Abstract: A system for light based interrogation of a lung includes a memory, an electromagnetic (EM) board, an extended working channel (EWC), an EM sensor, a light source, a light receptor and a processor. The memory stores a 3D model and a pathway plan of a luminal network and the EM board generates an EM field. The EWC navigates a luminal network of a patient toward a target in accordance with the pathway plan and the EM sensor extends distally from a distal end of the EWC and is configured to sense the EM field. The light source is located at or around the EWC and is configured to emit light, and the light receptor is located at or around the EWC and is configured to sense reflected light from airway of the luminal network. The processor converts the reflected light into light based data and identifies a type of tissue.

Abstract: In some embodiments, a method of ameliorating diastolic dysfunction may include positioning at least a distal end of a system for cutting a trabeculae carneae in a left ventricle of a human heart. The system may include an elongated member, a grip, an engaging portion, and a cutting device. A second end of the engaging portion may turn in upon the engaging portion towards a first end of the engaging portion while still allowing trabeculae carneae to enter through an opening between the first and second ends. The cutting device may be positioned within an inner diameter of the engaging portion. The method may include positioning at least one trabeculae carneae in the inner diameter of the engaging portion. The method may include severing the at least one trabeculae carneae. The method may include increasing left ventricular compliance of the human heart.

Abstract: A device includes an optical delivery fiber having a core having a first inside diameter joined to a capillary having an outer surface and a capillary tube having an inner surface. The capillary tube has a second inside diameter in the region of the joining to the optical delivery fiber. The second inside diameter is less than the first inside diameter of the delivery fiber.

Abstract: An optical fiber device may include a unitary core including a primary section and a secondary section, wherein at least a portion of the secondary section is offset from a center of the unitary core, wherein the unitary core twists about an optical axis of the optical fiber device along a length of the optical fiber device, and wherein a refractive index of the primary section is greater than a refractive index of the secondary section; and a cladding surrounding the unitary core.

Abstract: Devices and methods for use in laser-assisted surgery, particularly cataract surgery. Specifically, the use of an optical fiber with a proximal and distal end, wherein the distal end has a non-orthogonal angle with the diameter of the optical fiber, to create an off-axis steam bubble for cutting and removing tissue in an operative region. Where the optical fiber is bent, rotating the fiber creates a circular cutting path for the steam bubble, allowing access to tissues that may normally be blocked by obstructions and obstacles.

Abstract: According one exemplary embodiment of the present invention, method and system can be provided for applying a laser radiation to at least one portion of a biological structure. For example, a beam of the laser radiation can be provided to the portion, whereas a cross-sectional area of the beam is at most about 1/10th of an entire area of the at least one portion. The beam can be applied to the portion (a) based on a predetermined pattern, (b) while modulating a wavelength of the laser radiation, and/or (c) while monitoring a depth of the application of the laser radiation.

Abstract: A system for ablation and removal of occlusions from blood vessels is provided. Laser cutting systems and mechanical cutting systems are provided in catheter devices, the cutting systems operable to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Aspiration systems are further provided, the aspiration systems operable to remove ablated, cut, or dislodged material through a primary orifice at the distal end of the catheter and/or through an auxiliary orifice, which may be on the side of the catheter.

Abstract: A reflective filter serving as a multi-bandpass filter for a light source configured to emit light in a plurality of color primary wavelengths to improve color purity. The addition of a reflective/recirculation assembly reinforces and recirculates light not passed by the multi-bandpass filter back into a desired spectrum, which is subsequently passed by the multi-bandpass filter, or converts light not passed by the multi-bandpass into electrical energy for use by the system. The reflective filter, solely or along with the recirculation assembly, can be placed adjacent a conventional light source. Alternatively the multi-bandpass filter and the recirculation assembly can be placed in a modified light source, or placed in an optical stack along the path of light emission. Collimating structures that enforce the light into desired incident angle of attack onto the reflective filter can be included to enhance the efficiency of the reflective elements in the assembly.

