Abstract: A microwave ablation probe including a probe body including a shielded portion and a radiation window that is at least partially transparent to microwave energy. The shielded portion includes a cannula, a coaxial cable within the probe body, and an antenna comprising a radiating portion for emission of microwave energy at a distal portion of the probe body, wherein the radiating portion is aligned with the radiation window. The probe body defines an irrigation path configured to carry cooling fluid to and from the distal portion of the probe body. At least one wall defining the irrigation path comprises a heat exchange surface having an average radius, wherein a surface area of the heat exchange surface is larger than a surface area of a smooth surface with a radius equal to the average radius.

Abstract: One general aspect includes a system for ablation including a catheter including a sheath defining a sheath lumen and a distal end, and an elongate electrode assembly axially moveable within the sheath lumen. The electrode assembly includes a shaft defining a central channel and a distal central channel opening. The electrode assembly also includes an expandable electrode array including two or more electrode elements positioned at the distal portion of the electrode assembly, where the electrode array is moveable between a retracted position contained within the sheath lumen and an expanded position protruding from the sheath.

Abstract: Electrosurgical generators having improved functionality and user interface. In an example, the user may modify therapy output parameters without interrupting therapy delivery within a therapy regimen. In an example, the display shows both therapy amplitudes and encountered impedances for a plurality of therapy pulses in different portions of a display. In an example, the electrosurgical generator is operable in a triggered mode using a cardiac signal trigger and provides the operator with an estimate of remaining time that is calculated in light of a calculated cardiac rate.

Abstract: A direct visualization catheter includes a handle, a balloon, an elongate shaft, and a camera assembly. The elongate shaft has a proximal end and a distal end opposite the proximal end. The proximal end is coupled to the handle. The distal end is coupled to the balloon and defines a longitudinal axis. The camera assembly is coupled to the distal end of the elongate shaft and is disposed within the balloon. The camera assembly includes a camera and an adjustment mechanism for varying a configuration of the camera relative to the distal end of the elongate shaft between a delivery configuration and a deployed configuration. The camera faces primarily in a radial direction in the delivery configuration and the camera faces primarily in an axial direction in the deployed configuration.

Abstract: In some aspects, the present disclosure provides a delivery device for delivering a detachable medical implant that comprises an elongated delivery member and a first engagement portion. The first engagement portion comprises a first proximal-facing surface, a first distal-facing surface, and a first lumen that is configured to accommodate an activation wire, wherein at least 50% of a surface area of the first proximal-facing surface is angled away from a proximal end of the first engagement portion. In other aspects, the present disclosure provides a medical delivery system comprising: such a delivery device; an implantable device comprising a medical device portion and a second engagement portion, the second engagement portion comprising a second lumen configured to accommodate an activation wire, a second proximal-facing surface and a second distal-facing surface; and an activation wire. Other aspects pertain to methods of medical device delivery using such a medical delivery system.

Abstract: In some aspects, the present disclosure provides a delivery device for delivering a detachable medical implant that comprises an elongated delivery member and a first engagement portion. The first engagement portion comprises a first proximal-facing surface, a first distal-facing surface, and a first lumen that is configured to accommodate an activation wire, wherein at least 50% of a surface area of the first proximal-facing surface is angled away from a proximal end of the first engagement portion. In other aspects, the present disclosure provides a medical delivery system comprising: such a delivery device; an implantable device comprising a medical device portion and a second engagement portion, the second engagement portion comprising a second lumen configured to accommodate an activation wire, a second proximal-facing surface and a second distal-facing surface; and an activation wire. Other aspects pertain to methods of medical device delivery using such a medical delivery system.

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 variable-length microwave ablation probe is provided. The probe is configured to have a range of resonant frequencies. The probe includes a microwave antenna, an outer conductor, and a cap. The probe further includes a radiation window that is at least partially transparent to microwave energy. The distal boundary of the outer conductor or the proximal boundary of the cap varies in distance from the probe distal end. The probe can have a choke length, an arm length, a radiating portion length, and a cap length. The lengths can each affect the resonant frequency of the antenna. Some examples provide a variable choke length, a variable arm length, a variable radiating portion length, and/or a variable cap length.

Abstract: The disclosure relates to systems and methods for irrigated bipolar radiofrequency ablation. The system includes an ablation probe that includes an elongate inner electrode assembly and an elongate outer electrode assembly. An irrigation path for irrigation fluid flow is defined between the outer surface of the inner electrode assembly and the outer surface of the outer electrode assembly. The irrigation path enables cooling fluid to be circulated within the probe body, cooling the outer electrode during ablation.

Abstract: Novel and versatile apparatuses for delivering one or more of thermal ablation and irreversible electroporation therapies to target tissue. In some examples, a device includes at its distal end a plurality of electrodes that can be advanced or retracted to pierce patient tissue, with a variable position and size shaft electrode provided near the distal end of the device to allow manipulation of therapy fields to achieve various tissue destruction field shapes. A number of method of use examples are described as well.

