Abstract: Methods for decreasing the size and/or changing the shape of pelvic tissues. Energy, preferably radio frequency or laser energy, may be applied to endopelvic fascia or other subcutaneous tissue transcutaneously, through one or more incisions in skin, or directly to the desired subcutaneous tissue after a strip of mucosa or skin has been removed. Such an application of energy may cause the subcutaneous tissue to shrink, thereby bringing the mucosa or skin edges closer together while minimizing damage to deep nerves and other surrounding tissues. Such manipulation of the layers of the skin may be utilized to decrease the size or change the shape of numerous anatomical structures and may also serve to alleviate the symptoms of urinary incontinence, dyspareunia, or chronic pelvic pain. The method steps of the present invention may further provide for the beneficial pretreatment of a tissue site prior to stem cell implantation.

Abstract: A system for the illumination of tissue structures including tubular structures within the body and a method for the use of the system. The system includes a transparent, biocompatible catheter and a light source.

Abstract: A light diffuser (10), which is particularly suitable for introducing diffuse light into a tissue, is produced by interpenetration of a diffuser material in a liquid state into a boundary layer (4) of a porous shaping material, by which process a diffuser surface is formed having a surface structure which represents essentially a negative of the pore structure of the shaping material and includes undercut structures induced by a surface tension. The light diffuser (10) is e.g. produced by introducing a diffuser blank (1) including material which is liquefiable through mechanical vibration into the shaping material and simultaneously stimulating it with mechanical vibrations, such that the liquefiable material liquefies at least there where it is in contact with the shaping material and is pressed into the shaping material. An in situ production of the diffuser is particularly advantageous for photodynamic therapy in bone tissue (20).

Abstract: This invention relates to the working end of a medical instrument that applies energy to tissue. In one embodiment, the instrument has a microfluidic tissue-engaging surface fabricated by soft lithography means together with optional superlattice cooling means that allows for very precise control of energy application, for example in neurosurgery applications. The tissue-engaging surface can eject a high-heat content vapor into the engaged tissue for treating tissue, while the superlattice cooling structure can prevent collateral thermal damage. Also, the superlattice cooling structure can be used to localize heat at a selected depth in tissue and prevent surface ablation. Also, the superlattice cooling structure can be used to prevent tissue sticking to a thermal energy delivery surface. In another embodiment, the tissue-engaging surface can be used in a jaw structure for sealing tissue together with hydrojet means for transecting the tissue.

Abstract: An interventional device uses light to diagnose and treat tissue regions near the surface. A high intensity ultraviolet light is used. The interventional device includes a housing adapted for placement inside a body and a flash lamp placed inside the housing. The flash lamp is capable of generating high intensity ultraviolet light.

Abstract: A laser energy soft tissue aspiration device comprises a cannula defining an aspiration lumen and having one or more aspiration inlet ports at a distal end. A laser energy transmission guide delivers laser energy from the proximal end of the cannula to the distal end which can be inserted to a tissue removal site within a patient. Reciprocating longitudinal motion of the cannula along with suction provided within the lumen can cause soft tissue to be suctioned into the lumen for removal. Laser energy contained within the lumen and directed by an optical delivery system can ablate soft tissue pulled within the lumen. The optical delivery system can further protect the terminal point of the laser energy transmission guide, from which, the laser energy can be delivered.

Abstract: Along with the advancement of cryoablation procedures, there have been developments resulting in technology that can use catheters adapted with cryogenic balloons containing two non-compliant membranes. These cryogenic balloons do not contact significant portions of the targeted tissue, which can result in a longer than desirable ablation procedure. It may be advantageous for these cryogenic balloons to conform to the targeted tissue more effectively than prior advancements have enabled. According to an exemplary embodiment of the present invention, an expansion chamber can contain an inner membrane and an outer membrane. In an exemplary expansion membrane, the outer membrane can conform to an anatomical structure during an ablation procedure and the inner membrane can facilitate a selective expansion of the outer membrane. In a further exemplary embodiment of the present invention, the inner membrane can be provided with a plurality of membranes.

Abstract: The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment, a deflectable sheath catheter includes an elongate catheter body having proximal and distal ends, a deflectable end section at the distal end of the catheter body, which upon deflection causes the distal end segment to bend into various curved positions within a plane of deflection, and a bent tip oriented in a direction that is out of the plane of deflection.

