Abstract: A novel medical probe assembly, system, and methods for the use thereof to treat tissue are described. The system optionally comprises an energy source, two probe assemblies, and one or more cooling devices to provide cooling to at least one of the probe assemblies. The probe assemblies may be configured in a bipolar mode, whereby current flows preferentially between the probe assemblies. The probe assemblies and system described herein are particularly useful to deliver radio frequency energy to a patient's body. RF energy delivery may be used for various applications, including the treatment of pain, tumor ablation and cardiac ablation.

Abstract: The invention relates to a medical device, including interchangeable parts thereof, for performing corneal cell freezing wherein said device comprises an elongate member having a flow line system through which a cryogenic fluid flows to cool a cryoprobe tip which tip is fixed and comprises a concave epithelial surface contact member.

Abstract: Methods and apparatus for the treatment of a body cavity or lumen are described where a heated fluid and/or gas may be introduced through a catheter and into treatment area within the body contained between one or more inflatable/expandable members. The catheter may also have optional pressure and temperature sensing elements which may allow for control of the pressure and temperature within the treatment zone and also prevent the pressure from exceeding a pressure of the inflatable/expandable members to thereby contain the treatment area between these inflatable/expandable members. Optionally, a chilled, room temperature, or warmed fluid such as water may then be used to rapidly terminate the treatment session.

Abstract: A cryoablation system includes thermally insulated containers for holding liquid refrigerant. The containers are placed in a docking station that charges the containers with a liquid refrigerant at a cryogenic temperature suitable for carrying out a surgical procedure. The charged containers are detachably connectable with an inlet line of a cryoablation probe. When the cryoprobe is activated, the chilled liquid refrigerant is transported from a delivery container, through the cryoprobe, and to a recovery container. The recovery container is preferably identical in design to the delivery container. The refilled recovery container is then placed in the docking station to charge. In another embodiment, a cartridge includes a delivery container and recovery container combined as a single unit. Methods are also described.

Abstract: A cryotherapy catheter can include an elongate member and an inflatable balloon at a distal end of the elongate member, the elongate member having lumens formed therein to supply cryogenic fluid to a chamber of the balloon and to channel exhaust from the balloon chamber; and a controller programmed to control a first rate at which the cryogenic fluid is supplied to the balloon chamber and a second rate at which exhaust is channeled from the balloon chamber, wherein the controller is programmed to a) develop, during a first phase of a cryotherapy procedure, a first pressure inside the balloon chamber at a value that is greater than an ambient pressure outside and adjacent to a proximal end of the elongate member, and b) develop, during a second phase of the cryotherapy procedure, the first pressure at a value that is less than the ambient pressure.

Abstract: A method in which a location is determined on the skin that is proximate to a sensory nerve that is associated with a painful condition. At least one needle of a cryogenic device is inserted into the location on the skin such that the needle is proximate to the sensory nerve. The device is activated such that the at least one needle creates a cooling zone about the sensory nerve, thereby eliminating or reducing severity of the painful condition.

Abstract: A medical system, comprising an ablation catheter is disclosed. The ablation catheter includes an elongate shaft with a proximal end, a distal end and a lumen disposed between the proximal end and the distal end. The ablation catheter also includes an expandable element in fluid communication with the lumen, a first temperature sensor operable to measure a first temperature; and a second temperature sensor operable to measure a second temperature. The first temperature sensor and the second temperature sensor are longitudinally separated from each other by at least a portion of the expandable element.

Abstract: The present disclosure relates to a thermal ablation probe device that integrates deployable sensors with a freezing probe or heating probe for use in ablating tissues. The ablation probe includes a longitudinal body including a thermal ablation energy source which may be, e.g., a cryosource or a heat source. The longitudinal body has a proximal end and a distal end terminating at a probe tip; and at least one deployable assembly disposed within the longitudinal body. The deployable assembly includes a flexible and substantially rigid deployment member, and at least one sensor affixed to a distal end of the deployment member. The ablation probe further includes a control mechanism for controlling deployment and retraction of the deployable assembly.

