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 method of using 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. A reinforcing sleeve for the fiber is mounted to a shielded, Piezo-electric motor constructed and arranged to move the fiber both longitudinally and rotationally within an optional elongate cannula. 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.

Abstract: The present invention relates to comprehensive systems, devices and methods for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In certain embodiments, systems, devices, and methods are provided for treating a tissue region (e.g., a tumor) through application of energy.

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, the distal end having a distal tip region that includes a plurality of flexible segments with varying degrees of stiffness. A handle portion can be located at the proximal end of the catheter body to provide a steering mechanism that causes the distal tip region to deflect according to a compound curve.

Abstract: A liquid cryogen fluid system for providing cryogenic liquid to a cryoprobe in a cryosurgical system for treating fibroadenomas and other lesions in the body. The system includes a cryoprobe to cryoablate a fibroadenoma with a treatment regimen that takes less time and consumes less cryogen than currently accepted regimens.

Abstract: A cryosurgical instrument for separating a tissue sample from a biological tissue to be treated, for purposes of biopsy. The cryosurgical instrument includes a probe for bringing a probe head up to the biological tissue and a gas line for supplying cooling gas from a gas source of a cryosurgical apparatus to the probe head. The probe head cools a limited tissue region, by means of the supplied gas, for obtaining a tissue sample. The tissue sample can be separated from the surrounding tissue when frozen onto the probe head. The instrument has a support tube in which the probe is guided and which can be moved relative to the probe in such a way that the surrounding tissue can be supported by means of the support tube during the separating of the tissue sample. The instrument also includes an accelerating device that provides a predefined force for the separating process.

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: The present invention provides a medical device having an elongate body with both a proximal end and a distal end, wherein the elongate body defines an intake lumen and an exhaust lumen. The medical device also has a first pliable element defining a cooling chamber disposed at a point along the elongate body, with the cooling chamber being in fluid communication with the intake lumen and the exhaust lumen. A second pliable element is provided which at least partially encloses the first pliable element, thereby defining a junction between the first and second pliable element. Moreover, a check valve is included which is in fluid communication with the junction between the first pliable element and second pliable element, the valve further being in fluid communication with the exhaust lumen. In addition, the medical device may include sensors or other monitoring means in fluid communication with the junction and the cooling chamber.

Abstract: Neuromodulation cryotherapeutic devices and associated systems and methods are disclosed herein. A cryotherapeutic device configured in accordance with a particular embodiment of the present technology can include an elongated shaft having distal portion and a supply lumen along at least a portion of the shaft. The shaft can be configured to locate the distal portion intravascularly at a treatment site proximate a renal artery or renal ostium. The supply lumen can be configured to receive a liquid refrigerant. The cryotherapeutic device can further include a cooling assembly at the distal portion of the shaft. The cooling assembly can include an applicator in fluid communication with the supply lumen and configured to deliver cryotherapeutic cooling to nerves proximate the target site when the cooling assembly is in a deployed state.

Abstract: A cryosurgical system for assisting an operator in placing and operating cryosurgical probes in the prostate of a human patient. The cryosurgical system includes a computer system being programmed with software capable of performing the following steps: a) capturing a plurality of transverse views of the prostate; b) capturing a sagittal view of the prostate; c) outlining the capsule of the prostate, the urethra and the rectal wall of the patient with the assistance of the operator, utilizing the captured plurality of transverse views and the captured sagittal view; d) constructing a 3-dimensional model of the prostate, the urethra and the rectal wall utilizing the outlines of step c), above; and, e) utilizing the 3-dimensional model of the prostate, the urethra and the rectal wall to determine i) the number of cryosurgical probes to be utilized; ii) probe settings; and, iii) probe placement positions. The resultant ice thus produced by the cryosurgical probes is optimized for a specific patient.

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: 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: A method of operating a medical system, including coupling a medical system to an outlet of a fluid distribution network having a plurality of fluid outlets in a patient treatment center; delivering fluid from the outlet to the medical system; compressing the delivered fluid with the medical system; decreasing the moisture content of the delivered fluid with the medical system; cooling the fluid with the medical system; delivering the fluid from the medical system to a medical device; and removing the fluid from medical device with the medical system.

