Abstract: An ultrasound transducer array (408) includes at least one transducer element (412) having a first (604) and second (606) portions separated by an acoustical discontinuity (520). The first portion (604) has the desired length to form a half-wave k31 resonance, while the second portion (606) has a resonant length for an undesired very low frequency out-of-band k31 resonance. The thickness of the transducer element (412) is designed for k33 half-resonance. Given the design, the transducer element (412) can operate and provide for both forward-looking (514) and side looking (512) elevation apertures. A method is also disclosed for using the disclosed ultrasound transducer (412) in ultrasound imaging.

Abstract: Device for carrying out rotablation, comprising a rotablation catheter, an OCT sensor, an IVUS sensor, position sensors and also an image processing unit, which is embodied for the creation of combined 2D or 3D images based on the data of the sensors.

Abstract: A noninvasive technique that can be used to deny blood flow to a particular region of tissue, without the inherent risks associated with invasive procedures such as surgery and minimally-invasive procedures such as embolization. Blood flow in selected portions of the vasculature can be occluded by selectively treating specific portions of the vasculature with high intensity focused ultrasound (HIFU). The occlusion denies undesired tissue the nutrients and oxygen provided by blood flow, causing necrosis in the undesired tissue. An imaging technology (such as magnetic resonance imaging, magnetic resonance angiography, ultrasound imaging, Doppler based ultrasound imaging, or computed tomographic angiography) is used to identify the undesired tissue, and the vascular structures associated with the undesired tissue.

Abstract: Methods and systems for processing and/or superimposing a medical image of an anatomical body (e.g., a heart) with graphical information are provided. Reference elements and/or reference catheter are placed in contact with the anatomical body. A physical structure within a navigational coordinate system is located using the reference elements and/or reference catheter. An image reference within an image coordinate corresponding to the physical structure is located. Location of the image reference can be accomplished, e.g., by displaying the medical image and electronically marking the displayed image reference, or by automatically locating image data corresponding to the image reference. The navigational and image coordinate systems are then registered based on the location of the physical structure within the navigational coordinate system and the location of the image reference within the image coordinate system, which allows graphical information to be accurately merged with the medical image data.

Abstract: Device for removing a complete vascular occlusion using a CTO catheter, at the distal end of which are disposed stretching tongs and IVUS monitoring, whereby the CTO catheter is combined with an IVUS catheter to form an integrated unit.

Abstract: In one embodiment, an endoscope has a proximal end portion opposite a distal end portion. A view port is included at the distal end portion to view an internal body region through a passageway of a patient's body. Also located at the distal end portion are one or more piezoelectric elements operable in one mode to determine position of the distal end portion relative to internal body region and operable in a second mode to ablate tissue of the internal body region. The endoscope carries a balloon positioned about the one or more piezoelectric elements to selectively hold the distal end portion in a desired position in the passageway.

Abstract: An intracardiac catheter for ultrasound guided ablation and EP mapping. Ablation and mapping electrodes 34, 36, 38, 39 are carried on the surface of an outer catheter 30 and an ultrasound array is mounted inside an inner catheter 20. Backloading the inner catheter into the outer catheter provides the ultrasound array in position to image tissue near the surface electrodes. An acoustic coupling fluid is provided between the catheters and a number of the electrodes 34, 38 are positioned directly within the image field of the array.

Abstract: A position of an imaging plane relative to a catheter or other probe is aligned with tissue of interest. Ultrasound tissue images may be registered to the catheter position with minimal rotational ambiguity. The spatial position of an ablation catheter or other device with respect to the imaging plane is more accurately determined, allowing a physician to identify specific anatomy in the relative location of a catheter or catheters. Another alternative or additional approach to determining the position of an imaging plane is to determine the relative position of two or more catheters. A catheter associated with imaging is then moved or bent in a direction having a known spatial relationship with the imaging plane. The position of the catheter is relative to each is then determined again to determine the angle or position of the imaging plane.

Abstract: An ultrasonic surgery apparatus capable of setting surgical conditions properly in accordance with hardness of a nucleus lentis and performing surgery with efficiency is disclosed. The ultrasonic surgery apparatus includes an ultrasonic vibration inducing unit, having an ultrasonic chip which induces ultrasonic vibrations to fragment and emulsify a nucleus lentis, an input unit which inputs a judgment result of hardness of the nucleus lentis, and a setting unit which sets a condition of the ultrasonic vibrations thereafter based on the inputted judgment result.

