Abstract: Provided herein are conjugates, compositions and methods for use in photoimmunotherapy, such as photoimmunotherapy induced by activation of a phthalocyanine dye conjugated to a targeting molecule that binds a protein on cell, for example, an IR700-antibody conjugate. In some embodiments, the phthalocyanine-dye conjugate can be activated by irradiation with near-infrared light. Features of the conjugates, compositions and methods, including the dose of the conjugate, provide various advantages, such as lower toxicity and/or improved efficacy. In some embodiments, also provided is a dual label phthalocyanine-dye conjugate in which the targeting molecule is conjugated to an additional fluorescent dye, which can be used for photoimmunotherapy while, for example, also exhibiting improved performance for imaging or detection. Also provided are therapeutic methods using the conjugates and compositions for treatment of diseases and conditions, including tumors or cancers.

Abstract: An endoluminal lasing system for treating vascular disorders is disclosed. Treatment comprises an elongated member that conveys laser radiation to tissue and a motorized mechanism, through which elongated member is rotated. As motor drives, its movement spins elongated member leading to a spiral movement as physician manually moves member in a longitudinal direction. In a preferred embodiment, elongated member is an optical fiber for endoluminal vessel treatment. In another preferred embodiment optical fiber comprises an off-axis firing distal end or side-firing distal end. Optical fiber can be a radial emitting fiber. Spin velocity can be varied according to treatment needs, i.e., pathology, type of vessel, energy source, vessel diameter, etc. One advantage, spiral movement prevents adherence to vessel wall in treatments. Another advantage is that radiation is applied more uniformly along vessel wall. The vessel wall is, thus more evenly treated under most conditions.

Abstract: Systems for enabling delivery of very high peak power laser pulses through optical fibers for use in ablation procedures preferably in contact mode. Such lasers advantageously emit at 355 nm wavelength. Other systems enable selective removal of undesired tissue within a blood vessel, while minimizing the risk of damaging the blood vessel itself, based on the use of the ablative properties of short laser pulses of 320 to 400 nm laser wavelength, with selected parameters of the mechanical walls of the tubes constituting the catheter, of the laser fluence and of the force that is applied by the catheter on the tissues. Additionally, a novel method of calibrating such catheters is disclosed, which also enables real time monitoring of the ablation process. Additionally, novel methods of protecting the fibers exit facets are disclosed.

Abstract: A test device is used to test photosensitivity of a skin. The test device is provided with an irradiation unit including a plurality of light irradiation units arranged in a first direction. The plurality of light irradiation units output, in a second direction intersecting the first direction, irradiation light beams that mutually differ at least in one of wavelength characteristics and intensity. The irradiation unit is configured such that intensities of the irradiation light beams output from the plurality of light irradiation units are progressively smaller in the first direction.

Abstract: A medical instrument includes a housing and a shaft coupled to the housing. The shaft has a proximal end and a distal end. An end effector assembly is disposed at the distal end of the shaft. The end effector assembly includes first and second jaw members. At least one of the first and second jaw members is movable from a first position wherein the first and second jaw members are disposed in spaced relation relative to one another to at least a second position closer to one another wherein the first and second jaw members cooperate to grasp tissue therebetween. The medical instrument also includes one or more light-emitting elements and one or more light-detecting elements configured to generate one or more signals indicative of tissue reflectance. The one or more light-emitting elements are adapted to deliver light energy to tissue grasped between the first and second jaw members.

Abstract: A method for photoselective vaporization of prostate tissue includes delivering laser radiation to the treatment area on the tissue, via an optical fiber for example, wherein the laser radiation has a wavelength and irradiance in the treatment area on the surface of the tissue sufficient because vaporization of a substantially greater volume of tissue than a volume of residual coagulated tissue caused by the laser radiation. The laser radiation is generated using a neodymium doped solid-state laser, including optics producing a second or higher harmonic output with greater than 60 watts average output power. The delivered laser radiation has a wavelength for example in a range of about 200 nm to about 650 nm, and has an average irradiance in the treatment area greater than about 10 kilowatts/cm2, in a spot size of at least 0.05 mm2.