Abstract: Visual electrode ablation systems are described herein which include a deployment catheter and an attached imaging hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. An electric current may be passed through the fluid such that it passes directly to the tissue region being imaged and the electrical energy is conducted through the fluid without the need for a separate ablation probe or instrument to ablate the tissue being viewed.

Abstract: This invention is a circumferential ablation device assembly which is adapted to forming a circumferential conduction block in a pulmonary vein. The assembly includes a circumferential ablation element which is adapted to ablate a circumferential region of tissue along a pulmonary vein wall which circumscribes the pulmonary vein lumen, thereby transecting the electrical conductivity of the pulmonary vein against conduction along its longitudinal axis and into the left atrium. The circumferential ablation element includes an expandable member with a working length that is adjustable from a radially collapsed position to a radially expanded position. An equatorial band circumscribes the outer surface of the working length and is adapted to ablate tissue adjacent thereto when actuated by an ablation actuator.

Abstract: In some embodiments, without limitation, the invention comprises a catheter having an elongated housing with a channel disposed therein. A laser delivery member is movable and at least partially disposed within the channel. A ramp is disposed within the housing at an angle to its central axis and proximate to its distal end. The ramp is adapted to move the distal end of the laser delivery member outwardly from the central axis of the housing. A guidewire biases the distal end of the laser delivery member generally inwardly toward the central axis of the housing. In some embodiments, without limitation, the offset of the central axis of the tip of the laser delivery member from the central axis of the housing is determined by adjusting the extent to which the laser delivery member travels on the ramp, and disposition of the laser delivery member on the guidewire maintains the offset tip substantially parallel to the central axis of the housing.

Abstract: A system using bioelectric impedance to guide a flexible elongate transluminal device through an occlusion in a vessel. The device can be a guidewire or a device for performing an atherectomy, discectomy, ablation or similar technique. The device includes a first electrode disposed on a distal portion of the device. A second electrode is disposed in electric contact with the patient separate from the first electrode. An electric current is supplied between the first and second electrodes and a voltage drop is measured between the first and second electrodes. The voltage drop is converted to bioelectric impedance. Based on the impedance measurement, a clinician can determine if the device is approaching the vessel wall, permitting the clinician to redirect the device away from the vessel wall.

Abstract: Systems and methods for photodynamic ablation of cardiac tissue via an esophagus are disclosed. An exemplary system includes an ablation catheter having an expandable distal end for securing the ablation catheter in the esophagus. The distal end of the ablation catheter contains at least one light source operable to activate a photodynamic substance delivered to the target area of the cardiac tissue to be ablated and form a lesion. The system also includes at least one feedback device contained in the distal end of the ablation catheter. The at least one feedback device provides feedback for at least one of: positioning a distal end of an ablation catheter in a desired position in the esophagus adjacent a target area of the cardiac tissue to be ablated, forming an adequate lesion, and assessing lesion formation.

Abstract: Method and systems for accessing a Eustachian tube of a patient are disclosed. The system includes a guide configured for passing into a nasal passage of the patient to position a distal tip of the catheter at or near a Eustachian tube, the guide having distal tip with a bend having an angle between 30 and 90 degrees; and a guidewire configured to pass through the guide into the Eustachian tube.

Abstract: A method and apparatus wherein an application of energy is limited to a specific diseased portion of body tissue (target tissue) for the purpose of localizing the treatment to the target tissue and avoiding an adverse effect on surrounding tissue. In one embodiment, access to the target tissue is provided by inserting an energy transmission device through a needle for delivery of the energy into the target tissue. Guidance of the needle is alternatively enhanced through use of an image guidance device. Alternatively, in addition the localized treatment is further controlled by use of an energy-concentrating/enhancement agent and/or photosensitizing/photoselective agent, chromophore dye and viscous substance to cause selective interaction with a specific wavelength of an energy source. The treatment can be further controlled and localized by improving the accuracy and positioning of the delivery device into the target tissue using imaging guidance.

Abstract: Method and apparatus for the ionization of living cells where an optical device (14) delivers an optical pulse having an optical field power which is modified locally by an optical field power modifying means (18) to effect ionization and destruction of living cells (16).

Abstract: The present disclosure relates to devices that facilitate release of nitric oxide from one or more photolyzable nitric oxide donors.

