Abstract: A method for treating cardiac arrest includes defibrillating the patient and/or ventilating the patient and/or administering a cardiac arrest drug such as epinephrine to resuscitate the patient, and then cooling the patient using one or more cooling catheter positioned in the central venous system of the patient.

Abstract: The invention provides techniques and devices for treating atherosclerotic disease using controlled cryogenic cooling, often in combination with angioplasty. The efficacy of endoluminal cryogenic cooling is enhanced by limiting cooling of target tissues using an insulated cryogenic balloon, the insulation ideally comprising a fluid which undergoes a phase change at a predetermined temperature. A combination cryogenic/angioplasty catheter avoids exchange procedures between dilation of a stenotic region within a vessel wall and the application of cryogenic cooling. The combination angioplasty/cryogenic cooling catheter may cool the diseased blood vessel before, during, and/or after dilation. Controlled cooling of the vessel wall may change its mechanical properties, weakening the vessel and allowing it to be expanded at a much lower pressure than with conventional uncooled angioplasty.

Abstract: Electrode assemblies and associated systems employ a nonporous wall having an exterior for contacting tissue. The exterior peripherally surrounds an interior area. The wall is essentially free of electrically conductive material. The wall is adapted to assume an expanded geometry having a first maximum diameter and a collapsed geometry having a second maximum diameter less than the first maximum diameter. The assemblies and systems include a lumen that conveys a medium containing ions into the interior area. An element free of physical contact with the wall couples the medium within the interior area to a source of electrical energy to enable ionic transport of electrical energy from the source through the medium to the wall for capacitive coupling to tissue contacting the exterior of the wall.

Abstract: A heat exchange catheter having an expandable insulating region thereon. The catheter has a heat exchange region and the insulating region disposed proximally thereto. The insulating region assumes a first size about a catheter shaft to facilitate insertion of the catheter into the body. Once the insulating region is inserted into the body, the insulating region is expanded a second size. The insulating region may be a balloon around the catheter shaft that is inflated to the second size to create a gap between the wall of the balloon and the catheter shaft. Heat flows through the catheter shaft to and from the heat exchange region, and thus heat loss or gain to and from the surrounding body is minimized in the insulating region. The exchange region may include a fluid circulation path comprised of lumens through the catheter shaft.

Abstract: A catheter system and method are provided which change the temperature of a fluid, such as blood, by heat transfer. Selective cooling or heating of an organ may be performed by changing the temperature of the blood feeding the organ. The catheter system includes an inlet lumen and an outlet lumen structured and arranged to carry a working fluid having a temperature different from the adjacent blood. The outlet lumen is configured to induce turbulence in the adjacent fluid passing adjacent the outlet lumen.

Abstract: An apparatus to modify a stomach wall comprises an elongated member including at least one lumen. A deployable member is coupled to the elongated member. The deployable member is configured to be advanceable and removable from the stomach in a non-deployed state and sized to be positioned in the stomach in a deployed state to engage at least portions of the stomach wall. The deployable member is further configured to house a fluidic media and at least portions of the deployable member wall is configured to be cooled by the fluidic media. The deployable member has a contour in the deployed state approximating at least a portion of a stomach. A microwave antenna is movably positioned in the deployable member so as to control a microwave field strength vector in relation to the antenna.

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

Abstract: A method for treating cardiac arrest includes defibrillating the patient and/or ventilating the patient and/or administering a cardiac arrest drug such as epinephrine to resuscitate the patient, and then cooling the patient using one or more cooling catheter positioned in the central venous system of the patient.

Abstract: A catheter system and method are provided which change the temperature of a fluid, such as blood, by heat transfer. Selective cooling or heating of an organ may be performed by changing the temperature of the blood feeding the organ. The catheter system includes an inlet lumen and an outlet lumen structured and arranged to carry a working fluid having a temperature different from the adjacent blood. The outlet lumen is configured to induce turbulence in the adjacent fluid passing adjacent the outlet lumen.