Abstract: The present disclosure provides, according to some embodiments, methods and systems for selectively reducing, blocking or inhibiting at least part of the neural activity in an organ of a subject. In preferred embodiments, the method and system are used for selectively blocking at least part of the neural activity in a duodenum of a subject in need thereof. According to some embodiments, the selective blocking occurs through use of laser radiation. According to some embodiments, the selective blocking occurs through use of ultrasound energy. According to some embodiments, the selective blocking comprises causing damage to at least part of sensory nerves located within a target area while maintaining functional activity of tissue surrounding the sensory nerves by means of shielding it from the effects of laser radiation.

Abstract: A surgical instrument includes an optical fiber having a proximal end and a distal end, the optical fiber configured to emit light at the distal end. The surgical instrument also includes at least one scattering material coupled to the proximal end, the distal end, or a combination of both the proximal end and the distal end.

Abstract: A balloon catheter (10) has a shaft (12) having an elastically expandable balloon (11) on the distal end side and space provided inside and allowing a fluid to flow into and flow out the balloon (11), a heat generating member (22) provided in the internal space of the balloon (11), and optical fibers (20A, 20B) which are extended up to the internal space of the balloon (11) along the shaft (12) and emit light beams input into the proximal end to the heat generating member (22) from the distal end.

Abstract: A system in one embodiment includes an image forming device for forming an image from an area of interest containing different image components; an illumination device for illuminating the area of interest with light containing multiple components; at least one light source coupled to the illumination device, the at least one light source providing light to the illumination device containing different components, each component having distinct spectral characteristics and relative intensity; an image analyzer coupled to the image forming device, the image analyzer decomposing the image formed by the image forming device into multiple component parts based on type of imaging; and multiple image capture devices, each image capture device receiving one of the component parts of the image. Additional systems and methods are presented.

Abstract: Systems and methods for illumination of a vascular space and its contents using an electromagnetic energy source that supplies a plurality of wavelengths ranging from ultraviolet to infrared are shown. Illumination can be performed using multiple wavelengths, simultaneously or sequentially, and can be performed in accordance with a protocol where an initial illumination produces an effect that is at least partially reversed by a subsequent illumination. Illumination protocols can be stored on a database and accessed via a user interface displayed on the electromagnetic energy source. The database can be used to store data related to performance of system components, and such data can be used to override or modify an illumination protocol.

Abstract: An electrosurgical device and methods are disclosed for creating a channel through a region of tissue. The device comprises an elongate member for receiving the energy from an electrical energy source. An electrical insulation layer surrounds the elongate member along the device proximal region. An electrode tip is coupled to the distal end of the elongate member for delivering the energy, the electrode tip being configured and sized for delivering the energy in a manner such that electrical arcing is generated in the region of tissue in order to create a channel through at least a portion of the region of tissue. An electrically insulative thermal shield is disposed between the electrode tip and the device proximal region for preventing arcing therebetween during the delivery of the energy and for thermally protecting the device proximal region from heat produced by the delivery of the energy through the electrode tip.

Abstract: An optical fiber includes an internal fiber, an end surface, a first cap member and a second cap member. The internal fiber terminates at a fiber tip. The end surface transmits laser energy delivered through the internal fiber. The first cap member extends over the end surface and includes a first end on a first side of the end surface and a second end on a second side of the end surface. The second cap member extends over the first cap member and includes a first end on the first side of the end surface and a second end on the second side of the end surface, the second end of the second cap member is attached to the second end of the first cap member.

Abstract: An angioplasty balloon including a non-deployable stent to prevent or reduce the potential for slippage of the inflated balloon with respect to the vessel wall being treated. The balloon includes a non-deployable stent that is adapted to be secured to the balloon or angioplasty balloon catheter. The stent has a proximal end, a distal end, and at least three radially-spaced struts, each, each strut connecting the proximal end to the distal end and having one or more bends that allow expansion of the strut to accommodate the inflation of the balloon. The stent is made or a material so that the stent collapses upon deflation of the balloon.

Abstract: A handheld controller for laser surgical applications includes a variable time delay control to allow a surgeon to delay interruption of laser firing in response to feedback from an overheating detector, and a detector sensitivity control for changing a sensitivity of the detector.

Abstract: Embodiments of a balloon biasing laser catheter are provided. In some embodiments, the laser catheter may include a distal tip that extends from the distal end of the catheter from a point near the light guide aperture. The distal tip may be disposed at the periphery of the catheter. In some embodiments, a balloon may be disposed between the light guide aperture and the distal tip, such that the a light guide extending from the aperture may be disposed proximate with the distal tip having the balloon in between. A retaining wire may be coupled with the distal tip and slidably coupled with the light guide. The retaining wire may keep the light guide biased relatively parallel with the distal tip and/or the catheter body when the balloon is inflated. The light guide may include a guidewire lumen the extends to the distal end of the distal tip.