Abstract: This invention describes an occlusion crossing apparatus for creating an opening in occluded tissue at a target location in interventional and surgical applications with simultaneous or nearly simultaneous intravascular imaging.

Abstract: Steerable catheters are provided including an elongated flexible member having a proximal end, a distal end and a lumen extending therebetween (i.e., between the proximal end and the distal end). A plurality of electrical cables is bundled together and positioned within the lumen of the flexible member. The cross-section of the bundle of electrical cables is substantially ovular or rectangular so as to be bendable in two approximately opposite directions. Methods of steering such a catheter within a body include advancing the catheter within a body while a first force is applied to the bundle of electrical cables to cause the distal end of the elongate flexible member to form a bend. The catheter is farther advanced within the body while a second, opposite force is applied to the bundle of electrical cables to remove the bend in the distal end.

Abstract: A system and method to image an imaged subject is provided. The system comprises a controller, and an imaging system including an imaging probe in communication with the controller. The imaging probe acquires image data with movement through the imaged subject. The system also includes an ablation catheter including a marker having a unique identifier to be detected in the acquired image data, and a tracking system having one of a plurality of tracking elements located at the imaging probe and at least another tracking element located at the ablation catheter. A display illustrates the image data acquired with the imaging probe in combination with a graphic representation of an imaging plane vector representative of a general direction of a field of view (FOV) of image acquisition of the imaging probe in spatial relation to a graphic representation of the identifier and the location of the ablation catheter.

Abstract: An intravascular ultrasound catheter system is provided and enables a simplified, economical technique for ultrasound visualization of a blood vessel. The catheter may include a park ablation system for crossing chronic total occlusions and severe stenoses. The catheter is advanceable and is oriented entirely under manual control of the clinician and the application of radiofrequency energy for spark erosion of the stenosis also is controlled manually by the clinician. The system enables the clinician to observe an ultrasound image sufficiently to determine where to orient the ablation electrode so as to reduce the risk of dissection or perforation of the blood vessel. The ultrasound image is generated in response to manual rotation of the catheter and the ablation spark is generated only when the physician is satisfied as to the orientation of the electrode within the vessel.

Abstract: A surgical device includes a probe, a transducer assembly operatively coupled to the probe for generating an ultrasonic resonant vibration therein, and a frequency generator operatively coupled to the transducer assembly for energizing the transducer component. A control component is operatively connected to the frequency generator for inducing the frequency generator to produce an alternating signal sequence including a first electrical excitation signal and a second electrical excitation signal, wherein the first electrical excitation signal has at least one first ultrasonic frequency and at least one first amplitude collectively selected to generate cavitation bubbles at a wound site to fragment damaged tissue and debride the wound site.

Abstract: The present invention relates to a catheter system that can be used to treat atrial fibrillation and other cardiac arrhythmias by ablating cardiac tissue comprising a catheter, a guide wire, and an ultrasonically driven mechanical ablation probe. The catheter system may further comprise means of delivering cryogenic energy to the mechanical ablation probe, to a region of the catheter in close proximity to the mechanical ablation probe, and/or to another region of the catheter. The catheter may further comprise means of rotating and steering the mechanical ablation probe.

Abstract: This disclosure relates to catheters and related systems and methods. In some embodiments, a catheter defines a lumen and an aperture extending from an outer surface of the catheter to the lumen, and a waveguide is disposed within the lumen of the catheter.

Abstract: A tissue ablation device includes an elongate body having a proximal end and a distal end, an array of ablation elements located at the distal end, and a connector configured to releasably engage the tissue ablation device with at least one medical device. The body is preferably flexible, and may form a wand-type device. The connector may be a magnetic element that magnetically engages the tissue ablation device with the medical device or a hook, for example a plastic hook, that extends outwardly from the array of ablation elements to hook the tissue ablation device to the medical device. The connector may be removably coupled to the ablation elements. The medical device may also be a tissue ablation device, and the connector may engage the two devices such that their respective ablation elements are substantially aligned to form a substantially continuous lesion.