Abstract: A warming catheter for use during cryosurgical ablation of the prostate having a warming section with diffuser ports promoting even warming of the prostatic urethra; the warming catheter is also provided with a short monorail lumen, monorail tip lumen, or a full length monorail lumen.

Abstract: The invention provides a method and device for selectively controlling the temperature of a selected organ of a patient for performance of a specified application. The method includes introducing a guide catheter into a blood vessel. The guide catheter may have a soft tip and a retaining flange, and may be used to provide treatments such as administration of thrombolytic drug therapies, stenting procedures, angiographic procedures, etc. A supply tube is provided having a heat transfer element attached to a distal end thereof. The heat transfer element having a plurality of exterior surface irregularities, these surface irregularities having a depth greater than the boundary layer thickness of flow in the feeding artery of the selected organ. The supply tube and heat transfer element may be inserted through the guide catheter to place the heat transfer element in the feeding artery of the selected organ.

Abstract: A method and expandable device for thermally affecting tissue in which there is a fluid conduit. An expandable element includes a wall defining an inner volume. The wall has a tissue contact region which is non-coaxial with the longitudinal axis of the fluid conduit. The tissue contact region is operable to have a first contact surface area and a second contact surface area in which the second contact surface area is larger than the first contact surface area. A port is formed through the wall and is in fluid communication with the fluid conduit.

Abstract: A catheter system and method are provided which change the temperature of a fluid, such as blood, by heat transfer. Selective cooling or heating of an organ may be performed by changing the temperature of the blood feeding the organ. The catheter system includes an inlet lumen and an outlet lumen structured and arranged to carry a working fluid having a temperature different from the adjacent blood. The outlet lumen is configured to induce turbulence in the adjacent fluid passing adjacent the outlet lumen.

Abstract: An electrosurgical probe (10) comprises a shaft (13) having an electrode array (58) at its distal end and a connector (19) at its proximal end for coupling the electrode array to a high frequency power supply (28). The shaft includes a return electrode (56) recessed from its distal end and enclosed within an insulating jacket (18). The return electrode defines an inner passage (83) electrically connected to both the return electrode and the electrode array for passage of an electrically conducting liquid (50). By applying high frequency voltage to the electrode array and the return electrode, the electrically conducting liquid generates a current flow path between the return electrode and the electrode array so that target tissue may be cut or ablated. The probe is particularly useful in dry environments, such as the mouth or abdominal cavity, because the electrically conducting liquid provides the necessary return current path between the active and return electrodes.

Abstract: An electrosurgical probe (10) comprises a shaft (13) having an electrode array (58) at its distal end and a connector (19) at its proximal end for coupling the electrode array to a high frequency power supply (28). The shaft includes a return electrode (56) recessed from its distal end and enclosed within an insulating jacket (18). The return electrode defines an inner passage (83) electrically connected to both the return electrode and the electrode array for passage of an electrically conducting liquid (50). By applying high frequency voltage to the electrode array and the return electrode, the electrically conducting liquid generates a current flow path between the return electrode and the electrode array so that target tissue may be cut or ablated. The probe is particularly useful in dry environments, such as the mouth or abdominal cavity, because the electrically conducting liquid provides the necessary return current path between the active and return electrodes.

Abstract: An ablating device has a cover which holds an interface material such as a gel. The cover contains the interface material during initial placement of the device. The ablating device may also have a removable tip or a membrane filled with fluid. In still another aspect, the ablating device may be submerged in liquid during operation.

Abstract: Systems and methods that treat disorders of the gastrointestinal tract by applying one or more treatment agents to tissue at or near the region where abnormal neurological symptoms or abnormal tissue conditions exist. The treatment agent is selected to either disrupt the abnormal nerve pathways and/or to alleviate the abnormal tissue conditions. The treatment agent can include at least one cytokine and/or at least one vanilloid compound to evoke a desired tissue response. The systems and methods can be used a primary treatment modality, or as a neoadjuvent or adjuvant treatment modality.