Abstract: A redirecting delivery catheter includes a first longitudinal member having an inner chamber configured to receive a second longitudinal member, an outer surface surrounding the inner chamber, a first region located at a proximal end, a second region located at a distal end, and a length. An opening in the outer surface extends along a portion of the length of the first longitudinal member between the first region and the second region. A deflecting mechanism is located proximate to the opening and is configured to be capable of transforming from a first position to a second position. The deflecting mechanism is configured to enable the second longitudinal member to access the second region in the second position and to deflect the second longitudinal member towards the opening in the first position. Methods of use of the redirecting delivery catheter are also disclosed.

Abstract: A non-cylindrical hypotube is disclosed, such as for use in OCT and endoscopy. The hypotube is defined by a non-cylindrical, rotationally symmetric tube and has an interior, a proximal-end section with an outer diameter D1, a distal-end section with an outer diameter D3, and a middle section between the proximal-end and distal-end sections and having an outer diameter D2, wherein D2<D1, and D2<D3. The distal-end section is sized to accommodate the optical probe and includes an outer surface with an aperture that allows for optical communication therethrough.

Abstract: An apparatus comprises an instrument including an elongated shaft. The apparatus also comprises a first shape sensor including an elongated optical fiber extending within the elongated shaft at a first radial distance from the neutral axis. The apparatus also comprises a twist resistant feature configured to reduce twisting of the elongated optical fiber relative to the elongated shaft while permitting axial translation of the elongated optical fiber within the elongated shaft.

Abstract: A pre-assembled, telescoping needle system comprising an outer needle surrounding a finer gauge needle which, after percutaneous penetration by the outer needle, extends to penetrate the intervertebral disc into which the injectable is to be delivered.

Abstract: Systems and methods for aligning directionally operable medical devices with and upon target tissue. Systems and methods for aligning medical devices such as directional ablation catheters to and upon target tissue by monitoring irrigant backpressure. The current disclosure provides solutions to the problem of rotationally or angularly aligning a directional medical device toward tissue.

Abstract: An ablation therapy system is disclosed comprising an ablation catheter system for treating atrial fibrillation (AF). The ablation catheter system comprises a catheter body including a lumen for receiving a visualization catheter, an ablation element for ablating tissue in a patient's heart having abnormal electrical activity, a support assembly for supporting the ablation element, the support assembly being supported by the catheter assembly. The support assembly includes a lumen to receive the visualization catheter, wherein the support assembly is configured to rotate and/or pivot with respect to the catheter body.

Abstract: Methods and systems for modifying tissue use a pressurized fluid stream carrying coherent light energy. The methods and systems may be used for resecting and debulking soft and hard biological tissues. The coherent light is focused within a stream of fluid to deliver energy to the tissue to be treated.

Abstract: The present invention provides a light transmittable and tissue integration integrable biofiber device including a plurality of biofibers. The plurality of biofibers consist a single bare fiber or a single constructed fiber. The single constructed fiber consists a core layer and either a single cladding layer or a plurality of cladding layers, and the cladding layer clads and fuses a circumferential surface of the core layer. Each of the plurality of biofibers comprises a light receiving end and a light emitting end, a light radiates through the light receiving end and the light is emitted from the a light emitting end. Therefore, the biofiber device of the present invention may simultaneously accomplish light transmittable and tissue integrable purposes to facilitate light therapy, optical gene therapy and optogenetics.

Abstract: Systems and methods for treating a lung disease including capturing a first set of images of at least a portion of a lung displaying symptoms of a lung disease, generating a three dimensional model from the first set of images, locating a target nerve proximate the portion of the lung, generating a treatment plan, and on-invasively denervating the target nerve based on the treatment plan such that the function of the portion of the lung is affected.

Abstract: Systems and methods for treating a lung disease including capturing a first set of images of at least a portion of a lung displaying symptoms of a lung disease, generating a three dimensional model from the first set of images, locating a target nerve proximate the portion of the lung, generating a treatment plan, and on-invasively denervating the target nerve based on the treatment plan such that the function of the portion of the lung is affected.

