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: 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: 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: Low temperature lesion formation apparatus, systems and methods. The apparatus includes a base member and an inflatable element carried by the base member.

Abstract: Cryosurgical instruments and methods utilizing improved heat transfer characteristics. A cryosurgical device includes: a tubular housing; a cryogen supply passage; a heat exchange enhancing member in the housing, disposed along a longitudinal axis of the housing; an annular cooling passage between the heat exchange enhancing member and the tubular housing; a tip cooling and cryogen flow directing section that transmits a temperature of a cryogen flow to the tip, and an insulation element in the tubular housing.

Abstract: An apparatus and methods for treating lesions on skin are presented. The apparatus collects information about a lesion and can automatically determine a course of treatment for the lesion. The device can include a controller that positions the nozzle proximate to a surface region of the lesion and automatically dispenses a pulse of the cryogenic fluid from the nozzle. The controller then positions the nozzle proximate to another surface region of the lesion and automatically dispenses a pulse of the cryogenic fluid from the nozzle.

Abstract: A cryosurgical system adapted for treatment of fibroadenomas within the breast of a patient. The system includes cryoprobes and a control system which operates the cryoprobes to accomplish freezing in two stages, including a high power freeze and a low power freeze.

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 vacuum insulation tube assembly which is utilized as a component in a cryosurgical probe. The vacuum insulation tube assembly includes an inner tube; and, an outer tube concentrically positioned about the inner tube. The outer tube is securely soldered at end portions of the inner tube and forms a vacuum space between the inner tube and the outer tube. The vacuum tube assemblies may be conveniently mass produced using a special fixture.

Abstract: The present invention is of a system and method for accurate cryoablation, useable to enhance a surgeon's ability to accurately cryoablate a selected cryoablation target and to limit cryoablation to that selected target. Presented are apparatus and method for accurately delimiting a cryoablation volume, for minimizing damage to tissues surrounding a cryoablation volume, and for real-time visualization of a border of a cryoablation volume during cryoablation. Also presented are a method for mildly heating tissues during cryoablation, cryoprobes operable to simultaneously cool first tissues while heating second tissues, and cryoprobes operable to cool tissues extending in a first lateral direction from those probes while not substantially cooling tissues extending in a second lateral direction from those probes.

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: Methods and apparatus for dermatology treatment are provided which involve the use of continuous wave (CW) radiation, preheating of the treatment volume, precooling, cooling during treatment and post-treatment cooling of the epidermis above the treatment volume, various beam focusing techniques to reduce scattering and/or other techniques for reducing the cost and/or increasing the efficacy of optical radiation for use in hair removal and other dermatological treatments. A number of embodiments are included for achieving the various objectives indicated above.

Abstract: A cryosurgical apparatus capable of operating both a first cryoprobe with a pressure-resistant return run and a second cryoprobe with an unpressurized return run. The apparatus has a first mode for operating the first cryoprobe and a second mode for operating the second cryoprobe. The apparatus includes a controller, a fluid source for providing a fluid for cooling the cryoprobes by of the Joule-Thomson effect, at least two cryoprobe connections one of which is connected to the first and second cryoprobe in the first and second mode, respectively, and a pressure-setting device with at least one proportional valve. The pressure-setting device can regulate, in the first and second modes, the pressure ratio of the admission run to the return run of the cryoprobe and the pressure in the admission run of the cryoprobe, respectively. The controller controls the cooling power of the cryoprobes by way of setting the proportional valve.

Abstract: A cryosurgical system using a low-pressure liquid nitrogen supply, which requires only 0.5 to 15 bar of pressure to provide adequate cooling power for treatment of typical breast lesions. The pressure may be provided by supplying lightly pressurized air into the dewar, by heating a small portion of the nitrogen in the dewar, or with a small low pressure pump.

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 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: Methods and systems for detecting fluid egress, assessing lesion quality, determining tissue composition or structure, determining ice coverage of catheter tip and providing tissue contact assessment, by providing a catheter having a shaft with a proximal end portion and a distal end portion, the proximal end portion and the distal end portion define at least one fluid pathway therebetween with the shaft having a plurality of electrodes, positioning the catheter at a tissue treatment site, applying an electrical current between at least two of the plurality of electrodes, measuring impedance voltage between the at least two of the plurality of electrodes and, processing the measured impedance voltage caused by the applied electrical current to determine if fluid egress is present, to assess lesion quality, to determine tissue composition, ice cover of catheter tip, and to provide contact assessment.