Abstract: A method and apparatus is provided for determining an effective thermal mass of a patient. The effective thermal mass is employed to determine a gain factor used in a feedback control system controlling patient temperature. The method begins by inducing hypothermia or hyperthermia in at least a selected portion of the patient with a device having a heat transfer surface. Next, power is transferred between the device and the patient. A change in temperature over time, which arises in the selected portion of the patient, is measured while performing the step of inducing hypothermia or hyperthermia. Finally, an effective thermal mass is calculated based on the measured power and the measured temperature change over time.

Abstract: The present invention provides an apparatus and a method for producing a virtual electrode within or upon a tissue to be treated with radio frequency alternating electric current. An apparatus in accordance with the present invention includes a supply of a conductive or electrolytic fluid to be provided to the patient, an alternative current generator, and a processor for creating, maintaining and controlling the ablation process by the interstitial or surficial delivery of the fluid to a tissue and the delivery of electric power to the tissue via the virtual electrode. The method in accordance with the invention includes the steps of delivering a conductive fluid to a predetermined tissue ablation site for a predetermined time period, applying a predetermined power level of radio frequency current to the tissue, monitoring at least one of several parameters and adjusting either the applied power and/or the fluid flow in response to the measured parameters.

Abstract: A method and apparatus for treatment for body structures, especially internal body structures involving disorders involving unwanted features or other disorders, that does not require relatively invasive surgery, and is not subject to other drawbacks noted with regard to the known art. A relatively minimally invasive catheter is inserted into the body, treatment of the body structures is applied using the catheter, and the unwanted features or disorders are relatively cured using the applied treatments. The applied treatments can include application of energy or substances, including application of energy (such as of radio frequency energy, microwave energy, or laser or other electromagnetic energy) or substances (such as collagen or other bulking, plumping, or shaping agents; saline or other energy-receiving electrolytes; astringents or other debulking, reducing, or shaping agents; antibiotics or other bioactive, chemoactive, or radioactive compounds).

Abstract: The present invention includes an adapter for advancing a temperature sensor through the drainage lumen of an operational Foley catheter. The Foley catheter includes a catheter body having proximal end, a distal end and a drainage lumen extending between the ends. A balloon mounts on the distal end for holding the catheter in the bladder of a patient. The adapter attaches to the proximal end for inserting a temperature sensor via the catheter drainage lumen to the distal end of the catheter. This adapter enables a typical Foley catheter to achieve a temperature sensing capability and provides collocated sensor elements in Foley catheters having a single temperature sensor element. Such temperature sensor measurements are useful, for example, in conjunction with various heat exchange catheter systems.

Abstract: A flexible three-paths catheter provided with a balloon carries a sealingly sheathed radiofrequency radiating antenna, together with the shielded power supply cable and with some thermocouples, within a plastic lining surrounded by a flow of liquid; a second path carries the power supply cables of some outer thermocouples, flooded by the reverse liquid flow, while the third path allows a fluid to flow through for inflating the balloon. Introduction of the catheter into a hollow organ makes it possible to perform hyperthermal therapy of tumors by means of radiation.

Abstract: Electrode assemblies actively cool mucosal surface tissue at or near a sphincter while applying energy through an electrode to ohmically heat tissue beneath the surface. The applied energy creates one or more lesions, or a prescribed pattern of lesions, below the mucosal surface. Natural healing of the subsurface lesions leads to a physical tightening of the sphincter and/or adjoining tissue to treat sphincter dysfunction. The active surface cooling preserves and protects the mucosal surface against thermal damage. Furthermore, electrode assemblies can deliver a therapeutic material to the tissue region independent of or as an adjunct to lesion formation. The therapeutic material can comprise, e.g., a tissue ablating chemical; or a drug, such as a tissue growth factor, or a fibrosis inducer, or a fibroblast growth factor, or a sclerosant; or a tissue bulking agent; or an exotoxin.

Abstract: A method and expandable device for thermally affecting tissue in which there is a fluid conduit. The fluid conduit defining a spiral-shaped element. The fluid conduit includes a wall defining an inner volume. The inner volume being configured to pass thermally transmissive fluid. Optionally, the tissue contact region is operable to have a first contact surface area and a second contact surface area in which the second contact surface area is larger than the first contact surface area. A method of use of the device is provided.

