Abstract: The invention features bone drill guides, sleeves, and methods of use thereof in inserting hardware into bones, in particular to repair bone defects. The bone drill guides are designed to seat firmly against bone while allowing translational, rotational, and angular movement during an operation. The bone drill guides also allow for insertion of multiple devices, such as guide wires, into bone at defined and constrained relative position.

Abstract: A number of orthopedic surgical instruments for use in a surgical procedure to prepare a patient's femur to receive an orthopedic prosthesis. The tools include guide tools, cutting tools, surgical blocks, and other orthopedic surgical instruments configured to plan and guide the preparation of the patient's femur. A method of using the orthopedic surgical instruments is also disclosed.

Abstract: A surgical device includes a body having a first side with a first surface that is complementary to a surface of a foreign object disposed within a patient based on preoperative imaging of the patient. The body defines at least one hole positioned relative to the body to facilitate insertion of an elongate device at a predetermined location relative to the foreign object.

Abstract: A system can comprise a catheter and a device having an elongate member and an expandable member. The expandable member can be coupled to the elongate member. The elongate member can extend through the catheter. The expandable member can be positioned with a proximal member end proximal to a distal catheter end, a distal member end positioned distal to the distal catheter end, and at least a portion of the expandable member between the distal catheter end and the distal member end in an expanded state in which a maximum transverse dimension of the expandable member is larger than a maximum transverse dimension of the distal member end. The catheter can be advanced in a patient's body with the expandable structure, in the expanded state, at the distal end of the catheter.

Abstract: Devices for restoring blood flow to facilitate lysis of clots and/or enable capture of clots are disclosed. The devices can be configured to be disposed within a lumen of a microcatheter that is inserted within neurovasculature above a carotid siphon to a location of a clot. The devices can include an elongate pusher member and a self-expandable capturing member coupled to a distal end of the elongate pusher member. The capturing member can comprise a generally cylindrical body having an cell structure that is configured to compress the clot against an inner wall of the neurovasculature and capture the clot at least partially on a surface of the generally cylindrical body upon deployment of the capturing member from the microcatheter, thereby restoring blood flow to the neurovasculature downstream of the clot.

Abstract: Methods and devices described herein facilitate diaphragm entry for posterior access of body organs.

Abstract: The present disclosure relates to a dissecting tip for use in a surgical stapler or instrument.

Abstract: A minimally invasive tissue incision system for creating joint capsulotomies and releasing/incising various tendon and fibrous band structures. The system contains a penetrating needle which is retractable so as to expose a cutting element, and which may be used as a penetrating needle to pierce the skin and other soft tissue structures. The cutting element provided within the penetrating needle may be used to incise subsequent tissue structures after the initial penetration. The system facilitates such procedures by providing the cutting element with the confines of the needle which provides safe introduction of the cutting element directly to the site via the needle.

Abstract: An ultrasonic instrument includes a body, an actuation assembly, a shaft assembly, an ultrasonic blade, and a movable member. The body is configured to receive an ultrasonic transducer. The actuation assembly includes a first activation member and a second activation member. The first activation member is operable to trigger activation of the ultrasonic blade in a first power mode. The second activation member is operable to trigger activation of the ultrasonic blade in a second power mode. The movable member is configured to move between a first position and a second position. In the first position, the movable member is configured to permit access to the first activation member and prevent access to the second activation member. In the second position, the movable member is configured to permit access to the second activation member and prevent access to the first activation member.

Abstract: An articulating ultrasonic surgical end effector includes a clevis, a transducer housing pivotably coupled to the clevis, an ultrasonic transducer disposed within the transducer housing, a waveguide extending distally from the ultrasonic transducer, an ultrasonic blade disposed at the distal end of the waveguide, a shaft extending distally from the transducer housing about at least a portion of the ultrasonic blade, and a clamp arm pivotably coupled to the shaft and movable relative to the ultrasonic blade between an open position and a clamping position. Ultrasonic energy produced by the ultrasonic transducer is transmitted along the waveguide to the ultrasonic blade for treating tissue therewith.