Abstract: A medical apparatus and system for determining contact assessment includes a catheter having an elongate body having a proximal end, a distal end opposite the proximal end, and defining an injection lumen and an exhaust lumen, an expandable membrane defining a cooling chamber disposed at a point along the elongate body, the cooling chamber in fluid communication with the injection lumen and the exhaust lumen, and a contact assessment element which may be a temperature sensor located proximate the coolant return lumen for measuring an internal temperature of the chamber. The system may include the catheter, a console having a fluid supply, an exhaust path and at least one control mechanism operationally coupled to the temperature sensor for processing a temperature signal received from the temperature sensor. The apparatus and system can also have multiple electrodes to measure and process various impedances to determine contact assessment.

Abstract: Systems, apparatus and methods for dispersing a coolant along different portions of a supply tube of a cryo-ablation device which may be in the form of a linear ablation device or catheter probe or a balloon catheter. A supply tube includes multiple tubes that are in fluid communication with an inner space of a transmissive region or an inner space of an inflatable balloon. The tubes are coaxially arranged and extend to different lengths or to different locations such that the coolant is dispersed from different tubes at different axial locations. Annular apertures are defined by pairs of tubes and have different sizes. The tubes and arrangement thereof are structured to provide uniform or substantially uniform coolant distribution to provide uniform or substantially uniform cryo-ablation of surrounding tissue.

Abstract: A cryosurgical probe assembly that includes a gas delivery assembly, including a stem and a fluid conduit subassembly bonded to the stem. The fluid conduit subassembly delivers and returns cooling fluid used for cryogenic cooling. The fluid conduit subassembly, comprises a shaft for providing a heat exchange surface for cryogenic ablation; a housing securely connected to said shaft; and, an insulation element slideably engaged with an inner surface of the shaft and slideably engaged with the stem. The cryosurgical probe assembly includes an adjustable sliding apparatus that includes a slider assembly securely attached to said insulation tube for slideably guiding the insulation tube along said shaft; and, a button assembly operatively connected to the slider assembly for allowing a user to actuate the slider assembly to provide a desired adjustment of the insulation tube relative to the shaft. A handle assembly is positioned about the housing.

Abstract: A flexible multi-tubular cryoprobe, including a housing for receiving an inlet flow of near critical cryogenic fluid from a fluid source and for discharging an outlet flow of the cryogenic fluid. A plurality of fluid transfer tubes are securely attached to the housing. This includes a set of inlet fluid transfer tubes for receiving the inlet flow from the housing; and, a set of outlet fluid transfer tubes for discharging the outlet flow to the housing. Each of the fluid transfer tubes is formed of material that maintains flexibility in a full range of temperatures from ?200° C. to ambient temperature. Each fluid transfer tube has an inside diameter in a range of between about 0.10 mm and 1.0 mm and a wall thickness in a range of between about 0.01 mm and 0.30 mm. An end cap is positioned at the ends of the plurality of fluid transfer tubes to provide fluid transfer from the inlet fluid transfer tubes to the outlet fluid transfer tubes.

Abstract: An expandable, flexible multi-tubular cryoprobe operational with a near critical cryogenic working fluid. The inlet fluid transfer micro-tubes utilized are formed of material that maintains flexibility in a full range of temperatures from ?200° C. to ambient temperature. During operation, the cryoprobe is mechanically actuated to provide radial expansion of the inlet fluid transfer micro-tubes. Thus, enhanced thermal contact with target biological tissue to be treated is provided.

Abstract: A balloon elongation apparatus includes an elongated hypotube with a distal end having a reduced inner diameter portion that is configured to radially expand when a mandrel is advanced through a lumen of the hypotube towards the reduced inner diameter portion. A medical kit includes a catheter having a distally-located balloon and the elongation apparatus disposed within a guide wire tube of the catheter. In use, the balloon is elongated following a procedure in order to facilitate retracting the balloon into a sheath. The balloon is elongated by first advancing the mandrel relative to the hypotube so that the hypotube radially expands and firmly engages an inner surface of the guide wire tube and then advancing the mandrel, hypotube, and distal end of the guide wire tube relative to the catheter body.