Abstract: The present invention provides an enhanced method and device to inhibit or reduce the rate of restenosis following angioplasty or stent placement. The invention involves placing a balloon tipped catheter in the area treated or opened through balloon angioplasty immediately following angioplasty. The balloon, which can have a dual balloon structure, may be delivered through a guiding catheter and over a guidewire already in place from a balloon angioplasty. A fluid such as a perfluorocarbon may be flowed into the balloon to freeze the tissue adjacent the balloon, this cooling being associated with reduction of restenosis. The catheter may also be used to reduce atrial fibrillation by inserting and inflating the balloon such that an exterior surface of the balloon is in contact with at least a partial circumference of the portion of the pulmonary vein adjacent the left atrium.

Abstract: Catheter apparatuses, systems, and methods for cryogenically modulating neural structures of the renal plexus by intravascular access are disclosed herein. One aspect of the present application, for example, is directed to apparatuses, systems, and methods that incorporate a catheter treatment device comprising an elongated shaft. The elongated shaft is sized and configured to deliver a cryo-applicator to a renal artery via an intravascular path. Cryogenic renal neuromodulation may be achieved via application of cryogenic temperatures to modulate neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers.

Abstract: A cryoprobe with a reliable and inexpensive quick coupling unit including a male unit and a suitable corresponding female coupling unit. The female unit is installed on the distal end of a hose supplying the liquid cryogen into the cryoprobe.

Abstract: A cryogenic medical device for delivery of subcooled liquid cryogen to various configurations of cryoprobes is designed for the treatment of damaged, diseased, cancerous or other unwanted tissues, particularly as utilized for the ablation of cardiac tissue in the treatment of atrial fibrillation. The device is a closed or semi-closed system in which the liquid cryogen is nitrogen contained in both the supply and return stages. The device is capable of generating cryogen to a supercritical state, specifically supercritical nitrogen, and may be utilized in any rapid cooling systems. As designed, the device also integrates endocardial catheters and epicardial probes.

Abstract: A system and a method for its use are provided to cool a cryotip at the distal end of a probe for a cryosurgical procedure. In particular, the cryotip is cooled by a liquid refrigerant to cryogenic temperatures in order to perform a cryosurgical procedure on biological tissue. The system is closed-loop, and during transit of the liquid refrigerant through the entire system, the liquid refrigerant always remains in a liquid state at a relatively low pressure.

Abstract: Some embodiments of the invention relate to a system for treating tissue internal to a body, such as heart tissue. For example, the system may be used to ablate tissue as a treatment for atrial fibrillation. In certain embodiments, the system is capable of causing scar tissue to form in ostial areas of the atrium rather than inside the pulmonary vein. In such embodiments, the system may include a tissue treatment member that is operable to form an annular area of ablated tissue along the outer portion of the ostium in an area known as the antrum.

Abstract: The invention provides a method and apparatus for performing selective hypothermia to the brain and spinal cord for injury protection without the need for systemic cooling. A flexible catheter is inserted into the cerebral lateral ventricle or spinal subdural space. The catheter has lumens with a heat transfer element. The lumens of the catheter circulate a coolant and communicate at the distal heat transfer element for transfer of heat from the cerebrospinal fluid. Furthermore a method of maintaining catheter patency and providing blood clot hemolysis and drainage is also provided through the use of ultrasonic and/or laser energy delivered through the catheter.

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 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 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 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: The cryosurgical probe assembly with multiple deployable cryoprobes includes a) a housing assembly; b) a plurality of elongated structural support elements, each securely connected at a first end to the housing assembly; c) a tip member securely connected to second ends of the plurality of elongated structural support elements, the tip member including a plurality of cryoprobe openings; and, d) a plurality of cryoprobes each having a shaft thereon, each shaft being deployable through a respective cryoprobe opening during operation to a deployed position used for ablating tissue. In an alternate embodiment, a cylindrical housing is utilized rather than elongated structural support elements.

Abstract: A cryogenic catheter includes an outer flexible member having at least one cryogenic fluid path through the flexible member. The at least one fluid path is defined by a plurality of flexible members disposed within the outer flexible member.

Abstract: A liquid cryogen fluid system for providing cryogenic liquid to a cryoprobe in a cryosurgical system for treating fibroadenomas and other lesions in the body. The system includes a cryoprobe to cryoablate a fibroademona with a treatment regimen that takes less time and consumes less cryogen than currently accepted regimens.

