Abstract: Catheterization systems and methods for treatment of a condition within a blood vessel are provided that include the use of a catheter, a balloon immediately adjacent to the distal end of the catheter, an inflation device for expanding the balloon, and an occlusion-penetrating device for gaining access through an occlusion. The occlusion penetrating device may include an indeflator configured to injected fluid at a high pressure, an RF wire, a hollow needle wire, a dissection tool, a laser wire, or even a very small balloon to exploit existing microchannels in the occlusion.

Abstract: The present system relates to an apparatus for desiccating tissue. The apparatus includes an electrode assembly having a heating element, a metal electrode, and a temperature sensor. The apparatus also includes a radio frequency (RF) generator, coupled to the metal electrode, having a signal generator for generating an electrical signal, and switch for selecting between a first mode, second mode and third mode of operation. In the first mode, the electrical signal is directed to the metal electrode and applied to the tissue. In the second mode, the electrical signal is directed to the heating element such that heat produced by the heating element is applied to the tissue. In the third mode, the electrical signal is directed to the metal electrode and the heating element, for applying the electrical signal and the heat to the tissue.

Abstract: A system for monitoring ablation size is provided and includes a power source including a microprocessor for executing at least one control algorithm. A microwave antenna is configured to deliver microwave energy from the power source to tissue to form an ablation zone. A radiation detection device is operably disposed on the microwave antenna. The radiation detection device is configured to generate a voltage corresponding to a radius of the ablation zone, wherein the radiation detection device is in operative communication with at least one module associated with the power source. The at least one module triggers a signal when a predetermined threshold voltage is measured corresponding to the radius of the ablation zone.

Abstract: A system for monitoring the target tissue during a tissue sealing procedure is disclosed. The system includes a forceps having opposing jaw members movable from a first position in spaced relation relative to one another to at least one subsequent position wherein the jaw members cooperate to grasp the tissue therebetween. Each of the jaw members includes a sealing member. The system also includes a generator coupled to the sealing members so that therapeutic energy is delivered to the target tissue. The generator includes an output stage configured to generate therapeutic energy and a microwave detector configured to measure reflected and/or absorbed microwave signals. The monitored microwave signals may be either the therapeutic energy signal or a separate non-therapeutic microwave monitoring signal. The generator also includes a controller operatively coupled to the microwave detector.

Abstract: A method includes delivering a Radio Frequency (RF) signal having a time-varying power from an intra-body probe to tissue in a vicinity of the probe in order to ablate the tissue. A temperature is measured in the vicinity of the probe. A decision is made as to whether the probe is in contact with the tissue, by comparing the measured temperature to a temperature threshold that varies in time depending on the time-varying power of the RF signal.

Abstract: This document discusses, among other things, a system for translocating a multilayer patch. The system includes a support structure having a contact surface for bonding to the patch. The support structure has a shape configured to support the patch following separation of the patch from a surrounding tissue.

Abstract: Described are methods and systems for reshaping a cartilage structure. Such methods comprise treating the cartilage structure with electromagnetic energy and fitting a device to the cartilage structure to retain it in the desired place, form, and/or orientation. Systems comprise an emitter of electromagnetic energy and a device to the cartilage structure to retain it in the desired place, form, and/or orientation.

Abstract: An energy-delivery device suitable for delivery of energy to tissue includes an antenna assembly, a chamber defined about the antenna assembly, and a cable having a proximal end suitable for connection to an electrosurgical energy source. The energy-delivery device also includes a flexible, fluid-cooled shaft coupled in fluid communication with the chamber. The flexible, fluid-cooled shaft is configured to contain a length of the cable therein and adapted to remove heat along the length of the cable during delivery of energy to the antenna assembly.

Abstract: According to some embodiments, a method of treating a subject having diabetes or symptoms associated with diabetes is provided. The method includes delivering a neuromodulation catheter within a vessel (e.g., hepatic artery) having surrounding nerves that innervate the liver (e.g., sympathetic nerves of the hepatic plexus). The method may also include modulating (e.g., disrupting, ablating, stimulating) the nerves by mechanical compression, energy delivery, or fluid delivery.