Abstract: Expandable laser catheters for utilizing laser energy to remove obstructions from body passages are described. In one embodiment, the laser catheter includes a shaftway having a distal end including a flexible portion configured in a series of radial folds. Multiple optical fibers, configured to transmit laser energy, extend along the shaftway and are attached to the flexible portion. An inflatable, ring-shaped balloon is attached to the catheter within the flexible portion. In use, the catheter is inserted into a body passage such as an artery, and advanced until the distal end is adjacent to an obstruction. The balloon is inflated to expand the flexible portion and to bring the optical fibers nearer the inner wall of the body passage. Laser energy is directed by the optical fibers toward targeted regions of the obstruction. As the catheter is advanced and the process repeated, a core is formed from the obstruction and contained within the flexible portion.

Abstract: A steerable laser probe may include a handle having a handle distal end and a handle proximal end, a housing sleeve disposed in an inner bore of the handle configured to project a distance from the handle distal end, an optic fiber disposed in the housing sleeve, a shape memory sleeve disposed over a distal end of the optic fiber, and a light source configured to connect to a proximal end of the optic fiber. The shape memory sleeve may be configured to curve the distal end of the optic fiber at an angle, e.g., 90 degrees, when the shape memory sleeve is not contained within the housing sleeve.

Abstract: Apparatus, devices, methods, systems, computer programs and computing devices related to autofluorescent imaging and ablation are disclosed.

Abstract: A method and system for ablation of cardiac tissue in a living being via the esophagus is provided. The method includes the step of introducing a photodynamic substance to the cardiac tissue. A deformable, elongated body defining a proximal end and a distal end is inserted into an esophagus of the living being. The distal end of the elongated body is located proximate the cardiac tissue. A first set of electromagnetic radiation is then directed from the distal end of the elongated body towards the cardiac tissue. Reflective and opaque surfaces at the distal end of the elongated body may be used to direct the electromagnetic radiation and an expandable membrane at the distal end may be used to urge the distal end of the elongated body to a predetermined position within the esophagus.

Abstract: An apparatus for applying a plurality of electro-magnetic radiations to a sample is provided. In one exemplary embodiment, the apparatus can include an arrangement which has a specific portion with a plurality of channels. One of channels can facilitate a first radiation of the radiations to be forwarded to the sample that is within an anatomical structure, and another one of the channels can facilitate a second radiation of the radiations to be forwarded to the sample. The first radiation may have a first wavelength band, and the second radiation may have a second wavelength band. The first wavelength band may be substantially different from the second wavelength band. According to another exemplary embodiment, the first radiation can be adapted to be delivered to a first area of the sample, and the second radiation may be capable of being delivered to a second area of the sample. The first area may be substantially enclosed by the second area.

Abstract: Methods of ablating tissue in an alimentary tract are provided. The methods include advancing an ablation structure into an alimentary tract while supporting the ablation structure with an endoscope. The methods further include a step of moving at least part of the ablation structure with respect to the endoscope and toward a tissue surface, before activating the ablation structure to ablate a tissue surface.

Abstract: A light-based method of endovascular treatment, in particular, of pathologically altered blood vessels. Provided are a Method of Endovascular Light Treatment and a corresponding Endovascular Light Application Device.

Abstract: A steerable laser probe may include a handle having a handle distal end and a handle proximal end, a housing sleeve disposed in an inner bore of the handle configured to project a distance from the handle distal end, an optic fiber disposed in the housing sleeve, a shape memory sleeve disposed over a distal end of the optic fiber, and a light source configured to connect to a proximal end of the optic fiber. The shape memory sleeve may be configured to curve the distal end of the optic fiber at an angle, e.g., 90 degrees, when the shape memory sleeve is not contained within the housing sleeve.

Abstract: A catheter device provides a balloon structure and a side-firing laser lumen within the balloon to create lesions in the pulmonary vein (PV) in the treatment of atrial fibrillation. Mounted on the balloon so as to contact the PV when the balloon is inflated are one or more electrodes which may be used in a measurement mode, a treatment mode, or both.

