrode, an outer electrode assembly having an outer elongate shaft and a proximal electrode, wherein the outer electrode assembly defines a central passage configured to slidably receive the inner electrode assembly, wherein the distal electrode or the proximal electrode is axially moveable with respect to the other, and an energy source configured to be electrically connected to the distal electrode and the proximal electrode and configured to deliver a pulsed electric field (PEF). One of the distal electrode and proximal electrode is part of a first expandable electrode array comprising two or more electrode elements moveable between an unexpanded position and an expanded position.