Abstract: Radiofrequency energy emitted from and reflected back toward a thermal ablation probe may be used to detect a gradual dissolution of a reflective interface between a tumor and surrounding healthy tissue as the ablation zone passes through this interface providing a real-time guidance with respect to the progress of ablation.

Abstract: Apparatus and method for ablating target tissue including a non-linear area of tissue in the left atrium of a patient. The method can include selecting an ablation apparatus having an ablator with a tissue engagement section, penetrating a chest cavity of the patient, and identifying the target tissue. The method can also include positioning the ablation apparatus adjacent to the target tissue so that the tissue engagement section can transfer ablation energy to the target tissue. The method can further include energizing the tissue engagement section with ablation energy in order to create a footprint on the non-linear area of tissue in the left atrium and to reduce an overall mass of excitable tissue in the left atrium.

Abstract: An electrosurgical system is provided and includes a power source, a microwave applicator, a switching mechanism and a controller. The power source is configured to generate microwave energy. The microwave applicator is configured to deliver microwave energy from the power source to tissue. The switching mechanism includes a housing having input and output ports. The input port is connectable to the power source and the output port is connectable to the microwave applicator. The housing is configured to house one or more switches therein. The controller is in operative communication with the switching mechanism to toggle the switch from a first state, wherein microwave energy generated by the power source is directed to the microwave applicator to a second state, wherein microwave energy is directed to a resistive load operably coupled to the switching mechanism.

Abstract: A method is provided for treating a neuromuscular defect in a subject. One step of the method includes locating a target nerve. After locating the target nerve, a treatment probe is provided. The treatment probe includes an elongated body member having a proximal end portion and a distal end portion. The distal end portion includes an energy delivery mechanism for stimulating or ablating the target nerve, a monitoring mechanism, and a fluid aspiration/delivery mechanism. Next, the target nerve is verified as an appropriate target for ablation by stimulating and then monitoring the target nerve via the energy delivery mechanism and the monitoring mechanism, respectively. After verifying the target nerve, a tumescent fluid is injected into the tissue surrounding the target nerve. An electric current is then delivered to the energy delivery mechanism to substantially ablate the target nerve.

Abstract: An electrosurgical ablation apparatus for generating and emitting electromagnetic radiation energy for ablating biological tissue is disclosed. The apparatus comprises an operating unit (1), a handheld applicator unit (3) with an applicator antenna (4) and a cable connection (2) between both. The applicator antenna (4) is a dual or multi-resonant ablation antenna (41a, . . . 41d) for transmitting microwave ablation energy at at least two different frequencies which are selected especially according to the electrical properties and dimensions of the tissue to be ablated.

Abstract: A system and method for treating subcutaneous histological features without affecting adjacent tissues adversely employs microwave energy of selected power, frequency and duration to penetrate subcutaneous tissue and heat target areas with optimum doses to permanently affect the undesirable features. The frequency chosen preferentially interacts with the target as opposed to adjacent tissue, and the microwave energy is delivered as a short pulse causing minimal discomfort and side effects. By distributing microwave energy at the skin over an area and adjusting power and frequency, different conditions, such as hirsuitism and telangiectasia, can be effectively treated.

Abstract: An apparatus for operating on tissue has a body, an elongate shaft, and an end effector. The elongate shaft extends distally from the body. The elongate shaft has an articulation section that is operable to selectively deflect the end effector laterally relative to the elongate shaft. The articulation section presents a first indication section and a second indication section. The first and second indication section may be configured to visually indicate the direction and degree of articulation of the articulation section. The first and second indication section may alternatively be configured to indicate the angular orientation of the end effector about the longitudinal axis. The body may further comprise a knob that is operable to rotate the shaft about the longitudinal axis. The knob may include a third indication section and a fourth indication section that align with the first and the second indication sections of the articulation section, respectively.