Abstract: An ultraviolet irradiation system includes a medical device having a central lumen, an optical fiber having a longitudinal length, and an ultraviolet wave generator, wherein ultraviolet waves generated by the wave generator are dispersed along the longitudinal length of the optical fiber to disinfect the central lumen of the medical device.

Abstract: Apparatus and method for optical spectroscopy and/or imaging with a variable fiber offset. An optical probe includes one or more first optical fibers, one or more second optical fibers, and one or more actuators. The first optical fibers are to deliver light to an object. The second optical fibers are to collect light emitted from the object. The actuators are configured to change a distance between the first optical fibers and the second optical fiber while the object is being illuminated by light emitted from the first optical fibers.

Abstract: The invention provides a photodynamic therapy-based method for treating ocular glaucoma. A photosensitizer, for example, a benzoporphyrin derivative photosensitizer, is administered to a mammal either having or at risk of developing ocular glaucoma. The photosensitizer, when present in the ciliary body, is activated by light, for example, light from a laser. The treatment results in a reduction of intraocular pressure within the treated eye, which can persist for a prolonged period of time.

Abstract: A catheter enables real-time light measurements, for example, without limitation, diffuse reflectance, fluorescence, etc., from biological materials, such as tissue (including blood), while performing RF ablation. The catheter tip design isolates illumination and collection paths within the tip electrode such that light for illuminating the tissue of interest (e.g., cardiac tissue or blood) is isolated within the tip electrode from light that returns from the tissue to the catheter tip, and vice versa. Such a design advantageously avoids saturation of the optical detector, and ensures diffusion of the illumination light within the medium of interest. The catheter has a catheter body and a tip electrode with a shell wall and a hollow cavity. The shell wall has at least an illumination opening and a collection opening.

Abstract: A device for resecting undesired tissue from an inner wall of a body cavity, the device having a tip section in a shape of a cylinder's sector, the tip section comprising: a plurality of optical fibers located along an inner surface of the tip section and configured to transmit laser radiation to the undesired tissue; and a cutter having a shape of a cylinder's sector located inwardly or outwardly to the plurality of optical fibers, wherein said cutter is configured to cut through the undesired tissue and thereby detach at least a part of the undesired tissue from the inner wall of the body cavity.

Abstract: A method of treating a mobile target tissue with a laser beam includes: providing a laser device for generating a laser beam and providing an optical fiber having a delivery end for guiding the laser beam to the target tissue; a controller causes the laser device to generate one or more laser pulses substantially along the same longitudinal axis. The controller causes the laser device to provide one or more laser pulses. The one or more pulses are selected to allow a vapor bubble formed by the one or more pulse to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the delivery end of the fiber and the target tissue. The one or more pulses are delivered to the target tissue through the vapor bubble after the vapor bubble has reached its maximum extent and has begun to collapse to reduce retropulsion of the mobile target tissue.

Abstract: An end-firing optical fiber includes protective ferrule through which treatment radiation is fired in an axial direction, the protective ferrule having refractive properties that cause the radiation to disperse laterally and/or the fiber having sufficient flexibility to enable the fiber to be aimed at a tissue situated to the side of the axis along which the fiber was inserted. The fiber and protective ferrule may be mounted in a cannula, with the cannula being sufficiently flexible to enable the cannula to be withdrawn into a scope having a straight working channel, but has a pre-formed curvature that enables treatment of lateral tissues when the cannula is extended out of a scope.

Abstract: A feeding tube assembly comprising a feeding tube body and an optical system. The feeding tube body includes an administration lumen and an optical lumen. The optical lumen is isolated relative to the administration lumen, with the distal end opening corresponding to the distal opening of the administration lumen. The optical system includes an optical element and an end dispersion element. The optical element is positioned within the optical lumen and the first end of the optical element is attachable to a fiber optic line. The end dispersion element is positioned at the second end of the optical element and is structurally configured to disperse light transmitted through the optical element.