Abstract: The invention provides a method and apparatus for producing reversible focal hypothermia of the nervous system to control chronic pain. Nerve conduction is blocked by mild cooling (0 to 25° C.), or hypothermia. At these temperatures, nerve tissue is not destroyed and recovers completely when cooling is terminated, such that the treatment is reversible. By blocking conduction in pain nerves, pain sensation is eliminated in a manner analogous to drugs such as lidocaine that also block nerve conduction to provide anesthesia. The invention can be applied to a variety of conditions such as urge incontinence, muscle spasticity, and epilepsy. Many of these disorders are mediated by nerve and nervous tissue that could be interrupted by cooling. In addition, neurologic dysfunction found in multiple sclerosis may improve by cooling of the nerves. The method and apparatus may be used to cool areas of the nervous system affected by multiple sclerosis to allow more normal functions.

Abstract: A catheter includes a plurality of primary leads to deliver energy for ligating a hollow anatomical structure. Each of the primary leads includes an electrode located at the working end of the catheter. Separation is maintained between the primary leads such that each primary lead can individually receive power of selected polarity. The primary leads are constructed to expand outwardly to place the electrodes into apposition with a hollow anatomical structure. High frequency energy can be applied from the leads to create a heating effect in the surrounding tissue of the anatomical structure. The diameter of the hollow anatomical structure is reduced by the heating effect, and the electrodes of the primary leads are moved closer to one another. Where the hollow anatomical structure is a vein, energy is applied until the diameter of the vein is reduced to the point where the vein is occluded. In one embodiment, a balloon is inflated to occlude the structure before the application of energy.

Abstract: A method for treating cardiac arrest includes defibrillating the patient and/or ventilating the patient and/or administering a cardiac arrest drug such as epinephrine to resuscitate the patient, and then cooling the patient's body temperature using one or more cooling catheters positioned in the central venous system of the patient and/or particularly cooling the patient's brain temperature using a catheter advanced into the aortic arch or into the carotid artery whereby a bolus of cold saline solution is introduced into the blood supplied to the brain to lower the brain temperature quickly, and further cooling or maintaining the brain temperature at a desired level by pumping coolant in a closed circuit formation between the catheter and the coolant source to remove heat from the blood supplied to the patient's brain.

Abstract: The present invention provides an apparatus and a method for producing a virtual electrode within or upon a tissue to be treated with radio frequency alternating electric current, such tissues including but not limited to brain, liver, cardiac, prostate, breast, and vascular tissues and neoplasms. An apparatus in accordance with the present invention includes a source of super-cooled fluid for selectively providing super-cooled fluid to the target tissue to cause a temporary cessation of cellular or electrical activity, a supply of conductive or electrolytic fluid to be provided to the target tissue, and alternating current generator, and a processor for creating, maintaining, and controlling the ablation process by the interstitial or surficial delivery of the fluid to a tissue and the delivery of electric power to the tissue via the virtual electrode.

Abstract: A method and apparatus is provided for determining an effective thermal mass of a patient. The effective thermal mass is employed to determine a gain factor used in a feedback control system controlling patient temperature. The method begins by inducing hypothermia or hyperthermia in at least a selected portion of the patient with a device having a heat transfer surface. Next, power is transferred between the device and the patient. A change in temperature over time, which arises in the selected portion of the patient, is measured while performing the step of inducing hypothermia or hyperthermia. Finally, an effective thermal mass is calculated based on the measured power and the measured temperature change over time.

Abstract: The invention provides a device for heating or cooling a surrounding fluid in a feeding vessel and a method of manufacturing the same. The device includes a catheter assembly capable of insertion to a selected blood vessel in the vascular system of a patient. The assembly includes an elongated catheter body, a heat transfer element located at a distal portion of the catheter body and including an interior, an elongated supply lumen adapted to deliver a working fluid to the interior of the heat transfer element and having a hydraulic diameter, an elongated return lumen adapted to return a working fluid from the interior of the heat transfer element and having a hydraulic diameter, and wherein the ratio of the hydraulic diameter of the return lumen to the hydraulic diameter of the supply lumen is substantially equal to 0.75.