Abstract: A coaptive surgical sealing tool may be similar to an ordinary hemostat with long (50, 60, 70 or 80 mm) thin jaws for sliding into the liver parenchyma, without tearing the larger blood vessels. The jaws are spring loaded and are designed for uniform compression, and to avoid closing too quickly. The jaws are capable of sealing a 50, 60, 70 or 80 mm sealing length, in a single bite, although it can also seal shorter lengths as well. The tool can be used with existing ablative therapy microwave generators. The tool may be provided with irrigation and/or suction.

Abstract: A directional reflector assembly includes a tubular shaft having a proximal end and a distal end and adapted to operably engage an electrosurgical ablation probe, and a conical aperture having a proximal open apex joined to a distal end of the tubular shaft, and a distal open base, wherein an interior volume of the tubular shaft is open to the conical aperture.

Abstract: Apparatus and methods for delivering electromagnetic energy to a patient's tissue with a reduction in the pain experienced by the patient. The tissue treatment apparatus includes a delivery device configured to transfer electromagnetic energy through the skin surface to a region of tissue and a vibration device mechanically coupled with the delivery device. The vibration device is configured to transfer mechanical vibrations through the skin surface to the region of tissue.

Abstract: An electrosurgical instrument is provided and includes an elongated housing having proximal and distal ends. The proximal end configured to couple to a source of electrosurgical energy via first and second channels extending along a length of the housing to the distal end thereof. The distal end including a reflector having a dielectric load operably coupled thereto and configured to receive at least a portion of the first conductor therein. In a first mode of operation, electrosurgical energy is transmitted to the first channel and reflected from the reflector to electrosurgically treat tissue. The reflector is configured to receive at least a portion of the second channel therein. In a second mode of operation, electrosurgical energy transmitted to the second channel to dissect tissue.

Abstract: An electrosurgical generator and related systems and methods using a gain-compensated full bridge topology. Gain nonlinearity is corrected by applying impedance and phase correction factors to a control loop to achieve a linear gain structure. In embodiments, gain compensation is performed by comparing an RF setpoint signal with a calculated output signal to generate a first error signal. An impedance correction factor is applied to the first error signal to generate a second error signal. The second error signal is processed by a proportional-integral-derivative controller to generate a phase control signal. A phase control correction factor is applied to the phase control signal to generate a corrected pulse width modulation driving signal, which is used to generate PWM driving signals for a full-bridge inverter. One or more sensors provide feedback for comparison with the RF setpoint.

Abstract: The present invention provides improved methods and apparatus for skin treatment and tissue remodeling. The apparatus includes an array of needles that penetrate the skin and serve as electrodes to deliver radio frequency current or other electrical or optical energy into the tissue being treated, causing thermal damage in controlled patterns. The damaged regions promote beneficial results such as uniform skin tightening by stimulation of wound healing and collagen growth.

Abstract: An electrosurgical energy channel splitter apparatus includes a channel input a plurality of channel outputs, and a controller. The channel input is configured to receive electrosurgical energy from an electrosurgical energy source. Each channel output is configured to couple to a respective electrosurgical device. The controller is coupled to the channel input and the plurality of channel outputs. The controller is configured to selectively direct the electrosurgical energy from the channel input to one of the plurality of channel outputs.

Abstract: The present invention discloses embodiments of microwave antennas and other energy delivery systems. The present invention also discloses systems and methods for the delivery of various medical components within or on a body for performing one or more medical procedures. Several embodiments herein disclose medical systems comprising a combination of one or more medical components and one or more elongate steerable or non-steerable arms that are adapted to mechanically manipulate the one or more medical components. Several embodiments of microwave antennas are disclosed that comprise an additional diagnostic or therapeutic modality located on or in the vicinity of the microwave antennas.

Abstract: A medical probe includes an insertion tube, having a longitudinal axis and having a distal end. A distal tip is disposed at the distal end of the insertion tube and is configured to be brought into contact with a body tissue. A joint couples the distal tip to the distal end of the insertion tube. A joint sensor, contained within the probe, senses a position of the distal tip relative to the distal end of the insertion tube. The joint sensor includes first and second subassemblies, which are disposed within the probe on opposite, respective sides of the joint and each include one or more magnetic transducers.