Abstract: The invention relates to a coolant dosing device for the application of cryogenic gas for producing low temperatures as required e.g. in cryosurgery. The invention aims to ensure a disturbance-free operation in spite of often dirty gas and to exclude possible operating errors in the connection of capsules of the prior art. According to the invention, the coolant dosing device comprises a capillary tube that receives gas that has been filtered in the capsule and directly supplies it to the dispenser, thereby ensuring a disturbance-free operation. The low force connection between the capsule and the metering device by means of O-rings that are slipped over ensures a tight seal and an error-free operation.

Abstract: A cryosurgical instrument features a cryogen in liquid or liquid-gaseous (mist) form being supplied by a feeding lumen into the internal space of a cryotip at the distal end of the cryosurgical instrument. The distal section of the feeding lumen is helically coiled, so that an outer diameter of the helically coiled distal section fits an inner diameter of a cylindrical envelope of said cryotip, and said helically coiled distal section and said cylindrical envelope are in thermal contact.

Abstract: A method for performing cryotherapy on a target tissue region in a body includes positioning a first cooling element in a first location in a body adjacent a target tissue region, positioning a second cooling element in a second location in the body adjacent the target tissue region, and cooling the respective first and second cooling elements so as to cool the target tissue region.

Abstract: A cryosurgery apparatus is disclosed. The cryosurgery apparatus an introducer having a hollow and a distal portion, the distal portion being sufficiently sharp so as to penetrate into a body, the hollow of the introducer being designed and constructed for containing a plurality of cryoprobes each of the cryoprobes being for effecting cryoablation, such that each of the plurality of cryoprobes is deployable through the distal portion of the introducer when the distal portion is positioned with respect to a tissue to be cryoablated.

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: An insulated cooling probe including a probe sleeve assembly having an annular insulating jacket shaped in the vicinity of an evacuation vent to achieve a deeper vacuum within the insulating space than is applied to the vent, and a coolant inlet passageway and a coolant exit passageway bounded by a coolant passageway wall disposed within the insulating jacket, the probe also including a cooling tip extending outwardly from the sleeve assembly at one end of the probe and including a cooling region into which coolant enters from the coolant inlet passageway and from which coolant exits into the coolant exit passageway. The coolant expands across an orifice when upon exiting the coolant inlet passageway and entering the cooling tip. The coolant flowing in the coolant inlet passageway is pre-cooled in a heat transfer region of the probe by transferring heat to coolant flowing in the coolant exit passageway.

Abstract: A cryogenic catheter includes an outer flexible member having at least one cryogenic fluid path through the flexible member. The at least one fluid path is defined by a plurality of flexible members disposed within the outer flexible member.

Abstract: The present invention provides an enhanced method and device to inhibit or reduce the rate of restenosis following angioplasty or stent placement. The invention involves placing a balloon tipped catheter in the area treated or opened through balloon angioplasty immediately following angioplasty. The balloon, which can have a dual balloon structure, may be delivered through a guiding catheter and over a guidewire already in place from a balloon angioplasty. A fluid such as a perfluorocarbon may be flowed into the balloon to freeze the tissue adjacent the balloon, this cooling being associated with reduction of restenosis. The catheter may also be used to reduce atrial fibrillation by inserting and inflating the balloon such that an exterior surface of the balloon is in contact with at least a partial circumference of the portion of the pulmonary vein adjacent the left atrium.

Abstract: A cryosurgery device for dispensing a liquid refrigerant from a container having a valve stem extending outwardly therefrom. The device includes an actuator adapted to seat on the valve stem of the container in order to depress the valve stem to release the refrigerant from the container. The actuator includes an inner passageway having opposed ends disposed therein, one of the ends of the passageway being in fluid communication with the valve stem. An applicator tube is mounted to the actuator at the other end of the inner passageway. A cap is disposed on the top of the container. The actuator is movably positioned on the cap and a shield is attached to the cap to completely receiving the applicator tube. Liquid refrigerant can only be dispensed when the actuator is positioned properly and the applicator tube is disposed within the shield means.

Abstract: The cryosurgical probe assembly with multiple deployable cryoprobes includes a) a housing assembly; b) a plurality of elongated structural support elements, each securely connected at a first end to the housing assembly; c) a tip member securely connected to second ends of the plurality of elongated structural support elements, the tip member including a plurality of cryoprobe openings; and, d) a plurality of cryoprobes each having a shaft thereon, each shaft being deployable through a respective cryoprobe opening during operation to a deployed position used for ablating tissue. In an alternate embodiment, a cylindrical housing is utilized rather than elongated structural support elements.