Abstract: A method and a device for minimally invasive treatment of diseased deep and superficial venous valves are disclosed. Treatment seeks to repair/rejuvenate dysfunctional valve by reducing the circumference of dilated valve rings and by restoring their original shape and function using laser energy to make physical suture points and shrink collagen in selected points. Real time monitoring is by angioscopic view and endovenous echographic control. In a preferred embodiment, system comprises a specific catheter-like device for endovenous insertion that allows for real time view of energy emission and venous surface to be corrected. Catheter flexibility is such that viewing angle and direct energy emission can be oriented properly. Catheter can comprise channels for irrigation or for interchange of laser fibers according to desired irradiation pattern. A preferred embodiment of catheter device also comprises cuffs for temporary occlusion, by inflation and deflation.

Abstract: An infrared fiber-optic device is able to monitor esophageal temperature during an ablation/cryoablation procedure over a volume of interest to sense whether the temperature is too high or too low. The device may include a plurality of optical fibers each with a wide angle lens collectively disposed circumferentially and longitudinally to cover the volume of interest, as the particular region over which undesirable temperature may not be known beforehand. In other examples, the device may include an embedded array of infrared sensors extending sufficiently to encompass a volume of interest. The device may be used as part of a feedback control to regulate and stop operation of the ablation/cryoablation procedure to prevent vessel damage.

Abstract: Devices and methods for therapeutic photodynamic modulation of neural function in a human. One embodiment of a method in accordance with the technology includes administering a photosensitizer to a human, wherein the photosensitizer preferentially accumulates at nerves proximate a blood vessel compared to non-neural tissue of the blood vessel. The method can further include irradiating the photosensitizer using a radiation emitter positioned within the human, wherein the radiation has a wavelength that causes the photosensitizer to react and alter at least a portion of the nerves thereby providing a therapeutic reduction in sympathetic neural activity. Several embodiments of the technology are useful for disrupting renal nerves, such as renal denervation, for treating hypertension, diabetes, congestive heart failure, and other indications.

Abstract: An improved method and device for safe and efficient medical applications is provided. In a preferred embodiment, based on using the inherent benefits of laser diodes (such as efficient power generation from a reliable and compact solid state device), plasmas and high energy vapors are produced for medical applications with power levels and power densities sufficient to treat medical indications and avoid the creation of extensive damage zones. Transmissions means in different configurations are used to achieve a high power density, which is able to initiate plasma and high-energy vapor at the tip. Once a sparkless plasma and high energy vapor bubbles are formed, it is often found that it will also absorb other wavelengths in addition to the one that initiated it. As a consequence, other wavelengths more efficiently generated by diodes or diode pumped lasers may be added into the beam in order to improve treatment efficiency.

Abstract: An endovascular sheath device for use with a thermal treatment apparatus is provided. The device includes a longitudinal tube which is designed to receive a thermal treatment device and is designed to be inserted into a blood vessel. An ultrasonically visible reinforcement element is disposed along the length of the longitudinal tube. The reinforcement element such as a braided wire provides several functions including increased visibility under ultrasound, clearer identification of sheath tip, and increased durability to protect the fiber from needle punctures during tumescent injections into the perivenous space. The wire reinforcement also increases shaft torquability and kink resistance during sheath insertion and withdrawal.

Abstract: A medical device for removing a thrombus from a blood vessel and a process thereof is presented. The device includes an outer sheath with a plurality of lumens. A wire guide inserted through one of the lumens is used to place the device proximate to a thrombus. An optical fiber placed through a second lumen uses laser input to ablate the thrombus in the distal portion of the second lumen near its distal end. A vacuum coupled to the proximal end of the second lumen is used to remove any ablated residual material. The second lumen may be pivoted around the first lumen to reposition the second lumen proximate to an area of the thrombus that has not yet been ablated.

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: Tissue and vessel treatment devices and respective methods are provided. Devices comprise a flexible treatment layer that comprises a plurality of operable elements configured to be activated to apply the treatment to the obstruction upon bending of the flexible treatment layer beyond a specified curvature threshold and to be de-activated upon a specified decrease of the bending. The treatment layer may comprise optical fiber(s) with the operable elements as emission regions that emit electromagnetic radiation from the core upon bending the optical fiber beyond a specified bending threshold. Devices may be configured as vessel sealing tips for surgical forceps, in which the treatment layer is configured to yield vessel welding and vessel cutting effects.