Abstract: A kit for penetrating the cardiac septum and for implanting a transeptal lead, including a lead for the detection/stimulation of a left heart cavity. This kit includes a screw lead (16) and a radio-frequency puncture generator (32). The lead includes: a lead body with a deformable sheath (18); a proximal end having an electrical connector (20) for coupling to an implanted medical device housing; a distal end having a lead head (22) with an electrode including a projecting conductive helical screw (24) for penetrating into the septum (10) due to a screw movement applied from the proximal end of the lead, and a conductor (26) connecting the electrode to the electrical connector, the electrode including the screw.

Abstract: A Minimally Invasive Surgical Laser Hand-piece (“MISLH”) for use with a probe is described. The MISLH has a MISLH proximal end and MISLH distal end, and the MISLH may include an optical coupler located at the MISLH proximal end, a substantially straight central bore within the MISLH, and an internal beam stop aperture within the central bore adjoined to the optical coupler. The central bore may extend from the optical coupler to the MISLH distal end and the central bore may be configured to accept the insertion of the probe within the central bore at the MISLH distal end. Additionally, the central bore may be configured to accept the insertion of the probe such that the probe is adjoined to the internal beam stop aperture.

Abstract: According to some embodiments, a method of treating a subject having diabetes or symptoms associated with diabetes is provided. The method includes delivering a neuromodulation catheter within a vessel (e.g., hepatic artery) having surrounding nerves that innervate the liver (e.g., sympathetic nerves of the hepatic plexus). The method may also include modulating (e.g., disrupting, ablating, stimulating) the nerves by mechanical compression, energy delivery, or fluid delivery.

Abstract: A microwave energy delivery and measurement system, including a microwave energy source configured to delivery microwave energy to a microwave energy delivery device, a measurement system configured to measure at least one parameter of the microwave energy delivery device and a switching network configured to electrically isolate the microwave energy source and the measurement system. The measurement system is configured to actively measure in real time at least one parameter related to the microwave energy delivery device.

Abstract: Methods and devices described herein facilitate improved treatment of body organs.

Abstract: An apparatus for operating on tissue includes an end effector, an actuator, and a spring assembly. The end effector includes a first jaw and a second jaw that pivots relative to the first jaw from an open position to a closed position. The actuator is coupled with the second jaw to pivot the second jaw relative to the first jaw. The spring assembly is coupled with the actuator and is adjustable from a first position to a second position. The spring assembly compresses to resiliently bias the actuator to pivot the second jaw to the open position when the spring assembly is in the first position. The spring assembly compresses a smaller amount when the spring assembly is in the second position.

Abstract: An apparatus for operating on tissue comprises a body, an elongate shaft, an end effector, a compression member, and a firing beam. The end effector has a pair of jaws configured to open and close along a first plane. The end effector is capable of delivering RF energy to the tissue. The compression member is configured to drive the jaws to a closed position once the compression member has been distally driven into the end effector. The compression member is substantially inflexible along the first plane yet is flexible along a second plane that is transverse to the first plane. The firing beam is operable to sever tissue captured within the end effector. The compression member may be actuated distally to close the jaws upon tissue and provide uniform compression of the tissue along the length of the jaws before the firing beam is advanced through the tissue.

Abstract: The present disclosure relates to a method and a device for treating heart failure by normalizing elevated blood pressure in the left and right atria of a heart of a mammal The present disclosure includes methods for creating and maintaining an opening in the atrial septum. Tools for making an opening and enlarging the opening are also disclosed. Use of the techniques and tools described herein prolongs the patency of an intra-atrial pressure relief opening.

Abstract: Methods, apparatus, and systems for delivering electromagnetic energy to a patient's tissue with a reduction in the pain experienced by the patient. Electromagnetic energy is delivered from a treatment electrode through the skin surface to the tissue at a plurality of power levels over a treatment time. During the energy delivery, a portion of the treatment electrode is in a contacting relationship with the skin surface. A dielectric member may be disposed between the treatment electrode and the skin surface when the electromagnetic energy is delivered.