Abstract: The flexible ultrasound wire delivered through an endoscope can bend through multiple radii and deliver ultrasonic energy to the business end of the working channel of an endoscope without requiring percutaneous incisions. The flexible ultrasonic wire is wire or fiber that can be flexed in any direction and is connected at one end to an ultrasonic transducer which is connected to an energy delivering device. An insulating layer between the flexible ultrasonic wire and a metallic working channel is non-metallic and resilient and operates to prevent unwanted fragmentation of the device and possible collateral soft tissue injuries.

Abstract: A tissue cutting device includes a sizing element which detects the diameter of the vessel in which the cutting device is positioned. The sizing element is coupled to the cutting element so that the amount of the cutting element that is exposed varies in response to movement of the sizing element.

Abstract: An ultrasonic operating apparatus having an ultrasonic oscillator to generate ultrasonic oscillation, an oscillation transmitting member for transmitting ultrasonic oscillation, which has a proximal end connected to the ultrasonic oscillator, a jaw which grasps a living tissue in a clearance to the distal end of the oscillation transmitting member, a control unit which opens/closes the jaw with respect to the distal end of the oscillation transmitting member, and an instruction unit which detects that the jaw is closed by the control unit, and instructs the ultrasonic oscillator to output oscillation energy to generate ultrasonic oscillation when the jaw is closed.

Abstract: A system, method and/or apparatus is provided for visualization or imaging of the transverse carpal ligament and surrounding structures/features of a hand of a patient, and treatment of the transverse carpal ligament, particularly, but not necessarily, for performing non-invasive carpal tunnel release. The subject invention utilizes ultrasound waves preferably, but not necessarily, in the high frequency range and cavitations to image the transverse carpal ligament (TCL), record its location in three-dimensional space, and perform precision treatment on the transverse carpal ligament. Treatment may range from stretching or lengthening the TCL to complete tissue ablation or dissection of a portion or portions of the TCL (as is performed in a standard carpal tunnel release procedure) in order to release pressure within the carpal tunnel. Particularly, high temperature conditions are generated at target tissue of the TCL resulting in elongation or necrosis/dissection.

Abstract: A catheter is provided for insertion in the he blood vessel of a patient for ultrasonically imaging the vessel wall. The catheter includes a tubular element and an internally housed drive cable for effective circumferential scan about the catheter of an ultrasonic generating means. Both the tubular element and the drive cable are of a size and flexibility sufficient to permit their introduction into the vessel and subsequent advancement through the vessel to the location of the vessel wall where imaging is desired.

Abstract: Gamma rays obtained from radioisotope administered to an examinee are detected by a gamma ray information-detecting unit so that a first tomographic image obtained therefrom is formed on a CRT. Further, a second tomographic image of the examinee detected by using an ultrasonic wave information-detecting unit juxtaposed with respect to the gamma ray information-detecting unit is formed while making the second tomographic image overlap on the first tomographic image. Thus, it is possible to obtain a tomographic image in which relative positional relationship of tissue is clear.

Abstract: A cooling system for an ultrasonic imaging system is provided, the ultrasonic imaging system having a probe for transmitting and receiving acoustic signals through a tip of the probe to and from biological tissue contacting the tip at an outer surface of the tip. The cooling system includes a conduit for circulating cooling medium therein, and a heat exchanger in fluid communication with the circulating cooling medium and having means for removing heat from the circulating cooling medium, wherein at least a portion the conduit is in proximity to or contacts the outer surface of the probe tip. In a first embodiment the conduit includes an inlet fluid line extending from the heat exchanger to the tip of the probe for providing the circulating cooling medium from the heat exchanger to the probe tip, and an outlet cooling line extending from the tip of the probe to the heat exchanger for providing circulating cooling medium from the probe tip to the heat exchanger.

Abstract: An ultrasonic angioscope system which uses an imaging technique of sending ultrasonic waves to a portion ahead of a stricture of a blood vessel and visualizing a portion in the forward direction of the angioscope, and which uses a laser breakdown is provided.