Abstract: Systems and methods for performing RF ablation while monitoring the procedure using low coherence interferometry (LCI) data are described. A catheter includes a distal section, a proximal section, a multiplexer, and a sheath coupled between the distal section and the proximal section. The distal section includes several interconnected optical ports configured to transmit exposure radiation toward a sample and receive radiation that have been reflected or scattered from the sample. The interconnected optical ports are formed on a substrate having rigid sections and flexible sections arranged around the distal section. A holder maintains the interconnected optical elements in a fixed spatial relationship.

Abstract: Aspects of this disclosure pertain to a device with an elongated body having a distal end. The distal end may comprise a port that permits discharge of a laser energy towards a tissue from an optical fiber located in the distal end. An exterior surface of the distal end may include a cauterization portion that permits discharge of a cauterization energy towards the tissue. In some aspects, the device includes an insulative portion that attaches the distal end to the elongated body and limits energy transfer therebetween. Related systems and methods are also disclosed.

Abstract: The present disclosure relates to a system and method for providing laser energy through a catheter towards a second end portion of the catheter. Based on a characteristic of the laser energy multiple types of ablation therapy may be implemented. A first ablation therapy is directed at the target site when the laser energy at the second end portion of the laser energy delivery system has a first characteristic. A second ablation therapy is directed at the target site when the laser energy at the second end portion of the laser energy delivery system has a second characteristic. The first ablation therapy may be an optical ablation therapy wherein the laser energy is directed at the target site as optical energy and the second ablation therapy may be a pressure wave ablation therapy wherein pressure waves are directed at the target site as pressure wave energy.

Abstract: Systems and methods for performing RF ablation while monitoring the procedure using low coherence interferometry (LCI) data are described. A catheter includes a distal section, a proximal section, a multiplexer, and a sheath coupled between the distal section and the proximal section. The distal section includes several interconnected optical ports configured to transmit exposure radiation toward a sample and receive radiation that have been reflected or scattered from the sample. The interconnected optical ports are formed on a substrate having rigid sections and flexible sections arranged around the distal section. A holder maintains the interconnected optical elements in a fixed spatial relationship.

Abstract: A surgical instrument is configured to concurrently dissect and coagulate tissue. The surgical instrument includes a handle and a shaft extending distally from the handle. The shaft includes an outer hypotube, a lumen coaxially-disposed within the hypotube and extending beyond a distal end thereof, a coaxial feedline coaxially-disposed within the lumen, and having an inner conductor and an outer conductor disposed coaxially about the inner conductor, and a coolant tube coaxially-disposed between the lumen and the coaxial feedline to form an inflow conduit and an outflow conduit. The instrument further includes a dissecting head assembly coupled to a distal end of the shaft. The dissecting head assembly includes a dielectric core having a substantially planar radiating surface and at least one non-radiating surface, a reflective coating disposed on the at least one non-radiating surface of the dielectric core, and a blade extending from the radiating surface.

Abstract: A system and method for treating target tissue including a light source for generating a beam of light, a plurality of optical fibers, a deflection device configured to selectively deflect the light beam into the input ends of the optical fibers, one optical fiber input end at a time, and a probe having a tip with the output ends of the optical fibers and configured for insertion into target tissue. The probe tip is configured to sequentially project spaced apart spots of the light beam from the output ends as the deflection device deflects the light beam into the optical fibers. One or more moving or static deflecting optics at the probe tip can be used to statically or dynamically deflect the beam exiting the optical fibers.

Abstract: Devices and methods for fluid enhanced ablation therapy using microwave antennas are described herein that provide improved heat transfer into a target volume of tissue and improved antenna cooling compared to prior art designs. In one embodiment, fluid can be introduced into a target volume of tissue along with the delivery of therapeutic energy from a microwave antenna positioned within the target volume of tissue. The fluid can become heated by cooling the microwave antenna and, if additional heating of the fluid is desired, a heating element disposed within the microwave antenna can supplementally heat the fluid prior to introduction into the target volume of tissue.