Abstract: Methods and devices are disclosed that, in various embodiments and permutations and combinations of inventions, diagnose and treat Pulmonary Embolism or associated symptoms. In one series of embodiments, the invention consists of methods and devices for identifying patients whose Pulmonary Embolism or associated symptoms are caused or exacerbated, at least in part, by blockages of one or more of the patient's internal pulmonary veins. In some instances, stenoses or other flow limiting structures or lesions in the patient's affected veins are identified. Further, in some instances the nature of such lesions and whether there is a significant disruption of blood pressure, or both, is ascertained. In some embodiments, methods and devices for applying one or more therapies to the blockages in the patient's pulmonary veins are provided.

Abstract: The invention provides a system and method for percutaneous energy delivery in an effective, manner using one or more probes. Additional variations of the system include array of probes configured to minimize the energy required to produce the desired effect.

Abstract: An ablation electrode is mounted on the distal end of a catheter with a first portion inside and a second portion outside the catheter. The second portion is adapted to have a surface that makes maximum contact with a tissue to be ablated, leaving a minimum area not covered by the tissue and potentially exposed to blood. The first portion is adapted to provide an extended surface area for efficient exchange of heat with a coolant flowing inside the catheter. Outlets provided near the area not covered by the tissue in the second portion prevents blood from getting close to or come directly in contact with the area, thereby greatly reducing formation of dangerous blood clots. The minimizing of an electrical circuit through blood greatly reduces wasted power into the electrode so that the efficiently cooled electrode is not burdened. The catheter preferably has multiple electrodes with similar features.

Abstract: Systems and methods improve operation of an applicator that delivers heat-generating energy to an eye as a part of an eye therapy. For example, reflected power may be measured to determine whether sufficient contact has been established between the applicator and the eye for accurate and precise delivery of energy to the eye. In addition, at least one of forward and reflected power may be measured to monitor the application of coolant pulses that control the generation of heat in the eye when the applicator delivers energy to the eye. Further, the forward and reflected power may be measured to determine an efficiency of energy transfer or an impedance mismatch. Based on the efficiency of energy transfer or the impedance mismatch, an adjustable parameter of a tuning element may be modified.

Abstract: Surgical cutting apparatus having a treatment channel and a measurement channel for conveying microwave energy from a source to an antenna at a cutting edge. The measurement channel operates at lower power than the treatment channel for determining when higher energy can be safely applied. The apparatus may deliver microwave radiation at differing frequencies to one or more antennas at the cutting edge, e.g. to provide different treatment effects. The source may generate an output for an antenna whose frequency can be selected e.g. for most efficient operation. Selection may be automatic based on detected magnitude and phase of reflected signals during a frequency sweep of a forward signal. Power delivered to tissue via the cutting element may be manually boosted to deal with large blood vessels. The apparatus may include a reflected power monitor for recognising behaviour in reflected signals received from the antenna to trigger automatic pre-emptive action.

Abstract: Provided are a positron emission tomography (PET)-radiofrequency ablation (RFA) complex medical device and a treatment method using the same. According to an aspect of the present invention, there is provided a positron emission tomography (PET)-radiofrequency ablation (RFA) complex medical device comprising: a PET module which obtains, in real time, a location of a target to be treated by scanning a patient; and an RFA module which remotely treats the target using heat by focusing the heat on the location of the target.

Abstract: According to some embodiments, a method of treating a subject having diabetes or symptoms associated with diabetes is provided. The method includes delivering a neuromodulation catheter within a vessel (e.g., hepatic artery) having surrounding nerves that innervate the liver (e.g., sympathetic nerves of the hepatic plexus). The method may also include modulating (e.g., disrupting, ablating, stimulating) the nerves by mechanical compression, energy delivery, or fluid delivery.

Abstract: The microwave antenna assembly includes a feedline electrically connected to an elongated shaft by a choke electrical connector. The feedline includes an inner conductor, an outer conductor, an elongated shaft and a choke electrical connector. The inner conductor is disposed in coaxial arrangement with the inner conductor and forms a dielectric supply lumen therebetween. The elongated shaft at least partially surrounding the feedline and form a dielectric return lumen therebetween. The choke electrical connector surrounds at least a portion of the feedline and electrically connects the feedline outer conductor to the elongated shaft. A low-loss dielectric fluid is supplied between the inner conductor and the outer conductor of the feedline and forms a dielectric barrier therebetween.