Abstract: Disclosed is an ultrasonic surgical instrument that combines end-effector geometry to best affect the multiple functions of a shears-type configuration. The shape of the blade is characterized by a radiused cut offset by some distance to form a curved geometry. The cut creates a curved surface with multiple asymmetries causing multiple imbalances within the blade. Imbalance due to the curve of the instrument is corrected by a non-functional asymmetry proximal to the functional asymmetry. Imbalance due to the asymmetric cross-section of the blade is corrected by the appropriate selection of the volume and location of material removed from a functional asymmetry. The shape of the blade in one embodiment of the present invention is characterized by two radiused cuts offset by some distance to form a curved and potentially tapered geometry. These two cuts create curved surfaces including a concave surface and a convex surface.

Abstract: A catheter is provided for insertion in the he blood vessel of a patient for ultrasonically imaging the vessel wall. The catheter includes a tubular element and an internally housed drive cable for effective circumferential scan about the catheter of an ultrasonic generating means. Both the tubular element and the drive cable are of a size and flexibility sufficient to permit their introduction into the vessel and subsequent advancement through the vessel to the location of the vessel wall where imaging is desired.

Abstract: The present invention provides an apparatus and a method of using an ultrasonic probe with a pharmacological agent to enhance an occlusion treating effect of the ultrasonic probe to effectively remove an occlusion. The pharmacological agent is released through a catheter to treat the occlusion and enhance an effect of a transverse ultrasonic vibration of the ultrasonic probe to effectively remove the occlusion. The pharmacological agent continues to travel downstream of the site of the occlusion and work in conjunction with the ultrasonic probe to reduce the occlusion to a size that can easily be removed from the body naturally in order to prevent reformation of the occlusion and other health risks.

Abstract: A high efficiency ultrasonic surgical aspiration tip apparatus and accompanying method for surgical use. The apparatus has one or more substantially “V” or “U” shaped cuts in a contacting. The apparatus and method of use provides a cutting action at the contacting end when the tip is ultrasonically excited. The apparatus and method of use further provides a substantially uniform ultrasonic and aspiration field due to the positioning and shape of the substantially “V” or “U” shaped cuts. The aforesaid further allows a surgeon to position the ultrasonic generator handpiece at any rotational angle for provision of the benefits cited.

Abstract: A longitudinal position translator includes a probe drive module and a linear translation module. The probe drive module is coupled operatively to an ultrasonic imaging probe assembly having a distally located ultrasound transducer subassembly in such a manner that longitudinal shifting of the transducer subassembly may be effected. The probe drive module is preferably mounted to the linear translation unit so as to be moveable between a condition whereby longitudinal shifting of the transducer subassembly can be conducted either manually or automatically. When in the automatically-operable condition, the probe drive module will be engaged with a motor-driven screw associated with the linear translation module so as to cause the probe drive module to be longitudinally displaced at a constant motor-driven rate.

Abstract: A medical device for creating images of tissue within a body includes a disposable liquid-confining sheath supporting an elongate flexible drive shaft which carries an imaging device such as a ultrasound transducer. The device may include a trocar adapted to receive the sheath, the trocar permitting the device to be inserted into the body where no natural passageway exists, the trocar having a side-facing region adapted to maintain registry with the imaging device while the imaging device rotates. In another embodiment, the drive shaft includes an outer coil that is configured such that when the drive shaft is driven in the direction tending to decrease the diameter of the outer coil, the outer surface of the outer coil pressurizes liquid distally of the outer surface. The device optionally includes an inflatable balloon.

Abstract: A method of mounting a transducer to a driveshaft which eliminates the need for a transducer housing, the improved method directly attaches the transducer to a rigid distal tip of a driveshaft which is part of a rotatable imaging core of a catheter assembly. The method contemplates heat treating the distal tip of the driveshaft to make it rigid, machining the distal tip to be dimensioned to hold the transducer, and attaching the transducer to the distal tip by clamping, crimping, or an adhesive.

Abstract: A method of enhancing the permeability of a biological membrane, including the skin or mucosa of an animal or the outer layer of a plant to a permeant is described utilizing microporation of selected depth and optionally one or more of sonic, electromagnetic, mechanical and thermal energy and a chemical enhancer. Microporation is accomplished to form a micropore of selected depth in the biological membrane and the porated site is contacted with the permeant. Additional permeation enhancement measures may be applied to the site to enhance both the flux rate of the permeant into the organism through the micropores as well as into targeted tissues within the organism.