Abstract: The invention provides a device for heating or cooling a surrounding fluid in a feeding vessel and a method of manufacturing the same. The device includes a catheter assembly capable of insertion to a selected blood vessel in the vascular system of a patient. The assembly includes an elongated catheter body, a heat transfer element located at a distal portion of the catheter body and including an interior, an elongated supply lumen adapted to deliver a working fluid to the interior of the heat transfer element and having a hydraulic diameter, an elongated return lumen adapted to return a working fluid from the interior of the heat transfer element and having a hydraulic diameter, and wherein the ratio of the hydraulic diameter of the return lumen to the hydraulic diameter of the supply lumen is substantially equal to 0.75.

Abstract: A surgical apparatus for delivering a conductive fluid to a target site for subsequent formation of a virtual electrode to ablate bodily tissue at the target site by applying a current to the delivered conductive fluid. The surgical apparatus includes an elongated device forming a helical needle. The helical needle is configured to engage bodily tissue and is hollow for delivering conductive fluid from a fluid source. Finally, the helical needle terminates in a needle tip. In one preferred embodiment, an electrode is associated with the helical needle for applying a current to conductive fluid delivered from the helical needle. During use, following delivery of conductive fluid, the electrode applies a current to the delivered conductive fluid for creating a virtual electrode. The virtual electrode ablates bodily tissue contacted by the conductive fluid.

Abstract: An enhanced method and device are provided to inhibit or reduce restenosis following angioplasty or stent placement. A porous balloon-tipped catheter is disposed in the area treated or opened through balloon angioplasty immediately following angioplasty. The balloon, which can have a dual balloon structure, may be delivered through a guiding catheter and over a guidewire already in place. A fluid such as a perfluorocarbon flows into the balloon to freeze the tissue adjacent the balloon, this cooling being associated with reduction of restenosis. A similar catheter may be used to reduce atrial fibrillation by inserting and inflating the porous balloon such that an exterior surface of the balloon, as well as a portion of the cold working fluid, from the microporosity contacts at least a partial circumference of the portion of the pulmonary vein adjacent the left atrium.

Abstract: The invention provides a method and apparatus for producing reversible focal hypothermia of the nervous system to control chronic pain. Nerve conduction is blocked by mild cooling (0 to 25° C.), or hypothermia. At these temperatures, nerve tissue is not destroyed and recovers completely when cooling is terminated, such that the treatment is reversible. By blocking conduction in pain nerves, pain sensation is eliminated in a manner analogous to drugs such as lidocaine that also block nerve conduction to provide anesthesia. The invention can be applied to a variety of conditions such as urge incontinence, muscle spasticity, and epilepsy. Many of these disorders are mediated by nerve and nervous tissue that could be interrupted by cooling. In addition, neurologic dysfunction found in multiple sclerosis may improve by cooling of the nerves. The method and apparatus may be used to cool areas of the nervous system affected by multiple sclerosis to allow more normal functions.

Abstract: A skin-contact type terminal system includes a thermoelectric module for cooling or heating in accordance with a polarity of current provided from the skin-contact type terminal, with the temperature of cooling or heating being adjusted according to a level of a voltage provided thereto, and being controlled to maintain its cooling or heating operation for a predetermined time. A control unit senses generation of an alert request signal, supplies the voltage to the thermoelectric module in accordance with the sensed alert request signal so that the thermoelectric module cools or heats in accordance with the predetermined cooling or heating temperature. The control unit controls the thermoelectric module to maintain its cooling or heating operation for the predetermined time.