Abstract: An endovascular laser treatment device designed to be used with an optical fiber to treat venous diseases such as varicose veins is provided. The device includes a spacer that positions the distal end of the optical fiber away from the inner wall of the blood vessel during delivery of laser energy to provide an even distribution of thermal energy around the vessel, thereby avoiding vessel perforation and incomplete vessel collapse.

Abstract: Catheters for ablation and removal of occlusions from blood vessels are provided. Laser cutting systems and mechanical cutting systems are provided in catheter devices, the cutting systems operable to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. A helical or partially-helical inner surface structure is provided in the catheter, the structure operable to remove or translate dislodged material(s).

Abstract: A system and devices for ablation and removal of occlusions from blood vessels is provided. Laser cutting systems and mechanical cutting systems are provided in catheter devices, the cutting systems operable to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Catheter systems comprise distal end features adapted to cut and remove at least portions of an occlusion that generally correspond to dimensions of an inner lumen of a catheter.

Abstract: The present invention generally relates to methods for removing plaque from a vessel. The method can involve obtaining a first image of a blood vessel using a first imaging modality, obtaining a second image of the blood vessel using a second imaging modality, and coregistering the first and second images, thereby generating a coregistered data set. The method can further involve inserting an atherectomy catheter into the blood vessel and removing plaque from the vessel with the atherectomy catheter based on plaque identified in the coregistered set of data.

Abstract: The present invetion provides a method and apparatus for elimination of atherosclerosis from an artery. According to the present invetion the diseased artery is approached from external side and ablate is approached in such a way that incision/cut pass through tunica adventitia and tunica media of the diseased artery and a fibrous capsule of the atherselerosis. On ablation/incision, the contents plaques are exposed to the natural defense of the body and are destroyed by the natural defense system. The plaque escaping out of the artery on the external surface of the artery may be wiped or washed away with saline during or after the ablation procedure. Then, natural healing of artery is allowed which eliminates atherosclerosis thoroughly.

Abstract: Various embodiments of an eccentric balloon catheter are disclosed. In some embodiments, an eccentric balloon catheter includes an eccentrically positioned guidewire tube, with an interior lumen, that extends at least a portion of the length of the catheter body. Optical fibers may extend the length of the catheter body and may also be eccentrically positioned within the catheter body. An inflatable balloon may be positioned within a window within the catheter body near the distal end of the catheter. When inflated, the balloon and catheter may slide relative to one another. When used within a vessel, an inflated balloon may press against a vessel wall and bias the catheter toward an opposite vessel wall.

Abstract: In some embodiments, without limitation, the invention comprises a catheter having an elongated housing with a channel disposed therein. A laser delivery member is movable and at least partially disposed within the channel. A ramp is disposed within the housing at an angle to its central axis and proximate to its distal end. The ramp is adapted to move the distal end of the laser delivery member outwardly from the central axis of the housing. A guidewire biases the distal end of the laser delivery member generally inwardly toward the central axis of the housing. In some embodiments, without limitation, the offset of the central axis of the tip of the laser delivery member from the central axis of the housing is determined by adjusting the extent to which the laser delivery member travels on the ramp, and disposition of the laser delivery member on the guidewire maintains the offset tip substantially parallel to the central axis of the housing.

Abstract: Focused infrared light may be used in a non-invasive varicose vein treatment procedure with infrared light from a plurality of laser diodes that are combined in a multiplexer and coupled to a multi-mode fiber coupled to another fiber or fiber bundle that delivers the light to a lens/mirror assembly for application in the non-invasive procedures. The wavelength of light may be selected near 980 nm, 1210 nm, or 1720 nm to achieve a desired penetration depth and/or for absorption in a particular tissue type or water. Wavelengths near approximately 1100 nm, 1310 nm or 1650 nm may be advantageous for non-invasive procedures through the skin. The light may be focused with lower intensity on the skin or outer tissue to reduce collateral damage and higher intensity at a desired depth to induce thermal coagulation or occlusion at depths of about 1-2 mm or more. Surface cooling techniques, such as cryogenic sprays or contact cooling may be provided.

Abstract: Embodiments of the present invention comprise a fiber optic guidewire having a hypotube with a plurality of openings that provide variable stiffness and tracking characteristics between at least one proximal segment and one distal segment of the guidewire. In some embodiments, the guidewire further comprises a mandrel disposed within the hypotube, the mandrel cooperating with the optical fibers to permit the distal end of the hypotube to be shaped as desired by a user. Methods of manufacturing and using the guidewire are also disclosed.