Abstract: A method of cryogenically treating a tissue region is provided, including positioning a treatment region of a medical device proximate the tissue region; transferring coolant in a substantially liquid phase from a coolant reservoir to a subcooler; transitioning the coolant from the liquid phase into a supercritical state; transferring the supercritical coolant to the treatment region; changing the coolant from the supercritical state to at least one of a liquid phase and a gaseous phase at the treatment region; ablating the tissue region; and evacuating coolant from the treatment region of the medical device.

Abstract: A catheter includes a cryoablation tip with an ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber and have an RF electrode at its distal end. The electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled in combination with an RF treatment regimen to enhance the lesion size, speed or placement of multi-lesion or single lesion cycles. In one embodiment a microwave energy source operates to extend beyond the thermal conduction depth, or penetrate the ice ball and be absorbed in tissue beyond an ice boundary, thus extending a dimension of treatment. Also, the cooling and application of RF energy can be controlled to position the ablation region away from the surface contacted by the electrode thereby leaving surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth.

Abstract: The present invention relates to a cryosurgical instrument, comprising a cryoprobe, having a line system through which a compressed cooling fluid flows, particularly a cooling gas, for cooling at least part of the cryoprobe, wherein the line system has an expansion channel having a line cross-section that is successively enlarged in the flow direction across a predetermined length such that the compressed cooling gas successively relaxes on the flow path thereof through the expansion channel beyond a predetermined length while simultaneously cooling off, at least partially.

Abstract: A device, system and method for controlling the temperature differential between the medium within the cryosurgical instrument and the external temperature of the shaft, apart from at the cryotip itself, uses a fluid medium supplied within an internal space between the shaft and an intermediate lumen positioned between the shaft and a central feeding lumen of the cryosurgical instrument. The temperature of the fluid medium is controlled to provide control of the temperature differential.

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: 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: The present invention provides cryotherapy treatment of dissections in a blood vessel of a patient. The present invention further provides cryotherapy treatment of side branch occlusion in a bifurcated blood vessel. One method for treating potential or existing dissections in a blood vessel comprises cooling the blood vessel to a temperature and for a time sufficient to remodel the blood vessel such that dissections of the blood vessel are reduced. Another method for treating side branch occlusion in a bifurcated blood vessel, the bifurcated blood vessel having a side branch and a main branch, the main branch having plaque disposed thereon, comprises cooling an inner surface of the main branch to a temperature and for a time sufficient to inhibit plaque shift from the main branch into the side branch.

Abstract: Clamp based low temperature lesion formation apparatus, systems and methods.

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: 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: Methods and systems for detecting fluid egress, assessing lesion quality, determining tissue composition or structure, determining ice coverage of catheter tip and providing tissue contact assessment, by providing a catheter having a shaft with a proximal end portion and a distal end portion, the proximal end portion and the distal end portion define at least one fluid pathway therebetween with the shaft having a plurality of electrodes, positioning the catheter at a tissue treatment site, applying an electrical current between at least two of the plurality of electrodes, measuring impedance voltage between the at least two of the plurality of electrodes and, processing the measured impedance voltage caused by the applied electrical current to determine if fluid egress is present, to assess lesion quality, to determine tissue composition, ice cover of catheter tip, and to provide contact assessment.

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 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 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: To provide a cooling needle probe and cooling system which can accurately cool a minute region. A cooling needle probe 10 includes a first cylindrical body 14 and second cylindrical body 12 which are made of thin-walled dissimilar metals and run longitudinally by being electrically insulated from each other. The first cylindrical body 14 and second cylindrical body 12 serve both as a flow path for a refrigerant and compensating leads of a thermocouple. The first cylindrical body 14 and second cylindrical body 12 are closed and joined at one end, forming a distal part 18, which also serves as a measuring junction of a thermocouple of a thermocouple. A minute communicating section 20 is formed near the distal part 18 to communicate between interior and exterior of the first cylindrical body 14.

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 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. The device is a closed or semi-closed system in which the liquid cryogen is contained in both the supply and return stages. The device is capable of generating cryogen to a supercritical state and may be utilized in any rapid cooling systems. As designed, the device comprises a number of parts including a vacuum insulated outer dewar, submersible cryogen pump, baffled linear heat exchanger, multiple pressurization cartridges, a return chamber, and a series of valves to control the flow of the liquid cryogen. The cryogenic medical device promotes the subcooling to any external cryogenic instrument.

Abstract: A cryoprobe for surgical and other treatments. The cryoprobe comprises an expandable section that performs displacement of a distal cryotip forwards when there is elevation of the operation pressure in the interior of the cryoprobe. Needle-wise metal elements are installed on the external side of the cryotip. These needle-wise elements are deflecting outwards by a deflecting member fastened on the distal edge of an external shaft of the cryoprobe. This allows a significant enlargement of the frozen volume of the treated tissue with the same operation temperature and the outer diameter of the cryoprobe. In another embodiment, the needle elements are formed in a displaceable metal sheath and a distal section of a cryotip and/or special protrusions on this distal section act as the deflecting member.