Abstract: A surgical apparatus for delivering a conductive fluid to a target site for ablating bodily tissue. The apparatus includes a tube fluidly connected to a source of conductive fluid. The tube defines a proximal portion, a distal portion and a central pathway. The central pathway extends from the proximal portion to the distal portion and is configured to direct flow of conductive fluid to the distal portion. The distal portion is configured for placement at a target site of bodily tissue and forms a helical slot. The helical slot is configured to allow flow of conductive fluid from the central pathway. Following delivery of the conductive fluid, an electrical current is applied to create a virtual electrode for ablating bodily tissue at the target site.

Abstract: A medical probe for the heating of soft tissue, such as collagen tissue, wherein the medical probe has an elongated body with a proximal and distal end, a heating source, an RF electrode. Optional components include a thermocouple, and an insulative sleeve. The probe's elongated body is preferably hollow and flexible. The RF electrode and the heating source are powered by independently controlled power sources and cooperate to maintain a constant and smooth temperature to the distal end of the RF electrode. The heating source may be a contained liquid, such as saline, or an electrothermal mass, such as a ferrite, a toroid, a resistive element, or the like. Current induced from the conductor to the heating source creates heat in the heating source. The thermocouple measures the temperature of the heating source and adjusts the power to the conductor to maintain the heating source's temperature.

Abstract: A catheter and method are provided for modifying a temperature of a patient. The catheter includes a heat transfer element (“HTE”) having surface irregularities shaped to create turbulence in a surrounding fluid. The catheter also includes a supply catheter to deliver a working fluid to an interior of the heat transfer element and a return catheter to return a working fluid from the HTE. A guidewire lumen is provided to receive a guidewire. The guidewire may have a temperature-monitoring device disposed at its distal tip from which feedback may be provided to control the temperature of a source of the working fluid.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within a patient's. The present invention positions an electrosurgical instrument, such as a probe or catheter, in close proximity to a first body structure adjacent to a second body structure so that one or more electrode terminal(s) are brought into at least partial contact or close proximity with the first and second body structures. High frequency voltage is then applied between the electrode terminal(s) and one or more return electrode(s) to cut, remove, ablate, contract, coagulate, vaporize, desiccate or otherwise modify the first body structure without clinically damaging the second body structure.

Abstract: A catheter for intravascular corporeal cooling comprises an elongated tubular member having at least one lumen extending therethrough for providing cooled blood, an inflatable annular balloon positioned on the outer surface of the elongated tubular member, and a pressure reliever positioned in the external wall of the elongated tubular member and proximal to the annular inflatable balloon, wherein when the pressure of blood within a lumen reaches a predetermined value, the pressure reliever opens to permit fluid to be released from the elongated tubular member. In other embodiments of the invention the catheter may have two or more inflatable annular balloons that are separately inflatable and/or the catheter has an insulative outer annular member.

Abstract: The invention provides a device for heating or cooling a surrounding fluid in a feeding vessel and a method of manufacturing the same. The device includes a catheter assembly capable of insertion to a selected blood vessel in the vascular system of a patient. The assembly includes an elongated catheter body, a heat transfer element located at a distal portion of the catheter body and including an interior, an elongated supply lumen adapted to deliver a working fluid to the interior of the heat transfer element and having a hydraulic diameter, an elongated return lumen adapted to return a working fluid from the interior of the heat transfer element and having a hydraulic diameter, and wherein the ratio of the hydraulic diameter of the return lumen to the hydraulic diameter of the supply lumen is substantially equal to 0.75.

Abstract: An ablation catheter is disclosed having proximal and distal ends and an external surface, a lumen contained within the catheter body, a plurality of openings in the surface of the catheter, wherein the openings are in communication with the lumen, one or more electrodes secured within the catheter within the lumen and a source for conductive media to be introduced into the lumen to contact the electrode. The ablation catheter also may contain a conductive media flow control system which controls the flow of the conductive media through the openings in the surface of the catheter.