Abstract: The illumination system is a cannula comprising a transparent or semitransparent material capable of carrying light from the proximal end of the cannula to the distal end of the cannula, thereby illuminating a surgical field. The surgical field is thus illuminated through components that do not occupy space that may otherwise by used for optics and or surgical tools. The illumination source may be optically coupled with the cannula at any appropriate location. The cannula comprises a sterilizable polymer which functions as a waveguide. A waveguide is a material medium that confines and guides light. When in use, the light source connected to the hub provides light which may be guided to the distal end of the cannula or any other suitable location. Thus, the sheath provides structure-guided illumination resulting in the illumination of the surgical site.

Abstract: A laser surgical method is disclosed including: providing a laser surgical device including a handpiece including: an optical delivery component that transmits laser energy from a source to a treatment volume; and an accelerometer configured to provide information indicative of the position of the handpiece. The method includes using the handpiece to transmit laser energy from the source to a plurality of positions within the treatment volume; using the accelerometer, providing information indicative of the position of the handpiece; determining information indicative of an amount of energy delivered at each of the plurality of positions within the treatment volume based on the information indicative of the position of the handpiece, and displaying a graphical representation indicative of the amount of energy delivered at each of the plurality of positions within the treatment volume.

Abstract: A laser surgical method is disclosed including: providing a laser surgical device including a handpiece including: an optical delivery component that transmits laser energy from a source to a treatment volume; and an accelerometer configured to provide information indicative of the position of the handpiece. The method includes using the handpiece to transmit laser energy from the source to a plurality of positions within the treatment volume; using the accelerometer, providing information indicative of the position of the handpiece; determining information indicative of an amount of energy delivered at each of the plurality of positions within the treatment volume based on the information indicative of the position of the handpiece, and displaying a graphical representation indicative of the amount of energy delivered at each of the plurality of positions within the treatment volume.

Abstract: Method and apparatus for the ionization of living cells where an optical device (14) delivers an optical pulse having an optical field power which is modified locally by an optical field power modifying means (18) to effect ionization and destruction of living cells (16).

Abstract: A process for treatment of biofilm resident or present at a mammalian treatment site applies shockwaves to remove, disrupt, disperse, dislodge, destroy or attenuate the biofilm. The shockwaves can be generated in a handheld instrument by impinging a laser on a suitable target material. Removal of biofilm from implantable surgical devices is also described.

Abstract: The invention provides a catheter for optical ablation of tissue in a living body, the catheter including: a distal end; a proximal end; an elongate catheter body coupled between the distal end and the proximal end; a light emission device at the distal end and configured to emit an ablation light having characteristics selected to regulate an optically regulatable transcription control element operably linked to a nucleic acid sequence for a gene product, the expression of which gene product in cells directly or indirectly kills cells; and a projection control mechanism coupled to the light emission device and configured to control an effectively illuminated area where the optically regulatable transcription control element is effectively regulatable by the ablation light projected from the light emission device. Also provided is a system which includes the catheter, and methods to prevent, inhibit or treat AF which employ an expression cassette and/or one or more selected wavelengths of light.

Abstract: An ablation device, including a catheter and an ablation element incorporating one or more balloons at the distal end of the catheter, has a continuous passageway extending through it from the proximal end of the catheter to the distal side of the expandable ablation element. The ablation device ablates tissue by subjecting it to ultrasound energy, cryogenic energy, chemical, laser beam, microwave, or radiation energy. A probe carrying electrodes is introduced through this passageway and deploys, under the influence of its own resilience, to a structure incorporating a loop which is automatically aligned with the axis of the expandable ablation device, so that minimal manipulation is required to place the probe. Pulmonary vein potential is monitored in real time via the electrodes. The probe may have an atraumatic tip with a ball formed at the leading edge. The atraumatic tip prevents any tissue damage such as perforation of heart wall.

Abstract: Devices and methods for visually confirming the positioning of a distal end portion of an illuminating device placed within a patient include inserting a distal end portion of an illuminating device internally into a patient, emitting light from the distal end portion of the illuminating device, observing transillumination resulting from the light emitted from the distal end portion of the illuminating device that occurs on an external surface of the patient, and correlating the location of the observed transillumination on the external surface of the patient with an internal location of the patient that underlies the location of observed transillumination, to confirm positioning of the distal end portion of the illuminating device.

Abstract: Methods and systems for resecting and debulking prostatic tissue to utilize a shaft carrying an energy source. The shaft is anchored by a balloon or other structure expanded in the bladder, and the energy source is capable of directing ablative energy radially outwardly from the urethra, where the energy source will be moved in order to remove a pre-defined volume of prostatic tissue.