Abstract: A catheter-based medical device includes a catheter that is configured and arranged for at least partial insertion into a patient and that defines at least one lumen that is configured and arranged to receive a first fluid. A conductive-fluid detector is coupled to the at least one lumen and is configured and arranged to detect when a second fluid is disposed within the at least one lumen that is more conductive than the first fluid. The conductive-fluid detector includes a plurality of axially-positioned bodies, each body defining a lumen. The lumens of the axially-positioned bodies are aligned to form a shared lumen in fluid communication with the at least one lumen of the catheter. Spaced apart electrodes are disposed within the shared lumen.

Abstract: A cryosurgical instrument including: a shaft having a closed distal end defining an expansion chamber and an open proximal end adapted and configured to receive an inflow of cryogen and to exhaust a flow of expanded cryogen; and a heat exchanger. The heat exchanger includes: a plurality of cryogen delivery tubes that spiral around a longitudinal axis thereof; and a diffuser having a plurality of branches, each of the branches supplying received cryogen to a respective one of the delivery tubes. The cryogen delivery tubes, where they spiral, are spaced from each other and in fluid tight contact with the inner surface of the shaft so as to form spiraling cryogen exhaust pathways that extend along a portion of a length of the cryosurgical instrument from the distal end of the shaft.

Abstract: A method of performing a cryotherapy procedure can include introducing a cryotherapy balloon catheter at a treatment site inside a patient's body; regulating, during a first phase of a cryotherapy procedure, flow of cryogenic fluid to and exhaust from a distal balloon portion of the cryotherapy balloon catheter to cause an initial pressure to be maintained inside the distal balloon portion that is sufficiently high to cause an outer wall of the distal balloon portion to be pressed against body tissue at the treatment site; and regulating, during a second phase of the cryotherapy procedure, flow of cryogenic fluid to and exhaust from the distal balloon portion to cause a) a temperature inside the distal balloon portion to reach a value sufficient to deliver therapeutic levels of cryotherapy to the body tissue, and b) a second-phase pressure to be maintained that is within a threshold value of the initial pressure.

Abstract: A cryosurgical instrument including: a shaft having a closed distal end defining an expansion chamber and an open proximal end adapted and configured to receive an inflow of cryogen and to exhaust a flow of expanded cryogen; and a heat exchanger. The heat exchanger includes: a plurality of cryogen delivery tubes that spiral around a longitudinal axis thereof; and a diffuser having a plurality of branches, each of the branches supplying received cryogen to a respective one of the delivery tubes. The cryogen delivery tubes, where they spiral, are spaced from each other and in fluid tight contact with the inner surface of the shaft so as to form spiraling cryogen exhaust pathways that extend along a portion of a length of the cryosurgical instrument from the distal end of the shaft.

Abstract: A dispensing head for dispensing a cryogenic fluid may comprise a flow passage configured to be placed in flow communication with a reservoir containing a cryogenic fluid, the flow passage defining a flow passage inlet opening configured to receive the cryogenic fluid from the reservoir, and a flow passage outlet opening opposite the flow passage inlet opening. The dispensing head may further comprise a dispensing member configured to dispense the cryogenic fluid, the dispensing member defining a lumen having a lumen inlet opening and a lumen outlet opening; and at least one porous member disposed in the flow passage, the at least one porous member being configured as a primary flow regulation mechanism to limit a flow rate of the cryogenic fluid as it flows from the reservoir to the lumen outlet opening.

Abstract: A medical device, system and method are provided for thermal medical treatment. A medical device for cryogenic treatment may include a tip and a thermal guard or shield. The tip may be at a distal end of a catheter shaft, having a distal surface and lateral surfaces. The thermal guard may be coupled to the catheter proximal of the distal tip, surrounding the longitudinal axis and exposing the distal surface, to resist heat transfer from body fluids to the lateral surfaces of the tip. An efficiency of heat transfer from selected tissue to be treated to the distal surface of the cryogenic tip is thereby increased.