Abstract: Intravascular intervention catheters and catheters for performing an intravascular procedure that use a computer to control an operation at the end of the catheters are provided. The computer can process image data to determine where the important features are within a patient's vessels. The catheter can include imaging devices, steering devices, ablation mechanisms, or a combination thereof. By referencing the precisely-calculated location of the important features, the computer can provide signals that can be used by a control device (such as a set of servomotors for navigation) to operate the mechanisms at the catheter tip. Thus the catheter can be steered or an ablation mechanism can be operated or be prevented from operating depending on a detected location of the catheter.

Abstract: Various embodiments of devices and systems comprising a polymer driveshaft for use in high-speed rotational medical procedures, e.g., atherectomy, are disclosed. Generally, the primary driveshaft for transferring torque and activating rotation of a tool attached thereto, e.g., an abrasive element, is constructed with at least a polymer outer and inner surface. In certain embodiments, the polymer driveshaft may comprise a metallic band for fixed attachment of a structure, e.g., an abrasive element, thereto. Various embodiments may comprise a coupler that connects a drive shaft connected with a prime mover, e.g., a turbine or electric motor, with the polymer drive shaft, the coupler comprising openings through the coupler wall to the inner diameter of the coupler to allow fluid flow to the inner diameter of the coupled polymer drive shaft.

Abstract: A method of making a seal-set for a rotary catheter drive unit containing a motor and a seal-set, an output shaft of the motor being power transmittingly connected to a flexible shaft that is rotatably disposed through the seal-set, the seal-set comprising a bearing and an adjacent seal defining a first and a second concentric bores, respectively, the first bore being slightly larger than a diameter of the shaft so that it rotatably and accurately supports the shaft, the second bore being slightly smaller than the diameter so that it seals around the shaft, the bearing aligning the shaft, so that it is concentric with the second bore, by deflecting the shaft to compensate for eccentricity and misalignment of the second bore relative to the output shaft of the motor.

Abstract: A support apparatus for supporting a trocar while the trocar extends through a body wall of a patient includes an inflatable collar and a slidable abutment collar commonly connected for engagement onto the trocar following which the slide collar is released to slide along the trocar. The inflatable collar is inflated to a set size by a manually operable pump on the slidable collar operated by squeezing finger abutments together up to a latch so that threaded portion expels the inflation fluid. The abutment member is shaped to be received on an outer surface of the trocar and adjustable longitudinally of the trocar sleeve so as to be located at a selected position by a manually movable latch collar. The inflatable collar and slidably collar are held connected by a manually operable release.

Abstract: A trocar sensor unit including a base that is configured to be attached to and detached from a trocar and that has a through-hole through which an insertion section to be inserted into the trocar is inserted; a moving member that has a pressing surface forming at least a portion of an inner surface of the through-hole of the base and that is configured to be moved in a radial direction of the through-hole; and a sensor that is disposed in at least one of the moving member and a portion of the inner surface of the through-hole opposite the pressing surface and that detects the amount of movement of a surface of the insertion section in the through-hole.

Abstract: An assembling surgical access device includes a flexible tube and a connecting structure. The flexible tube includes a tube body and a positioning portion connected to the tube body. The connecting structure is connected to the flexible tube, and includes a housing and a tube fixing member. The housing includes a side wall, an end wall, a fixing portion and a tube hole. The fixing portion is connected to the positioning portion of the flexible tube, and the tube body is disposed through the tube hole. The tube fixing member is engaged into the side wall so as to position the positioning portion between the end wall and the tube fixing member.

Abstract: The present invention is directed to a minimally invasive surgical cannula provided with at least two grooves having a semi-circular profile as a non rotating feature. The non rotating grooves of cannula further accommodates at least one sensor and a strain gauge to detect and measure forces acting on cannula when it is coupled with a modular interfacing arrangement and facilitates maneuvering of surgical instrument inside the body cavity during surgical incision.

Abstract: An access device for surgical procedures includes an end cap having a rigid body with a flexible support sealingly mounted to the rigid body with at least one separate access port for accommodating introduction of individual surgical instruments into a body of a patient. The at least one access port is sealingly attached to the flexible support and extend in a proximal direction therefrom. The flexible support is of a material more flexible than those of the rigid body and the at least one access port to provide for relative angular movement of the at least one access port to provide flexibility for positioning surgical instruments introduced through the at least one access port.