Abstract: A transverse mode ultrasonic probe is provided which creates a cavitation area along its longitudinal length, increasing the working surface of the probe. Accessory sheaths are also provided for use with the probe to enable a user to select from features most suited to an individual medical procedure. The sheaths provide acoustic enhancing and aspiration enhancing properties, and/or can be used as surgical tools or as medical access devices, protecting tissue from physical contact with the probe.

Abstract: A medical device for creating images of tissue within a body includes a disposable liquid-confining sheath supporting an elongate flexible drive shaft which carries an imaging device such as a ultrasound transducer. The device may include a trocar adapted to receive the sheath, the trocar permitting the device to be inserted into the body where no natural passageway exists, the trocar having a side-facing region adapted to maintain registry with the imaging device while the imaging device rotates. In another embodiment, the drive shaft includes an outer coil that is configured such that when the drive shaft is driven in the direction tending to decrease the diameter of the outer coil, the outer surface of the outer coil pressurizes liquid distally of the outer surface. The device optionally includes an inflatable balloon.

Abstract: First sensing means senses the three-dimensional position of a microscope, with an operating site as the origin. Second sensing means senses the three-dimensional position of a surgical instrument with respect to the microscope. On the basis of the sensing results of the first sensing means and second sensing means, computing means calculates the three-dimensional position of the surgical instrument, with the operating site as the origin.

Abstract: A phacoemulsification needle includes a body having an aspiration lumen therethrough along with a hub disposed at a proximal end of the needle body for engaging an ultrasonic handpiece in order to couple ultrasonic energy into a needle body. A tip is provided at a distal end of the needle body for penetrating tissue to be emulsified and a conical ultrasonic surface disposed at the tip is provided for focusing ultrasound in tissue beyond an end of the tip in order to promote cavitation in tissue beyond the tip end. The conical ultrasonic radiation surface extends from the lumen to the end of the tip.

Abstract: A medical device for creating images of tissue within a body includes a disposable liquid-confining sheath supporting an elongate flexible drive shaft which carries an imaging device such as a ultrasound transducer. The device may include a trocar adapted to receive the sheath, the trocar permitting the device to be inserted into the body where no natural passageway exists, the trocar having a side-facing region adapted to maintain registry with the imaging device while the imaging device rotates. In another embodiment, the drive shaft includes an outer coil that is configured such that when the drive shaft is driven in the direction tending to decrease the diameter of the outer coil, the outer surface of the outer coil pressurizes liquid distally of the outer surface. The device optionally includes an inflatable balloon.

Abstract: An ablation catheter for the generation of linear lesions in the myocardium is provided with an elongated catheter body and a linear, substantially cylindrical ablation electrode on the distal end of the catheter body. At least one sensing electrode is disposed in the ablation electrode, insulated therefrom and embedded in the jacket thereof.

Abstract: A catheter tube carries an imaging element for visualizing tissue. The catheter tube also carries a support structure, which extends beyond the imaging element for contacting surrounding tissue away from the imaging element. The support element stabilizes the imaging element, while the imaging element visualizes tissue in the interior body region. The support structure also carries a diagnostic or therapeutic component to contact surrounding tissue.

Abstract: An apparatus is described for treating arterial occlusions combining an intraluminally operable catheter, having an occlusion-crossing working element, with a micro-invasive extraluminally operable locator for imaging the progress of the working element through the occlusion. Conical, abrasive, blunt-dissecting, and sharp-pointed, and steering and non-steering working elements including guide wires are described. Acoustic transducers and a flexible imaging tube are described for the locator. A suction cup is described for removably anchoring the imaging tube to a surface. A signal-emitting working element and cooperating signal-receiving locator are described. A method for treating arterial occlusions is described.

Abstract: An apparatus for guidance and monitoring of intra-uterine, cervical and tubal procedures is described, The apparatus includes an assembly, including (a) an endovaginal ultrasound transducer being adapted for insertion into a portion of a patient's vagina so as to be positionable against a cervix of the patient; (b) a cervical holder for holding the cervix; and (c) a connector for interconnecting the ultrasound transducer and the cervical holder, the connector being constructed so as to enable counter resisted movement of the ultrasound transducer relative to the cervical holder, the counter resisted movement being in a direction away from the cervix.