Abstract: Methods and apparatus for the treatment of a body cavity or lumen are described where a heated fluid and/or gas may be introduced through a catheter and into treatment area within the body contained between one or more inflatable/expandable members. The catheter may also have optional pressure and temperature sensing elements which may allow for control of the pressure and temperature within the treatment zone and also prevent the pressure from exceeding a pressure of the inflatable/expandable members to thereby contain the treatment area between these inflatable/expandable members. Optionally, a chilled, room temperature, or warmed fluid such as water may then be used to rapidly terminate the treatment session.

Abstract: The present invention generally provides improved medical devices, systems, and methods. Some embodiments of the present invention apply cooling with at least one small, tissue-penetrating probe, the probe often comprising a needle having a size suitable for inserting through an exposed surface of the skin of a patient without leaving a visible scar. The cooling may remodel one or more target tissue so as to effect a desired change in a composition of the target tissue and/or a change in its behavior. Exemplary embodiments make use of replaceable needle probes supported by a probe body handle, with small needle probes often being replaced during treatment of a single patient. Careful control over the control of cryogenic cooling fluid into a needle probe can allow the length of the active cooling to be controlled through depletion of liquid from an evaporating cryogenic cooling flow.

Abstract: A cryosurgical instrument that includes: an external shaft with a cryotip; a heat exchanger that cools a portion of the external shaft and the tip when cryogen is received thereby; and a flow diverter that receives a flow of cryogen, that splits the received flow of cryogen into two or more split cryogen flows, and that delivers the split cryogen flows to the heat exchanger, the flow diverter including a first passage with one or more inlet ports at an upstream side of the diverter that receive the flow of cryogen and two or more outlet ports at a downstream side of the diverter and in fluid communication with the heat exchanger.

Abstract: The handpiece for treating the skin with irradiation using a light beam (F1), comprises a first window (1) and a second window (2) and first means for cooling the first window (1). Said first window (1) and said second window (2) are positioned opposite one another and are separated by a gas-filled space. They are capable of transmitting a light beam (F1) and said first window (1) is intended to be applied in contact with the skin during the treatment. The handpiece comprises means for heating the gas between the two windows (1, 2).

Abstract: A cryogenic catheter includes an elongate, contiguous, thermally-transmissive region coupled to the catheter, the thermally-transmissive region being sufficiently flexible to change from a linear configuration to an arcuate configuration. The thermally-transmissive region may include a plurality of interconnected thermally-transmissive segments that are generally cylindrical in shape. The cryogenic catheter may be in fluid communication with a fluid source, and may include one or more fluid injection tubes. Further, an injection tube may be slidably disposed within the catheter so that the injection tube is longitudinally movable relative to an outer surface of the catheter. The cryogenic catheter may also be in communication with a controller programmed to regulate delivery of a cryogenic fluid from the fluid source to the medical device.

Abstract: Cryotreatment devices and methods of ablating tissue within the body are disclosed. A cryotreatment device in accordance with an exemplary embodiment of the present invention includes an elongated member having one or more needle-like ablation tips configured to induce necrosis at a target site within the heart. A cooling fluid such as a cryogen may be injected through a lumen extending into the distal portion of the device. The ablation tips can be configured to pierce and ablate surrounding tissue, blocking electrical stimuli that can cause fibrillations or other arrhythmias of the heart. The device may also include means for controlling the transmural depth at which the ablation tips are inserted into the cardiac tissue. Methods of forming a contiguous line of conduction block in accordance with the present invention are also disclosed.

Abstract: Described herein are methods and devices for performing ablation via a cryoablation catheter. An ablation catheter having a cyroablation chamber at its distal end can be used to achieve a uniform ablation band in or around the pulmonary veins. The cyrochamber can house a dispersion member in fluid communication with a refrigerant supply and can function to evenly distribute received refrigerant over some portion of the inner wall of the cryochamber. As a result of this even distribution of refrigerant within the cyrochamber, uniform ablation of the targeted tissue of the patient can be achieved.

Abstract: The invention relates to a device for cold treating a tissue. The invention also relates to an assembly of such a device and a container comprising a cryogenic liquid, such as a spray can. The invention further relates to a method for cold treating a tissue.