Abstract: A surgical probe is disclosed which includes a stiff treatment waveguide extending between a first end and a second end, the first end being adapted for connection to a handpiece, the second end being adapted for insertion through an incision into an area of tissue. The treatment waveguide in configured to receive treatment light from the handpiece at the first end, transmit the light to the second end, and emit the light from the second end into a portion of the tissue proximal the second end. The treatment waveguide is adapted to penetrate through a portion of the area of tissue in response to pressure applied to the handpiece.

Abstract: Devices and methods provide for ablation of cardiac tissue for treating cardiac arrhythmias such as atrial fibrillation. Although the devices and methods are often be used to ablate epicardial tissue in the vicinity of at least one pulmonary vein, various embodiments may be used to ablate other cardiac tissues in other locations on a heart. Devices generally include at least one tissue contacting member for contacting epicardial tissue and securing the ablation device to the epicardial tissue, and at least one ablation member for ablating the tissue. Various embodiments include features, such as suction apertures, which enable the device to attach to the epicardial surface with sufficient strength to allow the tissue to be stabilized via the device. For example, some embodiments may be used to stabilize a beating heart to enable a beating heart ablation procedure. Many of the devices may be introduced into a patient via minimally invasive introducer devices and the like.

Abstract: The disclosure describes embodiments of systems and methods for surgical illumination, particularly for spinal procedures. Embodiments of the system comprise a surgical port that acts as an optical guide to guide light from an illumination conduit to an illuminator section. The illuminator section can be configured to direct light into a passage to illuminate a target area.

Abstract: Apparatus and method for performing surgical procedures within the mediastinum and within the pericardium include an endoscopic cannula having a transparent tip, and an endoscope for introduction into the mediastinum and optionally into the pericardium via a single subxiphoid incision. A cavity may be initially dilated for advancing the endoscopic cannula using a dilating tool that exerts a lateral-expansive force against surrounding tissue for evaluating the endoscopic cannula to be introduced into the mediastinum. Other surgical instruments are positioned through the endoscopic cannula to cut a flap of the pericardium as an opening through which other surgical apparatus may be introduced. The endoscopic cannula may be swept around selected regions of the heart through an aperture near the apex of the heart to facilitate placement of epicardial tacks about regions of the heart.

Abstract: The present application discloses embodiments of a surgical instrument to monitor a surgical site within a patient. In one embodiment, the instrument includes an elongated extender including a distal end and a proximal end. A body may be attached to the distal end of the extender. A plurality of light elements may be permanently attached to the body. The light elements may be spaced around the body and form a perimeter to provide dispersed light to the surgical site. An optical input member may be permanently attached to the body. The optical input member may include a distal end that faces outward away from the extender and towards the surgical site.

Abstract: An intravascular diagnostic or therapeutic apparatus capable of removing blood in an intravascular lumen to be observed using a minimally invasive method is provided. The apparatus includes high-intensity pulsed light generating means and high-intensity pulsed light transmitting means for transmitting high-intensity pulsed light, capable of irradiating the interior of a blood vessel with high-intensity pulsed light, producing water-vapor bubbles and temporarily removing the blood in the blood vessel.

Abstract: Sinusitis, enlarged nasal turbinates, tumors, infections, hearing disorders, allergic conditions, facial fractures and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies, endoscopic studies and transillumination studies. Access and occluder devices may be used to establish fluid tight seals in the anterior or posterior nasal cavities/nasopharynx and to facilitate insertion of working devices (e.g., scopes, guidewires, catheters, tissue cutting or remodeling devices, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting devices, substance delivery implants, etc.

Abstract: Various methods and devices for treating a patient who has lost, or is at risk of losing cardiac function by cardiac ischemia are disclosed. Treatment includes first imaging a patient's heart, or a portion thereof, to identify underperfused regions of cardiac muscle, and a source of oxygenated blood that is proximate to the underperfused region. Between the underperfused regions and the oxygenated blood source, a target area is selected where thermal or mechanical injury is introduced, and optionally reintroduced, to convert initial capillary blush, resulting from the injury.

Abstract: The invention discloses a medical device and methods for site-specific diagnosis, energy therapy, sampling, and drug delivery in vivo with a catheter having at least a self-expandable piercing element and a drug delivery conduit.