Abstract: A self-limiting electrosurgical electrode for use with electrosurgery and various other surgical procedures is disclosed. The electrode includes a heating element for generating heat to warm a patient resting upon the electrode. The electrode can also include one or more pads to prevent the creation of pressure sores or decubitus ulcers on a patient resting upon the electrode. The electrode has an effective bulk impedance equal to or greater than about 4,000 ?·cm, which arises from resistive components, capacitive components, inductive components, or combinations thereof. Through the selection of the impedance characteristics for the electrode materials, and through tailoring of electrode geometries, the electrode of the present invention is self-regulating and self-limiting as to current density and temperature rise so as to prevent patient trauma.

Abstract: Apparatus and methods are provided to concentrate energy delivery in non-superficial target tissue within a trigone region of a human bladder wall to modulate bladder function.

Abstract: A microwave ablation system is provided. The microwave ablation system includes a power source. A microwave antenna is adapted to connect to the power source via a coaxial cable that includes inner and outer conductors having a compressible dielectric operably disposed therebetween. The inner conductor in operative communication with a radiating section associated with the microwave antenna. The outer conductor includes a distal end transitionable with respect to each of the inner conductor, compressible dielectric and radiating section from an initial condition wherein the distal end has a first diameter to a subsequent condition wherein the distal end has second diameter. Transition of the distal end from the initial condition to the subsequent condition enhances the delivery of microwave energy from the power source to the inner conductor and radiating section such that a desired effect to tissue is achieved.

Abstract: Technologies are generally described for detecting diseased tissues through fiber optic based Raman spectroscopy, image acquisition, and/or RF induced hyperthermia treatment of the detected tissues in an integrated manner. A fiber optic bundle for carrying optical and RF signals for the spectroscopy, visual imaging, and RF ablation may also be used to detect a temperature of the treated tissue such that level and duration of the RF signal can be controlled for optimum results. A shielding configuration in the form of a coaxial waveguide of the fiber optic bundle may be used to guide and deliver the RF signal. Sources and detectors for the optical and RF signals may be integrated into an endoscopic probe containing the fiber optic bundle or be externally positioned. An integrated or remote controller may be employed to manage the optical imaging, spectroscopy, RF ablation, and thermal sensing operations.

Abstract: Catheter apparatuses, systems, and methods for achieving renal neuromodulation 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 an energy delivery element to a renal artery via an intravascular path. Thermal or electrical renal neuromodulation may be achieved via direct and/or via indirect application of thermal and/or electrical energy to heat or cool, or otherwise electrically modulate, neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers.

Abstract: Systems and methods that enable delivery of radiofrequency energy and cryotherapy applications to adipose tissue for reduction and contouring of body fat are described herein. Aspects of the disclosure are directed to methods for reducing surface irregularities in a surface of a subject's skin resulting from an uneven distribution of adipose tissue in the subcutaneous layer. The method can include delivering capacitively coupled or conductively coupled radiofrequency energy to a target region of the subject at a frequency which selectively heats fibrous septae in a subcutaneous layer of the target region to a maximum temperature less than a fibrous septae denaturation temperature. Furthermore, the method can include removing heat such that lipid-rich lobules in the subcutaneous layer are affected while non-lipid-rich cells and lipid-rich regions adjacent to the fibrous septae are not substantially affected.

Abstract: Methods of treating a subject for a cardiac arrhythmia are provided. Aspects of the methods include thoracoscopically producing a cardiac Cox maze III set of lesions in cardiac tissue of the subject in a manner sufficient to treat the subject for the cardiac arrhythmia.

Abstract: Methods and devices for treating nasal airways are provided. Such devices and methods may improve airflow through an internal and/or external nasal valve, and comprise the use of mechanical re-shaping, energy application and other treatments to modify the shape, structure, and/or air flow characteristics of an internal nasal valve, an external nasal valve or other nasal airways.