Abstract: The invention provides surgical systems and methods for ablating heart tissue within the interior and/or exterior of the heart. A plurality of probes is provided with each probe configured for introduction into the chest for engaging the heart. Each probe includes an elongated shaft having an elongated ablating surface of a predetermined shape. The elongated shaft and the elongated ablating surface of each probe are configured to ablate a portion of the heart. A sealing device affixed to the heart tissue forms a hemostatic seal between the probe and the penetration in the heart to inhibit blood loss therethrough.

Abstract: The present invention advantageously provides a method and system for cryogenically ablating large areas of tissue within the left atrium. In an exemplary embodiment a cryotherapy device includes a catheter body having a substantially fixed diameter, a proximal end and a distal end; a first lumen for permitting passage of a cooling fluid from the proximal end to the distal end; a second lumen permitting return of the cooling fluid from the distal end to the proximal end; and an ablation element expandable from a first diameter that is substantially the same as the diameter of the catheter body to a second diameter that is at least twice the diameter of the catheter body, the ablation element having a surface portion that conforms to the uneven surface topography of the cardiac tissue. The ablation element can include one or more balloon and/or a flexible element that is deformed by moving the distal end of the catheter toward the proximal end of the catheter.

Abstract: An apparatus for moving the esophagus includes an elongate body having a distal tip, a controlled curvature section, and a flexible section. A handle is coupled to the flexible section to adjust the curvature of the controlled curvature section. The length of the controlled curvature section is less than the length of the thoracic portion of the esophagus. Further, a method of adjusting the curvature of the esophagus during a therapeutic procedure in a treatment area outside of the esophagus includes positioning within the esophagus an elongate body having a distal tip, a controlled curvature section, and a flexible section and adjusting the curvature of the controlled curvature section to increase the distance between the esophagus and a treatment area outside of the esophagus.

Abstract: An intravascular ablation device, including a flexible elongate body; an expandable element positioned on the elongate body; a radiofrequency or electroporation treatment segment located distally of the expandable element; a cryogenic coolant source in fluid communication with an interior of the expandable element; and a radiofrequency or electroporation energy source in communication with the radiofrequency or electroporation treatment segment.

Abstract: An invention relates to the area of cryosurgical equipment. It proposes a cryosurgical system, which incorporates measuring and computing means for estimation of a real time ice ball diameter and operation temperature of a cryotip (the distal section of a cryosurgical probe). The cryosurgical probe of the cryosurgical system operates by blowing in a gaseous medium at cryogenic temperature.

Abstract: Provided are systems and methods for destroying tissue using a cryogenic fluid. The systems generally comprise a hollow outer cylinder; a hollow inner cylinder placed within the hollow outer cylinder; a tip at the front end or distal end of the outer cylinder; wherein a cryogenic fluid is made to flow through the hollow region of the inner cylinder which oozes out or flows out of more than one grooves or apertures on the surface of the inner cylinder and then passes through the hollow portion of the outer cylinder. Yet another preferred embodiment provides for a housing component having a combination of storage for additional system cooling and exhaust facilities.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A configuration for a cryo-catheter which optimizes both the catheter's outer diameter and the size of the catheter's internal refrigerant flow path is described. Specifically, the inner dimensions of the cryo-catheter are configured to accommodate a pre-selected flow of refrigerant into the catheter's distal tip, and a return flow of refrigerant from the distal tip. The return flow is established in the void spaces between a refrigerant supply line and the inner wall of the catheter body. The available void space varies along the catheter length and depends on the presence/absence of various catheter accessories (i.e. pull wires, pressure tubes, etc.) which typically only extend through a portion of the catheter length. The disclosed configuration ensures that the cryo-catheter does not operate in a refrigerant limited condition, maintains the refrigerant as a liquid in the supply tube, and maintains the return line pressure at about 1 atmosphere.