Abstract: An active endoscopic system is disclosed containing an electromagnetic radiation system located at the distal end of the endoscopic device allowing for variable intensity application of desired wavelengths in the application of PhotoDynamic Therapy (PDT) over a broad area. The power sources are varied according to the needs of a specific application. Various attachments and configurations may be used to enhance performance of a desired application, including but not limited to multi-balloon systems for centering the apparatus or limiting the treatment area, fiber optics for directly viewing the treatment area, vacuum systems for waste removal, tubes for delivering aminolevulinic acid (ALA) or other photosensitizers, and other fiber optics for illumination of treatment area.

Abstract: A surgical access system for providing access to a surgical site in a patient includes a surgical access device defining a working channel for accessing a surgical site and an integrated light emitter for illuminating the surgical site. The light emitter is integrated in proximity to a distal end of the surgical access device. In some embodiments, the light emitter is offset from the distal end. In certain embodiments, the integrated light emitter includes a light transmission medium for transmitting light from a proximal end of the access device to the distal end.

Abstract: An apparatus for cutting or ablating hard tissue, includes an optical cavity; a gain medium disposed within the optical cavity; a diode light pump disposed within the optical cavity and optically aligned to light pump the gain medium to generate laser light. The generated laser light has a wavelength and power density suitable for cutting and ablating hard tissue.

Abstract: An ophthalmic laser treatment apparatus which irradiates a laser beam to a patient's eye to be treated is disclosed. The apparatus includes: a first optical fiber which delivers a first laser beam emitted from a first laser source; a first light delivery optical system which forms an image of an emission end surface of the first optical fiber on the affected part of the eye in a predetermined first spot size being in a range of 50 ?m to 1000 ?m; a second optical fiber which delivers a second laser beam emitted from a second laser source; and a second light delivery optical system which forms an image of an emission end surface of the second optical fiber on the affected part of the eye in a predetermined second spot size in a range of 500 ?m to 7000 ?m.

Abstract: Apparatus and methods are provided for thermally and/or mechanically treating tissue, such as valvular structures, to reconfigure or shrink the tissue in a controlled manner. The apparatus comprises a catheter in communication with an end effector which induces a temperature rise in an annulus of tissue surrounding the leaflets of a valve or in the chordae tendineae sufficient to cause shrinkage, thereby causing the valves to close more tightly. Mechanical clips can also be implanted over the valve either alone or after the thermal treatment. The clips are delivered by a catheter and may be configured to traverse directly over the valve itself or to lie partially over the periphery of the valve to prevent obstruction of the valve channel. The clips can be coated with drugs or a radiopaque coating. The catheter can also incorporate sensors or energy delivery devices, e.g., transducers, on its distal end.

Abstract: This invention is directed to an energy irradiation apparatus including an insertion portion (3) which includes a hollow cylindrical member (14) having a sealed distal end portion and is inserted into a living body, and an energy irradiation portion (20) which applies energy to living tissue through an irradiation window portion (17) which is provided on a side wall of the hollow cylindrical member (14) to extend in the longitudinal direction. This apparatus includes a driving unit which reciprocates with substantially a constant velocity the laser irradiation portion (20) in the direction indicated by an arrow D along the longitudinal direction of the irradiation window portion (17). With this structure, the energy irradiation apparatus can uniformly irradiate a lesion with energy.

Abstract: A medical needle set for visualized tissue ablation within a subject's body includes a cannula and components configured for inclusion in the cannula, including a trocar for occlusion of the cannula lumen during needle placement, and a visualizing ablation probe used for simultaneous endoscopic viewing and ablation of tissue sites with a laser beam. The cannula can include a tissue-gripping surface for stabilization of the needle set on the target tissue. A surgical system for tissue ablation includes a visualizing ablation needle set operably connected to an endoscope and a laser. A surgical procedure using this system permits simultaneous visualization and ablation of tissues, including those of the facet joints of the spine.

Abstract: A securing apparatus for selectively securing an ablating element of an ablation instrument proximate to a targeted region of a biological tissue. The securing apparatus includes a support base affixed to the ablation instrument relative the ablating element, and having a support face adapted to seat against the biological tissue proximate to the ablation element. The support base further defines a passage having one end communicably coupled to a vacuum source and an opposite end terminating at an orifice at the support face. The support face together with the biological tissue forms a hermetic seal thereagainst during operation of the vacuum source to secure the ablation instrument thereagainst. Essentially, the hermetic seal and the vacuum source cooperate to form a vacuum force sufficient to retain the ablation device against the biological tissue.