Abstract: A steerable laser probe may include a handle having a handle distal end and a handle proximal end, an auto-fixing actuation control, a flexible housing tube having a flexible housing tube distal end and a flexible housing tube proximal end, a first flexible housing tube portion having a first stiffness, and an optic fiber disposed within an inner bore of the handle and the flexible housing tube. An actuation of the auto-fixing actuation control may gradually curve the flexible housing tube. A gradual curving of the flexible housing tube may gradually curve the optic fiber.

Abstract: The present invention relates to a method, device, and system for improved mapping and/or ablation of a tissue. The device may generally include an elongate body and a distal assembly affixed to the elongate body that includes a treatment electrode having a conductive mapping region and a selectively conductive ablation region that is conductive of high-frequency current and substantially non-conductive of low-frequency current. Alternatively, the device may generally include a treatment electrode having a conductive mapping or ablation region and a region that is coated with an electrically insulated but thermally conductive layer.

Abstract: System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, the curved cannula comprising a curved distal end configured to be extended outward from the distal opening to generate a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured to allow a treatment device to be delivered through the central passageway to a location beyond the curved path.

Abstract: Systems and methods for accessing, stabilizing and sealing a device attached to a tissue surface comprising a tissue attaching device having an outer base ring defining an opening therethrough and a distally projecting tissue attachment element. The systems variously utilize annular sealing flanges distally attached to the outer base ring outside or inside the tissue attachment element to create a fluid tight seal. The systems variously utilize coils with regions of differing pitch to create sealing tissue pressure. Methods for installing an apical attaching device with a transapical port into a patient, comprising assessing the patient's viability for installation of the apical attaching device by determining an Index of Tissue Elasticity (ITE).

Abstract: The present disclosure provides, according to some embodiments, methods and systems for selectively reducing, blocking or inhibiting at least part of the neural activity in an organ of a subject. In preferred embodiments, the method and system are used for selectively blocking at least part of the neural activity in a duodenum of a subject in need thereof. According to some embodiments, the selective blocking occurs through use of laser radiation. According to some embodiments, the selective blocking comprises causing damage to at least part of sensory nerves located within a target area while maintaining functional activity of tissue surrounding the sensory nerves. According to some embodiments, the sensory nerves include neurons configured to transmit signals triggered by food passing through the duodenum, such as, but not limited to, neurohormonal signals.

Abstract: A medical laser system and related methods of utilizing cooling within and around an optical fiber tip to prevent premature failure of the optical fiber. The optical fiber is surrounded by protective jacket assembly including a body tube assembly and a tip cap assembly. The body tube assembly includes an internal fiber jacket and an external body tube with a body tube channel defined therebetween. The tip cap assembly includes an inner cap member and an outer cap member defining a cap irrigation channel therebetween. Together, the cap irrigation channel and body tube channel cooperatively define an internal irrigation channel. The optical fiber can be delivered to a treatment location through a cystoscope. Saline is directed through an external irrigation channel between the cystoscope and the protective jacket assembly as well as the internal irrigation channel to cool the fiber tip and prevent overheating and failure of the optical fiber.

Abstract: A system for preventing inadvertent actuation of a medical device. The system includes an elongate tube having a proximal end, a distal end, and a lumen extending from the proximal end to the distal end. The lumen is configured to receive a medical device configured to transition between an actuated state and an inactive state. The device further includes a detection system configured to determine a position of a distal end of the medical device relative to the distal end of the elongate tube. The detection system includes a transmitting element and a receiving element.

Abstract: According to an embodiment of the present application, there is provided a medical apparatus, including: a light source unit configured to be capable of emitting light including at least natural emission light, the light being guided into an optical probe; a first detecting unit configured to detect an intensity of light exiting from the light source unit; and a calculation unit configured to calculate to approximate to a non-linear function based on an intensity of light detected by the first detecting unit for calibration of the optical probe.

Abstract: Compositions and methods for changing a property of a coating are provided. The coating includes a dynamic material configured to be reversibly convertible between a hydrophobic state and a hydrophilic state, wherein transition between the hydrophilic state to the hydrophobic state occurs in an environment dependent manner. The coating also includes an environment altering material configured to alter the hydrophobic or hydrophilic state of the dynamic material.