Abstract: The present disclosure provides systems and methods for implanting an implantable cardiac monitor. An injection system includes an implantable cardiac monitor (ICM), a plunger, a plunger handle coupled the plunger, and an injector housing. The injector housing includes a tube extending from a first end of the injector housing to a second end of the injector housing, the tube configured to receive the ICM and the plunger, and at least one leaflet formed at the second end of the injector housing, the at least one leaflet configured to rotate outward when a user operates the plunger handle to push the ICM through the injector housing second end via the plunger.

Abstract: A set of instruments configured to deliver a therapy to a bone can include a cannulated syringe. The cannulated syringe can extend along a longitudinal axis between a proximal and a distal end. The cannulated syringe can have an inner tube and an outer tube that are interconnected at the distal end as a single fixed unit. A first cannulation can be formed along the longitudinal axis of the cannulated syringe within the inner tube and a second cannulation can be formed within an annular space between the inner and outer tubes. The outer tube can define an opening through a sidewall thereof. The cannulated syringe can be closed from fluid communication between the inner and outer tubes.

Abstract: Embodiments systems and methods for a platform that is configured to hold a medical device. In embodiments, a physician, nurse, medical practitioner, etc. may perform actions to change the positioning and orientation of the medical device while the medical device is secured to the platform. In further embodiments, the platform may include robotic components configured to change the positioning and orientation of the medical device.

Abstract: Provided is an apparatus and component parts of a system for the external fixation of bones. The component parts include fixation plates such as a C Plate, a N Plate, a J Plate, an I Plate and a K Plate. Two or more fixation plates are configured along an axis, the two or more fixation plates selected from a list, the list comprising a plurality of C Plates; a plurality of N Plates; a plurality of J Plates; and a plurality of I Plates; a plurality of telescoping adjustable struts that connect a first fixation plate along the axis with a second fixation plate of the plurality of fixation plates along the axis, wherein the first and second fixation plates are adjacent plates along the axis; and a plurality of posts, each post connecting two adjacent fixation plates of the plurality of fixation plates along the axis.

Abstract: The present invention generally relates to methods and device for treatment of spinal deformity, wherein at least one tether is utilized to maintain the distance between the spine and the an ilium to (1) prevent increase in abnormal spinal curvature, (2) slow progression of abnormal curvature, or (3) impose at least one corrective displacement and/or rotation.

Abstract: A spinal construct comprises a fastener including a first portion defining an implant cavity and a second portion configured to penetrate tissue. A member defines a cavity configured for disposal of at least a portion of the first portion. The member includes an implant engaging surface fixable within the implant cavity and connected to a connecting element fixable adjacent the first portion. Systems and methods of use are disclosed.

Abstract: A spinal stabilization system comprises a bone screw including a bone engaging portion and a yoke, the yoke having top surface and bottom surfaces. The yoke has a rod receiving channel defined by a pair of opposed arms, an elongate connecting rod being received within the channel. A head to head cross connector comprises a connecting element having one end in connection with the bone screw and an opposite other end. The one end defines a connecting portion having an opening therethrough and a connecting bar communicating with the opening. The connecting bar, having upper and lower surfaces, resides within the channel, the lower surface contacting the rod. The connecting bar in a non-secured position is movable within the channel in at least two degrees of freedom. A set screw supported by the yoke rigidly secures the connecting bar to the rod and the rod to the yoke.

Abstract: An implant for fusing a joint between first and second bone portions. The implant includes a screw member, and a washer polyaxially rotatable relative to the screw member. The screw member includes a head, a lag zone, and a threaded engagement zone. The implant includes a fusion zone for joint compression, extending from the washer to the proximal end of the engagement zone. Fenestrations may be present in the fusion zone. The length of the fusion zone ranges from about 10 mm to about 37 mm. Different surface finishes including roughened and non-roughened may be applied selectively to selected portions of the implant. In an embodiment, the joint is a sacro-iliac joint, and upon implantation the implant extends from the exterior of the ilium, across the joint and into the sacral vertebral body. Instrumentation and methods for preparing the joint and implanting the implant are disclosed.

Abstract: A spinal fixation device includes a bone screw, a tulip-shaped seat, a rod seat, and a washer. The bone screw comprises a spherical head and a threaded elongated body extending along a first direction. The tulip-shaped seat comprises a bottom portion that has a through-opening shaped and dimensioned to receive the bone screw so that an inner surface of the bottom portion engages the spherical head of the bone screw and prevents the bone screw from passing entirely through the through-opening, while the spherical head remains polyaxially rotatable within the bottom portion of the tulip-shaped seat. The rod seat sits within and engages the inner surface of the tulip-shaped seat and the rod seat comprises a semispherical bottom that is shaped and dimensioned to engage the spherical head of the bone screw while the spherical head remains polyaxially rotatable within the bottom portion of the tulip-shaped seat.