Abstract: A cryoablation system includes thermally insulated containers for holding liquid refrigerant. The containers are placed in a docking station that charges the containers with a liquid refrigerant at a cryogenic temperature suitable for carrying out a surgical procedure. The charged containers are detachably connectable with an inlet line of a cryoablation probe. When the cryoprobe is activated, the chilled liquid refrigerant is transported from a delivery container, through the cryoprobe, and to a recovery container. The recovery container is preferably identical in design to the delivery container. The refilled recovery container is then placed in the docking station to charge. In another embodiment, a cartridge includes a delivery container and recovery container combined as a single unit. Methods are also described.

Abstract: A tweezers device for the application of cryogenic matter directly on a skin lesion while protecting the collateral skin tissue from being damaged by the cryogenic matter, the device comprising an applicator body configured with opposing tweezer arms, each tweezer arm including a cryogenic matter application element such that when the opposing tweezer arms are closed about the skin lesion, the skin lesion is substantially encased by the cryogenic matter application elements.

Abstract: A probe that emits energy to coagulate lesions is disclosed. The probe is constructed and arranged to emit light from its distal end, either at an angle to its longitudinal axis, or along its longitudinal axis. Optionally, an end reflector may be used to direct the energy in a beam to one side of the fiber end. An MRI system is arranged to generate a series of output signals indicative of temperature in the targeted area. The application of energy is stopped when the temperature at the boundary of the lesion reaches the required hyperthermic temperature. Cooling of the tip portion of the probe is effected by expansion of a supplied cooling fluid through a restrictive orifice into an expansion zone at the probe end to minimize collateral tissue damage.

Abstract: Medical systems and methods including balloons having nanotubes are disclosed. In some embodiments, a medical system includes an elongated shaft, and an expandable balloon carried by the shaft and including nanotubes. The medical system is capable of cooling the balloon to less than about 37° C. In some embodiments, a method includes providing a medical device having an elongated shaft, and an expandable balloon carried by the elongated shaft and including nanotubes; and cooling the balloon to less than about 37° C.

Abstract: Improved systems, devices, and methods for delivering cryogenic cooling fluid to cryosurgical probes such as cryosurgical endovascular balloon catheters take advantage of the transients during the initiation and termination of cryogenic fluid flow to moderate the treatment temperatures of tissues engaged by the probe. A flow limiting element along a cryogenic fluid path intermittently interrupts the flow of cooling fluid, often cycling both the fluid flow and treatment temperature. This can maintain the tissue treatment temperature within a predetermined range which is above the treatment temperature provided by a steady flow of cryogenic fluid. In another aspect, room temperature single-use cooling fluid cartridges are filled with a sufficient quantity of cryosurgical fluid to effect a desired endovascular cryosurgical treatment.

Abstract: A cryogenic tissue ablation instrument includes an elongate flexible body with a proximal supply port for coupling with a pressurized coolant, a supply lumen in communication with the proximal supply port, and an expandable balloon carried on the elongate body. A dispersion member coupled to the elongate body has an interior lumen in communication with the supply lumen, the dispersion member having one or more coolant dispersion apertures sized and located such that a pressurized flowable coolant will enter the balloon interior in the form of a liquid spray that contacts and provides substantially uniform cooling of the balloon.

Abstract: A cryosurgical instrument including: a shaft having a closed distal end defining an expansion chamber and an open proximal end adapted and configured to receive an inflow of cryogen and to exhaust a flow of expanded cryogen; and a heat exchanger. The heat exchanger includes: a plurality of cryogen delivery tubes that spiral around a longitudinal axis thereof; and a diffuser having a plurality of branches, each of the branches supplying received cryogen to a respective one of the delivery tubes. The cryogen delivery tubes, where they spiral, are spaced from each other and in fluid tight contact with the inner surface of the shaft so as to form spiraling cryogen exhaust pathways that extend along a portion of a length of the cryosurgical instrument from the distal end of the shaft.

Abstract: A first trocar as an medical apparatus includes an insertion hole having a projection opening for leading out a biopsy forceps into a body of a subject, a lid body for blocking the projection opening of the insertion hole, and a cooling sheet for cryogenically cooling a biopsy portion arranged in the vicinity of the lid body in a state where the biopsy forceps is stored in the insertion hole, and is capable of easily harvesting a living tissue while retaining morphological change of tissues in a living body under various hemodynamics.