Abstract: A cryogenic applicator for rejuvenating skin and a treatment for use of the applicator. A barrel is hand-held. A head is rotatably mounted to the barrel. A cryogenic interface fluidly connects the barrel to a source of a biocompatible non-toxic cryogenic fluid to supply the cryogenic fluid through the barrel to the head that in turn sparges the cryogenic fluid onto the skin quickly, evenly, and smoothly when the head is rolled on the skin, and thereby rejuvenate the skin. The treatment includes the step of 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 cryogenic fluid onto the skin quickly, evenly, and smoothly when the head is rolled on the skin, and thereby rejuvenate the skin.

Abstract: A method is disclosed for treating heart and vascular tissue with cryotreatment. A medical instrument, such as a catheter is positioned to contact a target region of cardiac tissue such as the epicardial tissue. The instrument or catheter provided includes a cryotreatment element that has thermally-transmissive properties. The cryotreatment element may be a cryochamber for enclosing the flow of a fluid refrigerant therein. The cryotreatment element is disposed at the situs of heart or vascular tissue to be treated, usually by piercing the epicardium sac via an opening in the patient's body. A refrigerant flow within the cryochamber creates endothermic cooling with respect to the targeted heart or vascular tissue, inducing hypothermia and forming iceballs proximate the tissue. The cooling may be reversible and non-permanent, or may be permanent leading to cell death, necrosis, apoptosis and/or surgical excision or ablation of tissue.

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: A cryosurgical system adapted for treatment of fibroadenomas within the breast of a patient. The system includes cryoprobes and a control system which operates the cryoprobes to accomplish freezing in two stages, including a high power freeze and a low power freeze.

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.

Abstract: Methods and apparatus for cryo-therapy are disclosed herein. This includes a hollow guidewire disposed within a catheter having helical loops contacting tissue. A coolant delivery tube disposed within can have a coolant delivered from a proximal end into the guidewire lumen. The coolant flows back proximally through the guidewire while cooling the guidewire surface and cooling or cryogenically ablating the contacting tissue. To minimize guidewire exposure to surrounding fluids or tissue, insulative barriers can be attached to the guidewire. A coolant delivery tube and return lumen can be integrated from a single extrusion in various configurations. Expandable balloons can also be used to expand the loops of the guidewire to contact the tissue. Also, helical loops with a coolant delivery tube or stem disposed longitudinally within the loops can be used and the loops can also have a variable collapsible cooling region.

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: 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 laser induced liquid jet generating apparatus irradiates a laser beam on a liquid in a main body, guides the generated liquid jet into a catheter via a nozzle, and generates a flow in the direction opposite the liquid jet. Even by the use of a catheter having a small outside diameter, therefore, the apparatus is enabled to effect powerful laser irradiation without being thermally affected by the laser beam and consequently shatter thrombus, for example, and recover by aspiration the shattered thrombus through the distal end of the catheter.

Abstract: The invention proposes a cryosurgical instrument and its accessory system operating on the base of a refrigerant evaporation. The invention comprises combination of some technical solutions. Flow in a central lumen of the cryosurgical instrument has oscillating character; the refrigerant is provided on the internal surface of the distal cryotip in the form of separated portions. 2. The internal surface of the distal cryotip of the cryosurgical instrument is covered by a porous coating, which soaks completely one portion of the refrigerant. 3. Vapors obtained as a result of the refrigerant boiling on the porous coating of the cryotip are removed through the central lumen into the atmosphere. Combination of these technical solutions allows to construct a safely cryosurgical instrument with high freezing power and small outer diameter. The proposed cryosurgical instrument may be designed as a flexible cryocatheter or as a rigid cryoprobe.

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: A surgical process for freezing or cauterizing infected tissue, by inserting a transparent sleeve through a small slit in the flesh of a patient and wherein the inserted end of the sleeve is provided with a cone-shaped tip. Monitoring of the sleeve and probe insertion and location of the infected area is achieved by video camera. After removing the solid and rigid probe, a fiber optic tube is inserted into the sleeve whereby ambient light is conducted through the tube. A carbon rod is inserted through the fiber optic tube having its pointed end in contact with the infected area. The carbon rod is connected to a source of cold or heat. In a cold application, the infected area is frozen so when the carbon rod is removed and replaced by a suction device, the frozen area can be fragmented and the particles removed.

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.