Abstract: A medical device for cryotreatment of bodily regions is disclosed. The device comprises an inflatable support structure coupled to the distal end portion of a catheter shaft, the support structure being further enveloped by an expandable membrane to define an expansion chamber between the support structure and the membrane. An inflation lumen is coupled to the support structure to inject an inert, insulating fluid in the support structure, thereby expanding the support structure and the expandable membrane, wherein the resultant expansion chamber formed therebetween is substantially conical in shape. Refrigerant is injected into the expansion chamber, thereby creating localized cooling of tissues adjacent to the expansion chamber, the cooling region being substantially conical in shape.

Abstract: A selective organ heat transfer device with a mixing-inducing surface. The device can have a plurality of elongated, articulated segments, each having a mixing-inducing exterior surface. A flexible joint connects adjacent elongated, articulated segments. The device is formed of a mechanical layer such as Ni and a biocompatible layer such as Au. An antithrombogenic and/or lubricious coating may also be employed for hemocompatibility. A protective layer such as Au may be employed to provide a degree of non-corrosiveness when exposed to a working fluid.

Abstract: The invention provides a method and device for heating or cooling a surrounding fluid in a feeding vessel. The device includes a catheter assembly capable of insertion to a selected feeding vessel in the vascular system of a patient. The assembly includes a heat transfer element at a distal end of the catheter assembly, the heat transfer element having a plurality of exterior surface irregularities shaped and arranged to create turbulence in a surrounding fluid, the surface irregularities having a depth at least equal to the boundary layer thickness of flow of the surrounding fluid in the feeding vessel. The assembly also includes a supply catheter to deliver a working fluid to an interior of the heat transfer element, a return catheter to return a working fluid from the interior of the heat transfer element, and a drug delivery catheter running substantially parallel to the axis of the catheter assembly.

Abstract: A heat transfer device has first and second elongated, articulated segments, each having a turbulence-inducing exterior surface. A flexible joint connects the first and second elongated, articulated segments. An inner coaxial lumen is disposed within the first and second elongated, articulated segments.

Abstract: A method and apparatus is provided for heating or cooling at least a selected portion of a patient's body. The method begins by inserting a catheter having a balloon into the colon or stomach of the patient. A heated or chilled fluid is conducted through a supply lumen of the catheter and into the balloon. The fluid is evacuated from the balloon through a return lumen of the catheter.

Abstract: An apparatus for thermal treatment of tissue, includes an outer member having a frame dimensioned for engagement with the hand of a surgeon and an elongated portion connected to the frame and extending distally therefrom. The elongated portion defines a longitudinal axis and has an axial opening. An electromagnetic probe assembly is releasably mounted to the outer member. The electromagnetic probe assembly includes a handle and an electromagnetic probe connected to the handle. The electromagnetic probe is at least partially positionable within the axial opening of the elongated portion and is adapted for reciprocal longitudinal movement therewithin between a non-deployed position and a deployed positions. A manually operable release member releasably mounts the electromagnetic probe assembly to the outer member.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within of a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to remove, contract or otherwise modify the structure of tissue structures. In one aspect of the invention, a method is provided for treating herniated discs within a patient's spine by applying sufficient electrical energy to the disc tissue to reduce a volume of the disc, thereby relieving pressure on a spinal nerve. In one embodiment, the high frequency voltage is sufficient to ablate a portion of the nucleus pulposis, either the extruded portion outside of the annulus or a portion or all of the pulposis within the annulus.

Abstract: An apparatus for effecting hyperthermia in a narrow body cavity or duct including: a disposable first part (1) having an elongate distal section (5) intended to be inserted into the cavity or duct having a centrally located, heat-releasing element (22), which is either surrounded by an elongate housing (24) or is itself constituted by an elongate housing, and a flexible and/or elastic enclosure (23) surrounding the housing in a liquid-tight manner, further including a device for supplying energy to the heat-releasing element (22) and an axially operating first inlet (135) at the proximal part of the housing, an outlet (133) from the housing being arranged for the supply of heat-transmitting medium under pressure for expansion of the flexible enclosure (23) to accommodate and to exert a controlled pressure on surrounding walls of the cavity or duct, a second inlet (131) to the housing (24), and medium-actuating device (13, 19) for the expansion of the flexible enclosure (23) and for internal circulation of the