Abstract: A cryosurgical instrument features a cryogen in liquid or liquid-gaseous (mist) form being supplied by a feeding lumen into the internal space of a cryotip at the distal end of the cryosurgical instrument. The distal section of the feeding lumen is helically coiled, so that an outer diameter of the helically coiled distal section fits an inner diameter of a cylindrical envelope of said cryotip, and said helically coiled distal section and said cylindrical envelope are in thermal contact.

Abstract: Devices and methods for cooling vessel walls to inhibit restenosis in conjunction with medical procedures such as coronary artery angioplasty. Stenosed vessel walls can be cooled prior to angioplasty, after angioplasty, or both. The invention is believed to inhibit restenosis through cooling to a temperature near freezing, preferably without causing substantial vessel wall cell death.

Abstract: Devices, systems, and methods treat cosmetic defects, and often apply cooling with at least one tissue-penetrating probe inserted through of the skin of a patient. 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 of the cooling treatments will interfere with the nerve/muscle contractile function chain so as to mitigate wrinkles of the skin. Related treatments may be used therapeutically for treatment of back and other muscle spasms, chronic pain, and the like. Some embodiments may remodel subcutaneous adipose tissue so as to alter a shape or appearance of the skin surface.

Abstract: During cryotherapy, using an endoscope that extends within a patient to a cold treatment site, the device of the invention vacuums gas from the site through radial intake ports to a cylindrical space in an evacuation chamber held elastically circumferentially about the distal end of the endoscope tube that carries the cryoprobe to the site.

Abstract: A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen.

Abstract: A method for tightening and rejuvenating skin utilizing a cryogenic applicator, which includes the steps of holding a handle of a barrel of the cryogenic applicator in a hand, fluidly communicating the barrel with a source of a biocompatible non-toxic cryogenic fluid to supply the biocompatible non-toxic cryogenic fluid through a hollow interior of the barrel, out through a plurality of openings in a distal portion of the barrel, and onto a head of the cryogenic applicator, rolling the head quickly, smoothly, and evenly over the skin being treated for a period of time in an order of hundredths or tenths of a second, and sparging the biocompatible non-toxic cryogenic fluid onto the skin quickly, evenly, and smoothly when the head is rolled on the skin, and thereby tightening and rejuvenating the skin.

Abstract: One embodiment of the invention is a flexible cryogenic probe tip. The flexible probe tip has a linear freeze zone at a distal end of the probe that allows for its placement and precisely controlled movements. The flexible cryogenic probe tip precisely conforms to the target tissue surface to create a linear lesion. In addition, the probe tip is steerable to facilitate proper placement with minimal access points into a patient's body. Various configurations of the flexible probe tip allow it to conform and ablate tissue of many sizes, shapes, and/or dimensions.

Abstract: The present invention relates to a treatment device utilized in the freezing treatment method and its treatment planning device, and has an object to settle a freezing period·defrosting period according to a size of a treatment portion. A cryotherapy device comprises a gas supply-exhaust system 100, a control system 200 therefore and a freezing probe system 300. The gas supply-exhaust system 100 supplies a freezing gas and a defrosting gas to a probe 60 of the freezing probe system 300 to freeze and defrost the treatment portion surrounding the tip of the probe 60 by the Joule·Thomson effect. The control system 200 controls the gas supply-exhaust system 100 and makes treatment planning data for this control. The treatment planning data includes a freezing·defrosting sequence to determine the freezing period and the defrosting period. The determination of this sequence is performed by the computer in the control system 200.

Abstract: A device, system and method for controlling the temperature differential between the material within the cryosurgical instrument and the external temperature of the shaft, apart from at the cryotip itself.

Abstract: A medical device is provided having a means for actuating a pair of opposing jaw members. The jaw members are movable relative to one another from a first position, wherein the jaw members are disposed in a spaced apart relation relative to one another, to a second position, wherein the jaw members cooperate to grasp tissue therebetween. An ablation mechanism is connected to at least one of the jaws members, such that the jaw members are capable of conducting ablation energy through the tissue grasped therebetween.

Abstract: A method of treating fibroadenomas with optimized freezing periods at a single freezing temperature and minimal thawing time between freezing periods, and a system for accomplishing the method.

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.

Abstract: A cryogenic medical system includes a medical device and a console connectable to the medical device at a connection point. The console controls the temperature of the medical device. The console includes a first cooling system directing coolant to the medical device at a first temperature along a coolant supply line and a second cooling system chilling the coolant within the coolant supply line to a temperature below the first temperature before the coolant reaches the connection point.