Abstract: Disclosed are fixation devices for repairing spondylolysis. The fixation device can include a first anchor, a second anchor, and a bridge that couples the first and second anchors together. In use, the first anchor can be implanted on one side of a pars fracture, the second anchor can be implanted on the other side of the pars fracture, and the bridge can span across the pars fracture. In some embodiments, the fixation device can be compressible to promote healing of the fracture.

Abstract: Various embodiments described herein provide interspinous process spacing devices and related systems and methods. In one embodiment, surgical instrument system for implanting an interspinous process spacing device includes a first arm having a proximal end, an elongated central portion, and a distal end, wherein the distal end includes a first engagement element configured for releasably engaging a first attachment side of an interspinous process spacing device. The system also includes a second arm having a proximal end, an elongated central portion, and a distal end, wherein the distal end includes a second engagement element configured for releasably engaging a second attachment side of the interspinous process spacing device. The first arm and the second arm are removably attachable to one another via attachment elements and are configured for aligning a spacer of the first attachment side and a spacer opening of the second attachment side.

Abstract: Provided are methods and systems for enlarging a spinal canal of a vertebra. Using the methods and systems disclosed the spinal canal of the vertebra is enlarged by cutting the posterior arch portion of the vertebra to create one or two implant receiving spaces in the posterior arch portion. The cutting of the posterior arch portion is completed through a minimally invasive approach. Once cut, the detached portion of the posterior arch portion is repositioned and an implant is positioned in the implant receiving space of the posterior arch portion to thereby enlarge the spinal canal such that the spinal cord is no longer compressed. The insertion of the implant is also completed through a minimally invasive approach.

Abstract: Surgical instruments to properly implant interspinous/interlaminar stabilization devices, and instrumentation kits containing these instruments are provided. These surgical instruments may be configured to be disposable, or for single patient use, and therefore do not require resterilization for reuse, thus reducing risk of infection as a result of reuse and logistical costs associated with these resterilization procedures.

Abstract: Minimally invasive methods and devices are provided for positioning a spinal fixation element in relation to adjacent spinal anchors. In an exemplary embodiment, the device is a percutaneous access device that can be coupled to a spinal anchor, and the method includes the step of positioning a spinal fixation element through at least one sidewall opening of at least two percutaneous access devices such that the spinal fixation element extends in a lengthwise orientation that is substantially transverse to the longitudinal axis of each percutaneous access device. The spinal fixation element can then be advanced in the lengthwise orientation to seat the spinal fixation element in or adjacent to the receiver heads of at least two adjacent spinal anchors. A fastening element or other closure mechanism can then be applied to each spinal anchor to engage the spinal fixation element within the receiver heads of the adjacent anchors.

Abstract: Bone anchors and surgical instruments (e.g., bone taps, drivers, etc.) are disclosed herein that include integrated guide tips. Use of these anchors or instruments can eliminate one or more of the steps in a conventional bone anchor installation procedure, improving surgical efficiency and safety. For example, a surgical instrument can include a guide projection configured for insertion through a cannulation formed in a bone anchor when the surgical instrument is coupled to the bone anchor. The surgical instrument can also include various mechanisms for adjusting the position of the guide projection relative to the bone anchor. The guide projection can replace the needle, stylet, and guidewire used in typical insertion procedures. The bone anchor can also include integrated tapping features to eliminate the need for a separate bone tap instrument. Thus, in some embodiments, targeting, tapping, and driving the bone anchor can be performed in a single step.

Abstract: An expandable implant system is configured to increase the height of a target bone, for instance that has been subjected to a compression fracture. The expandable implant system includes an implant assembly that can be inserted into the target bone, and subsequently expanded so as to increase the height of the target bone. The expandable implant system further includes an and insertion assembly that is configured to create an insertion channel into the target bone, such that the implant assembly can be inserted in a collapsed configuration into the target bone along the insertion channel, and subsequently expanded.

Abstract: This disclosure relates to bone fixation plate and a system for treatment of injuries of the distal tibiofibular syndesmosis. The bone fixation plate provides an improved stability to the distal fibula.