Abstract: Devices, systems and methods useable for dilating the ostia of paranasal sinuses and/or other passageways within the ear, nose or throat. A dilation catheter device and system is constructed in a manner that facilitates ease of use by the operator and, in at least some cases, allows the dilation procedure to be performed by a single operator. Additionally, the dilation catheter device and system may be useable in conjunction with an endoscope and/or a fluoroscope to provide for easy manipulation and positioning of the devices and real time visualization of the entire procedure or selected portions thereof. In some embodiments, an optional handle may be used to facilitate grasping or supporting a device of the present invention as well as another device (e.g., an endoscope) with a single hand.

Abstract: The invention is directed to a laser catheter (1) for bypass surgery, wherein the distal part (2) of the catheter (1) is provided with: a tubular arrangement (3) of optical fibers (4) having distal ends (5) defining a ring-shaped light emergence surface (6) for emitting a tubular bundle of light beams in the distal direction (D) of the catheter (1); and a stop surface (7) extending around the tubular arrangement (3) of optical fibers (4) and facing in the distal direction (D), the stop surface (7) being arranged at a distance (A) proximally from the light emergence surface (6). The light emergence surface (6) slants at a slanting angle (?) in the range of [20°, 60°] with respect to the longitudinal axis (8) of the catheter (1). The invention further relates to an assembly comprising such a catheter.

Abstract: Embodiments of a balloon biasing laser catheter are provided. In some embodiments, the laser catheter may include a distal tip that extends from the distal end of the catheter from a point near the light guide aperture. The distal tip may be disposed at the periphery of the catheter. In some embodiments, a balloon may be disposed between the light guide aperture and the distal tip, such that the a light guide extending from the aperture may be disposed proximate with the distal tip having the balloon in between. A retaining wire may be coupled with the distal tip and slidably coupled with the light guide. The retaining wire may keep the light guide biased relatively parallel with the distal tip and/or the catheter body when the balloon is inflated. The light guide may include a guidewire lumen the extends to the distal end of the distal tip.

Abstract: A technique for detecting and providing alerts or indications that can be used for controlling or altering the displacement speed of an applicator coupling skin heating energy across a treated skin. A temperature sensor monitors the rate of skin temperature change and provides feedback related to altering the applicator displacement speed according to the rate of skin temperature change. Disclosed is also an applicator for implementing this method.

Abstract: Apparatus for delivering laser energy suitable for denervation, such as renal denervation and the like, comprises an optical fiber inside a cannula and defining a channel therebetween for delivery of a liquid to cool and clean the tip of the optical fiber and to cool tissue subjected to laser irradiation, while the apparatus is Stationed, Moved, Rotated and or Swept during the emission of laser energy.

Abstract: A medical device for fragmenting objects and aspirating remaining debris enables a physician or other medical personnel quickly and easily remove objects, such as kidney stones, from a patient. The medical device can include a dual-lumen elongated member and a handle coupled to the elongated member. A first one of the lumens provides a suction passageway, and a second one of the lumens receives a laser fiber for delivering laser energy to an object, such as a kidney stone, within the patient. The handle can include a positioning mechanism to enable the physician by manual manipulation to move and hold in place the laser fiber longitudinally within the second lumen.

Abstract: A clearing module is provided that includes a main body configured and dimensioned to be received within a vessel or duct of a patient, adjacent a surgical target area in the patient. The main body includes: an instruction receiving unit configured to receive wireless instructions from an instruction transmitter located outside the patient's body while the module is located inside of the patient's body; a positioning element configured to be monitored by a system external of the patient's body while the positioning element is inside the patient's body; and a destructive energy emitter configured to emit destructive energy from the module toward the surgical target area according to instructions received from the instructions receiving unit.

Abstract: A catheter for debulking of an undesired deposit from an inner surface of at least one of a blood vessel wall and a stent located in a blood vessel, the catheter having a tip section comprising: circumferentially-directed laser optics; and a circular-action cutter, wherein said circumferentially-directed laser optics is configured to transmit laser radiation for modifying an area of the undesired deposit thereby preparing said area for penetration of said cutter, wherein said cutter is configured to cut through said modified area and thereby debulk at least a part of the undesired deposit. In addition, a catheter for pacemaker and ICD (Implantable Cardioverter Defibrillator) lead extraction is disclosed.