Abstract: The present disclosure is directed to a cryoprobe capable of improving the cooling power of a cryosurgical system. A representative cryoprobe can comprise an inner cooling chamber and a radial chamber, positioned between the inner cooling chamber and an exterior wall of the cryoprobe. Preferably, the radial chamber is formed to have a low thermal conductivity so as to significantly reduce the transfer of heat between the body and the refrigerant in the inner chamber during a cryosurgical procedure. The radial chamber can be fabricated such that a vacuum can be applied to the radial chamber to further reduce heat transfer between the body and the inner cooling chamber. The radial chamber extends partially along the length of the cryoprobe such that inner cooling chamber is in direct thermal contact with the exterior wall at a cryoprobe tip.

Abstract: A method of performing a cryotherapy procedure can include introducing a cryotherapy balloon catheter at a treatment site inside a patient's body; regulating, during a first phase of a cryotherapy procedure, flow of cryogenic fluid to and exhaust from a distal balloon portion of the cryotherapy balloon catheter to cause an initial pressure to be maintained inside the distal balloon portion that is sufficiently high to cause an outer wall of the distal balloon portion to be pressed against body tissue at the treatment site; and regulating, during a second phase of the cryotherapy procedure, flow of cryogenic fluid to and exhaust from the distal balloon portion to cause a) a temperature inside the distal balloon portion to reach a value sufficient to deliver therapeutic levels of cryotherapy to the body tissue, and b) a second-phase pressure to be maintained that is within a threshold value of the initial pressure.

Abstract: A cryosurgical instrument that includes: an external shaft with a cryotip; a heat exchanger that cools a portion of the external shaft and the tip when cryogen is received thereby; and a flow diverter that receives a flow of cryogen, that splits the received flow of cryogen into two or more split cryogen flows, and that delivers the split cryogen flows to the heat exchanger, the flow diverter including a first passage with one or more inlet ports at an upstream side of the diverter that receive the flow of cryogen and two or more outlet ports at a downstream side of the diverter and in fluid communication with the heat exchanger.

Abstract: A method for ablation in which a portion of atrial tissue around the pulmonary veins of the heart is ablated by a first elongated ablation component and a second elongated ablation component movable relative to the first ablation component and having means for magnetically attracting the first and second components toward one another. The magnetic means draw the first and second components toward one another to compress the atrial tissue therebetween, along the length of the first and second components and thereby position the device for ablation of the tissue.

Abstract: The present invention relates to devices and methods for altering the tissue in and around an intervertebral disc through localized hypothermia therapy to restore function of the disc and reduce pain. Hypothermia therapy is defined as the reduction of tissue temperature to below that of the equilibrium temperature. Target therapeutic temperatures and times are varied according to the desired treatment effect. Intended effects of hypothermia of the intervertebral disc include cellular disruption leading to cell death and or structural and chemical denaturation within the anulus fibrosus, nucleus pulposus, or nerve fibers, temporary or permanent deadening of the nerves within or surrounding the disc, induction of a healing response, angiogenesis, or accelerated degeneration and/or drying of the nucleus pulposus and/or anulus fibrosus. Various effects can be achieved by reaching different temperatures for differing periods of time or by the proximity of the hypothermia therapy device to the treatment target.

Abstract: A laser treatment device and process with controlled cooling. The device contains a cooling element with high heat conduction properties, which is transparent to the laser beam. A surface of the cooling element is held in contact with the tissue being treated while at least one other surface of the cooling element is cooled by the evaporation of a cryogenic fluid. The cooling is coordinated with the application of the laser beam so as to control the temperatures of all affected layers of tissues. In a preferred embodiment useful for removal of wrinkles and spider veins, the cooling element is a sapphire plate. A cryogenic spray cools the top surface of the plate and the bottom surface of the plate is in contact with the skin. In preferred embodiments the wavelength of the laser beam is chosen so that absorption in targeted tissue is low enough so that substantial absorption occurs throughout the targeted tissue. In a preferred embodiment for treating large spider veins with diameters in the range of 1.