Abstract: A longitudinal position translator includes a probe drive module and a linear translation module. The probe drive module is coupled operatively to an ultrasonic imaging probe assembly having a distally located ultrasound transducer subassembly in such a manner that longitudinal shifting of the transducer subassembly may be effected. The probe drive module is preferably mounted to the linear translation unit so as to be moveable between a condition whereby longitudinal shifting of the transducer subassembly can be conducted either manually or automatically. When in the automatically-operable condition, the probe drive module will be engaged with a motor-driven screw associated with the linear translation module so as to cause the probe drive module to be longitudinally displaced at a constant motor-driven rate.

Abstract: Acoustic imaging balloon catheters formed by a disposable liquid-confining sheath supporting a high fidelity, flexible drive shaft which carries on its end an ultrasound transducer and includes an inflatable dilatation balloon. The shaft and transducer rotate with sufficient speed and fidelity to produce real time images on a T.V. screen. In preferred embodiments, special features that contribute to the high fidelity of the drive shaft include the particular multi-filar construction of concentric, oppositely wound, interfering coils, a pre-loaded torque condition on the coils enhancing their interfering contact, and dynamic loading of the distal end of the probe, preferably with viscous drag. The coil rotating in the presence of liquid in the sheath is used to produce a desirable pressure in the region of the transducer.

Abstract: A real time three dimensional ultrasound imaging probe apparatus is configured to be placed inside a body. The apparatus comprises an elongated body having proximal and distal ends with an ultrasonic transducer phased array connected to and positioned on the distal end of the elongated body. The ultrasonic transducer phased array is positioned to emit and receive ultrasonic energy for volumetric forward scanning from the distal end of the elongated body. The ultrasonic transducer phased array includes a plurality of sites occupied by ultrasonic transducer elements. At least one ultrasonic transducer element is absent from at least one of the sites, thereby defining an interstitial site. A tool is positioned at the interstitial site. In particular, the tool can be a fiber optic lead, a suction tool, a guide wire, an electrophysiological electrode, or an ablation electrode. Related systems are also discussed.

Abstract: The apparatus for a cardiological therapy, in particular an ablation apparatus, comprises an ultrasonic transducer and an applicator which is arranged at the transducer and provided for an endocardial energy output. An echocardiographic thickness measurement of the myocardium can be performed by means of the transducer. Control means are provided by means of which the energy output is metered with the applicator and can be performed in a manner matched to the measured thickness.

Abstract: A guidewire imaging catheter includes a catheter body, housing secured to the distal end of the catheter body, a drive cable extending through a central lumen of the catheter body, and an imaging system disposed within the housing and coupled to the drive cable. A fixed guidewire is secured to the distal tip of the housing, and the catheter body is highly flexible while retaining sufficient torsional stiffness to allow the entire catheter to be used as a guidewire. Thus, the imaging guidewire can be used to first image a desired region within a patient's vascular system and subsequently as a guidewire to allow placement of a desired interventional catheter.

Abstract: An ultrasonic diagnosis and treatment system having a thin tube which is capable of being inserted into a body cavity, and which has at its extreme end an observing ultrasonic vibrator for emitting ultrasonic waves for observation and a treating ultrasonic vibrator for emitting strong ultrasonic waves for treatment. Observation and treatment are performed by using ultrasonic wave. The system further includes a processing device for performing an operation other than the ultrasonic treatment at least on a region observed by using ultrasonic waves. A guide for enabling the processing device to reach the region observed by using ultrasonic waves is provided on the thin tube.

Abstract: An operative element mover (22) is used as a part of an ultrasound imaging or other catheter system (2) including a hollow sheath (6) and a case (16) housing a rotary driver (10). A drive cable or other connecting member (8) is disposed within the sheath with a transducer (24) at its distal end (26) and its proximal end (12) coupled to the rotary driver. The rotary driver rotates the transducer about the longitudinal axis (14) of the sheath. A hemostasis valve (50) anchors the sheath to the patient where the sheath enters the patient. The transducer mover (22) is used to move the drive cable along the longitudinal axis and includes a body (38) fixedly mountable to and dismountable from the case and a movable anchor post (40). The anchor post is clipped to the sheath and is moved by a sheath anchor drive (46) to translate the sheath from or toward the case. This causes the transducer to move within the sheath in a proximal or distal longitudinal direction (52).