Abstract: Bone anchor assemblies and methods are provided having a multi-component bone anchor that is configured to allow the shank of the bone anchor to be bottom loaded into a receiver member. In one embodiment, a bone anchor assembly is provided having a shank with a distal threaded portion and a proximal head portion, a receiver member having an aperture formed in a distal end thereof through which the head portion of the shank can be received, the receiver member defining a polyaxial seat, a non-expandable outer ring configured to be polyaxially disposed within the polyaxial seat of the receiver member and defining a central opening through which the head portion of the shank can be received, and an expandable inner ring having an inner surface configured to mate with the head portion of the shank and an outer surface configured to mate with an inner surface of the outer ring to thereby lock the outer ring in a fixed position relative to the shank.

Abstract: A medical bone screw in particular in pedicle screw design includes a screw-and-thread shaft which has a distal shaft portion of a preferably smaller core diameter that transitions into a proximal shaft portion of a preferably larger core diameter, whose proximal end is provided with a screw head. The core cross-sectional shape along the distal shaft portion is formed to be out-of-round, preferably polygonal, and the core cross-sectional shape along the proximal shaft portion is formed to be circular.

Abstract: Devices and methods for repairing bone fractures are described herein. A pin directing device for steering a flexible bone screw is disclosed. A fluted entry tool for penetrating into cancellous bone without penetrating the far cortex of the bone is disclosed. A flexible bone screw having a rotational position marker positioned thereon at a terminal twenty-five percent of the shaft is disclosed. A flexible bone screw comprising at least eighty percent cold work hardened alloy is disclosed. A pin bending clamp having a transverse hole in the jaws is disclosed. A flexible bone screw with a cortex climbing thread portion at the tip, which is helicoid, is also disclosed.

Abstract: The instant invention is directed to a universal bone screw screwdriver and in particular to a universal screwdriver that permits the removal of screws from bone plates that are manufactured by different manufacturers having distinct characteristics. The universal bone screw screwdriver is adapted to removably receive an elongated tool bit having a hollow center. The elongated tool bits correspond to the screw heads of different manufacturers and comprises a torque limiting and locking spring assembly to secure the elongated tool bit to the driver shaft and inhibit over-tightening of the bone screw into the bone or bone plate as the case may be.

Abstract: A surgical cutting tool includes a catheter, a first diametrically expandable member such as an inflatable balloon at a first location on the catheter, a second diametrically expandable member such as an inflatable balloon at a second location on the catheter that is distally spaced from the first expandable member, a cutting tool such as a cauterization tip extending between the first and second expandable members, and expanding structure such as a lumen for enabling the first and second expandable members to be actuated between a reduced diameter state and an expanded diameter state, and thereby move and position the cutting tool radially with respect to the catheter.

Abstract: A radio-frequency (RF) amplifier having a direct response to an arbitrary signal source to output one or more electrosurgical waveforms within an energy activation request, is disclosed. The RF amplifier includes a phase compensator coupled to an RF arbitrary source, the phase compensator configured to generate a reference signal as a function of an arbitrary RF signal from the RF arbitrary source and a phase control signal; at least one error correction amplifier coupled to the phase compensator, the at least one error correction amplifier configured to output a control signal at least as a function of the reference signal; and at least one power component coupled to the at least one error correction amplifier and to a high voltage power source configured to supply high voltage direct current thereto, the at least one power component configured to operate in response to the control signal to generate at least one component of the at least one electrosurgical waveform.

Abstract: An arrangement having a device for providing high-frequency voltage UApp for contact coagulation of the biological tissue. The device is equipped to operate with a high voltage that is normally not suitable for contact coagulation, but otherwise used for spark coagulation, for example, more than 400V at the beginning of the contact coagulation. During the operation of the generator the tissue impedance Z is monitored. This can occur by means of continuously measuring the voltage UApp of the flowing current IApp and the phasing ? between the voltage and the flowing current. Using both, the measuring unit continuously determines the tissue impedance Z. A minimum detector is provided to determine if an impedance minimum Zmin has passed through and if such is found, to induce the generator control to reduce the voltage UApp delivered by the device to a value that avoids spark generation as well as desiccation of the tissue.