Abstract: A vascular occlusion device for deployment within a lumen of a vessel may include a self-expanding frame configured to shift between a collapsed configuration and an expanded configuration, the self-expanding frame defining a perimeter of an interior space disposed within the self-expanding frame, and an occlusive membrane secured to the self-expanding frame. The occlusive membrane may include a suspended portion disposed within the self-expanding frame and spaced apart from the perimeter of the interior space.

Abstract: A variable-length microwave ablation probe is provided. The probe is configured to have a range of resonant frequencies. The probe includes a microwave antenna, an outer conductor, and a cap. The probe further includes a radiation window that is at least partially transparent to microwave energy. The distal boundary of the outer conductor or the proximal boundary of the cap varies in distance from the probe distal end. The probe can have a choke length, an arm length, a radiating portion length, and a cap length. The lengths can each affect the resonant frequency of the antenna. Some examples provide a variable choke length, a variable arm length, a variable radiating portion length, and/or a variable cap length.

Abstract: The disclosure relates to systems and methods for irrigated bipolar radiofrequency ablation. The system includes an ablation probe that includes an elongate inner electrode assembly and an elongate outer electrode assembly. An irrigation path for irrigation fluid flow is defined between the outer surface of the inner electrode assembly and the outer surface of the outer electrode assembly. The irrigation path enables cooling fluid to be circulated within the probe body, cooling the outer electrode during ablation.

Abstract: Novel and versatile apparatuses for delivering one or more of thermal ablation and irreversible electroporation therapies to target tissue. In some examples, a device includes at its distal end a plurality of electrodes that can be advanced or retracted to pierce patient tissue, with a variable position and size shaft electrode provided near the distal end of the device to allow manipulation of therapy fields to achieve various tissue destruction field shapes. A number of method of use examples are described as well.

Abstract: An introducer set for a microwave ablation probe is disclosed. The introducer set includes a cannula that is at least partially transparent to microwave energy, and a stylet sized to be received by the lumen of the cannula. Other examples provide a microwave ablation system including a microwave ablation probe having a radiating portion and a cannula that is at least partially transparent to microwave energy. The radiating portion of the probe aligns with the transparent portion of the cannula when the probe is inserted into the cannula lumen. The technology provides a method including introducing a microwave ablation probe into the lumen of a cannula having a cannula body that is at least partially transparent to microwave energy, aligning the transparent portion of the cannula with the radiating portion of the probe, and causing microwave energy to be emitted from the radiating portion of the probe.

Abstract: A medical device for sympathetic nerve ablation may include a catheter shaft, an expandable member disposed on or coupled to the catheter shaft, and a plurality of elongate electrode assemblies each constructed as a flexible circuit having a plurality of layers. The expandable member may be configured to shift between an unexpanded configuration and an expanded configuration. The plurality of electrode assemblies may be disposed on an outer surface of the expandable member. Each of the plurality of electrode assemblies may include enhanced tear resistance properties such as through the inclusion of a reinforcement structure with one or more of the layers of the electrode assemblies.

Abstract: In some aspects, the present disclosure pertains to self-expanding emboli-capturing centering devices for centering a medical instrument in a conduit within a patient. The centering devices comprise (a) an elongate shaft, (b) a self-expanding centering member having an open distal end and an inner surface forming a central lumen with a flared distal portion, the centering member being configured such that a fluid flowing in a distal-to-proximal direction that is received by the open distal end flows proximally along the flared distal portion of the central lumen before exiting the central lumen through one or more openings in a proximal portion of the centering member, and (c) a filter material configured to filter the fluid received by the open distal end of the centering member. Other aspects of the present disclosure pertain to systems and methods employing such centering devices.

Abstract: Methods and devices for issuing ablation therapy using a cardiac signal as a trigger for therapy delivery. The cardiac signal itself may be analyzed before and/or between pulsed electrical field outputs to determine when, relative to fiducials within the cardiac signal, the output can safely be delivered. In some examples, the timing of therapy delivery is tailored to the patient's current cardiac state, such as the cardiac rate. In other examples, triggering signals can be analyzed to ensure that the trigger itself is appropriately detected.

Abstract: An example implantable microparticle for delivering therapeutic heat treatment comprises a generally spherical body. The body may be formed from a first material comprising a biodegradable material and a second material comprising a Curie temperature material. The biodegradable material may be a non-Curie temperature material or have a Curie temperature lower than a Curie temperature of the Curie temperature material. The first material and the second material are mixed to form a composite having a Curie temperature in the range of 35° C. and 100° C.

Abstract: Systems for the delivery of endoluminal devices are disclosed. An illustrative system may include a delivery sheath having an inner sheath and an outer sheath. The delivery sheath may be configured to restrain a stent in a compressed delivery configuration. The outer sheath may cover the entire length of the stent and the inner sheath may cover a portion of the length of the stent.