Abstract: To provide a medical energy irradiation apparatus which, having a simple and inexpensively manufacturable structure, enables a doctor using it in the heat curing of prostatic hypertrophy or the like to accurately and stably irradiate a prescribed site deep in a living body with a laser beam and, even if its observation window is smeared, to observe tissues of a living body. An inserting portion of the medical energy irradiation apparatus to be inserted into a living body according to the invention has an emitting portion for emitting a laser beam toward tissues of the living body; an observation window, provided near the tip of the inserting portion in its inserting direction, for observing the tissues of the living body; and a hollow pipe for supporting a supporting member, which supports the emitting portion, shiftably in the lengthwise directions of the inserting portion and feeding detergent to the observation window.

Abstract: A modified vacuum assisted wound closure system adapted for concurrent applications of phototherapy having a foam pad for insertion substantially into the wound site and a wound drape for sealing enclosure of the foam pad at the wound site. The foam pad includes an optical pigtail, whereby desired wavelength of light may be directed into and about the wound site. The foam pad is placed in fluid communication with a vacuum source for promotion of fluid drainage. The foam pad is made of a highly reticulated, open-cell polyurethane or polyether foam for good permeability of wound fluids while under suction and is also embedded with an optical pigtail. The optical pigtail comprises an optical fiber that has been formed to fan into a plurality of sections. The fibers of the most distal fanned sections, which are implanted in the foam pad at its base, are provided with tiny optical slots, oriented away from the foam pad and toward the wound site.

Abstract: A scanning optical system for delivering electromagnetic radiation onto tissue to be treated is cooperative with a lightguide or optical fiber. Radiation to be delivered is provided by a source thereof via the optical fiber. The optical system includes an optical projection arrangement comprising a plurality of lenses cooperatively arranged with the lightguide. A first of the lenses is arranged to receive radiation emerging from the lightguide. The beam of radiation is passed through the projection arrangement to form a treatment spot the radiation on the tissue. Scanning is effected by causing relative motion between the exit-end of said lightguide and at least the first lens, transverse to the optical axis of the projection arrangement. The treatment spot undergoes a related transverse motion over the tissue. In one example scanning is effected by moving the first lens with the lightguide fixed. The first lens is moved using an arrangement of piezo-electric actuators.

Abstract: Devices and methods for creating a series of percutaneous myocardial revascularization (PMR) channels in the heart. One method includes forming a pattern of channels in the myocardium leading from healthy tissue to hibernating tissue. Suitable channel patterns include lines and arrays. One method includes anchoring a radiopaque marker to a position in the ventricle wall, then using fluoroscopy repeatedly to guide positioning of a cutting tip in the formation of multiple channels. Another method uses radiopaque material injected into each channel formed, as a marker. Yet another method utilizes an anchorable, rotatable cutting probe for channel formation about an anchor member, where the cutting probe can vary in radial distance from the anchor. Still another method utilizes a multiple wire radio frequency burning probe, for formation of multiple channels simultaneously. Still another method utilizes liquid nitrogen to cause localized tissue death.

Abstract: This invention discloses a medical catheter and methods for removing a defective valve from a patient endoluminally. The method may comprise inserting a medical catheter endoluminally to a site of the defective valve; deploying a coupling mechanism of said medical catheter to stabilize and immobilize a free edge of at least one valve leaflet; deploying a cutting mechanism of said medical catheter to cut a valve base of said defective valve; and removing said defective valve from the patient.

Abstract: A system and method of marking percutaneous myocardial revascularization channels in a human heart and introducing into the channels a therapeutic or diagnostic agent by inserting a catheter system into the left ventricle of a heart, applying tissue ablative energy through the catheter to create a channel into the heart wall, introducing an imaging medium to the heart wall proximate the channel for marking the position of that channel for imaging, and introducing in or proximate the channel a therapeutic or diagnostic agent.

Abstract: A medical needle set for visualized tissue ablation within a subject's body includes a cannula and components configured for inclusion in the cannula, including a trocar for occlusion of the cannula lumen during needle placement, and a visualizing ablation probe used for simultaneous endoscopic viewing and ablation of tissue sites with a laser beam. The cannula can include a tissue-gripping surface for stabilization of the needle set on the target tissue. A surgical system for tissue ablation includes a visualizing ablation needle set operably connected to an endoscope and a laser. A surgical procedure using this system permits simultaneous visualization and ablation of tissues, including those of the facet joints of the spine.