Abstract: A surgical system and corresponding methods for identifying tissue or vessels and assessing their conditions includes a probing signal source for applying a probing signal to the tissue and a response signal monitor for monitoring a response signal that varies according to the level of blood circulation in the tissue or vessels. The response signal monitor monitors the response signal over an interval equal to or longer than an interval between two successive cardiac contractions. The surgical system includes a microprocessor that analyzes the amplitude and/or phase of the response signal to determine the level of blood circulation in the tissue or in different portions of the tissue, and determines a tissue parameter based upon the level of blood circulation. The surgical system may monitor a cardiac signal related to cardiac contractions and correlate the response signal and the cardiac signal to determine a level of blood circulation in the tissue.

Abstract: A jaw assembly of a forceps that includes a first jaw body and a second jaw body. The first jaw body and the second jaw body are disposed in opposition relative to one another, and at least one of the jaw bodies is movable relative to the other jaw body between an open position and a closed position. In both the closed and the open positions, a medial edge of the first jaw body is in opposition to a medial edge of the second jaw body. Lateral movement of the first jaw body or the second jaw body closes a lateral gap between the first jaw body and the second jaw body.

Abstract: Surgical devices and methods for cutting tissue are provided having a cutting element that is biased to facilitate tissue cutting. For example, a surgical device is provided with a handle that has an elongate shaft assembly with first and second jaws for engaging tissue. The surgical device includes a cutting element that is moveable through a slot formed in at least the second jaw for cutting tissue engaged between the first and second jaws. In an exemplary embodiment, the cutting element is biased toward the second jaw such that the cutting element remains within the slot in the second jaw when thick tissue is engaged.

Abstract: An end effector for an electrosurgical instrument includes a pair of opposing first and second jaw members (2), (3), movable between an open position in which the jaw members are disposed in a spaced relation relative to one another, and a closed position in which sealing surfaces of the jaw members cooperate to grasp tissue therebetween. A first sealing electrode (9) is located on the first jaw member (2), while a second sealing electrode (10) is located on the second jaw member (3). One or both of the sealing surfaces are provided with electrically conductive stop members (12), the one or more stop members maintaining a predetermined spacing between the first and second sealing electrodes when the jaw members are in their closed position. One or more insulating members (14), (17), (19) are present to prevent the conductive stop members from causing an electrical short between the first and second sealing electrodes when the jaw members are in their closed position.

Abstract: A surgical forceps includes a housing having a movable handle coupled thereto and movable between an initial position and a compressed position. A drive bar is operably coupled to the movable handle such that movement of the movable handle between the initial and compressed positions effects longitudinal translation of the drive bar. The drive bar further includes a coupling member disposed at a distal end thereof. An end effector assembly includes first and second jaw members movable between spaced-apart and approximated positions. Each jaw member defines a cam slot. A cam pin is slidably disposed within the cam slot of each of the jaw members. The coupling member is configured to releasably engage the cam pin such that movement of the movable handle between the initial position and the compressed position effects movement of the jaw members between the spaced-apart position and the approximated position.

Abstract: An end effector for an electrosurgical instrument includes a pair of opposing first and second jaw members (2), (3), movable between an open position in which the jaw members are disposed in a spaced relation relative to one another, and a closed position in which the jaw members cooperate to grasp tissue therebetween. One or more spring members (15), (16), (17), (18), (19) are connected between the first and second jaw members (2), (3), such that moving the jaw members from their open position to their closed position causes the one or more spring members to compress. The one or more spring members have a fully compressed condition such that when in their fully compressed condition they form stop members to maintain the first and second jaw members (2), (3), at a predetermined spacing one from the other when in their closed position.

Abstract: Methods for using a surgical device integrating a suction mechanism with a coagulation mechanism for improving lesion creation capabilities. The device comprises an elongate member having an insulative covering attached about means for coagulating soft tissue with at least one diagnostic element coupled to an energy transfer element of the device. Openings through the covering expose regions of the coagulation-causing elements and are coupled to lumens in the elongate member which are routed to a vacuum source and a fluid source to passively transport fluid along the contacted soft tissue surface in order to push the maximum temperature deeper into tissue.

Abstract: A catheter and catheter system may be used to treat disease tissue by gentle heating in combination with gentle or standard dilation. An elongate flexible catheter body with a radially expandable balloon having a plurality of electrodes engage tissue including diseased tissue when the structure expands.