Abstract: A method of optimizing the irradiation of a target with laser radiation includes selecting and mounting on a laser radiation delivery device either a waveguide or optical fiber type to be used; also, selecting at least the following parameters: selecting the total energy of the at least one train of pulses to be delivered to the target, and selecting the distance from the distal delivery end to the target; then, initiating irradiation of the target for the at least one train of pulses by generating a first laser pulse with sufficient energy (Ei) to form a vapor bubble in a liquid medium; allowing the vapor bubble formed to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the distal delivery end and the target; and, thereafter, after the selected time delay (Td) sufficient for the formed vapor bubble to reach its optimum extent, generating a second laser pulse (Ep), the second laser pulse being delivered to the target through the formed vapor bubble.

Abstract: A system for ablation and removal of occlusions from blood vessels is provided. Laser cutting systems and mechanical cutting systems are provided in catheter devices, the cutting systems operable to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Pulsed aspiration systems are further provided, the pulsed aspiration systems operable to remove ablated, cut, or dislodged material without excessive or unnecessary removal of blood and fluid.

Abstract: An optical fiber tip attachment comprising: a body having an opening at a first end of the body, the opening configured to receive an optical fiber; and a cavity extending from the opening through at least a portion of the body, wherein the cavity is configured to orient a cross-sectional surface of the optical fiber, from which electromagnetic radiation is delivered, at an angle to an axis of the optical fiber tip attachment at the opening.

Abstract: Described here are angioplasty balloon devices for generating shock waves to break up calcified plaques along a length of a vessel and methods of making such devices. Generally, the devices may be used in angioplasty and/or valvuloplasty procedures, but may alternatively be used in other applications. In some variations, the device may include an elongate member, a plurality of electrode assemblies, and at least one tubular sleeve interposed between adjacent or neighboring electrode assemblies that form a continuous outer profile between the electrode assemblies. These devices may have a smooth, continuous outer profile without substantial profile transitions and/or may have stiffening sections between electrode assemblies.

Abstract: A surgical apparatus is disclosed for delivering a therapeutic device to a desired location within the vasculature of a patient, which includes an elongated tubular body defining a longitudinal axis and having opposed proximal and distal end portions, the tubular body including an outer wall surrounding an interior lumen, wherein an elongated target opening is formed through the outer wall of the tubular body within the distal end portion thereof in communication with the interior lumen. At least one distal sensing electrode is provided on the tubular body adjacent a distal side of the target opening, and at least one proximal sensing electrode is provided on the tubular body adjacent a proximal side of the target opening, wherein the sensing electrodes allow placement of the target opening within the vasculature of a patient for the delivery of a therapeutic device to a desired location.

Abstract: Methods and systems for nanopillar sensors are described. Nanopillars can be defined on a substrate, and metal deposited on the nanopillars. A thermal treatment can reflow the metal on the nanopillars forming metallic bulbs on the top end of the nanopillars. These structures can have enhanced optical detection when functionalized with biological agents, or can detect gases, particles and liquids through interaction with the metal layer on the nanopillars.

Abstract: A system for irradiation of a vascular space and its contents is presented. An adapter device having a vascular access end and an optical interface end can include a waveguide affixed within a waveguide lumen and extending outwardly through the vascular access end. The optical interface end includes a tapered terminus configured to engage with a cavity of an optical connector adapter, creating an optical interface between the waveguide of the adapter device and a waveguide of a light or radiation source. The adapter device enables the simultaneous administration of radiation and exogenous fluids to a patient while maintaining the optical interface isolated from any fluids.

Abstract: Apparatus and methods for ablation efficacy are described herein where a hood having a deployable elongated feature can extend beyond a distal face of the hood. The elongated feature can channel the energy to the deeper regions within the tissue (such as trabeculated regions or other tissue structures) such that the energy can be delivered to the target tissue despite small or large irregularities in the target tissue surface (or region) and/or changes in the relative distances between the hood and the target tissue.