Abstract: A skin surface is treated with RF energy (e.g., unipolar, monopolar, bipolar or multipolar RF delivery). A first semiconductive cap disposed on a first distal end of a first electrode and, optionally, a second semiconductive cap disposed on a second distal end of a second electrode are applied to the skin surface. RF energy is delivered from the first electrode and the second electrode through the first semiconductive cap and the second semiconductive cap, respectively, through the skin surface. The first semiconductive cap and/or the second semiconductive cap have an electrical conductivity matched or substantially matched to the skin's electrical conductivity (e.g., about 0.1 to about 2 times that of the skin).

Abstract: A medical device is disclosed. The medical device may include an elongate member having a lumen extending at least partially between a proximal end and a distal end of the elongate member. The medical device may also include a plurality of legs coupled to a distal portion of the elongate member, and a distal end piece connected to each of the plurality of legs and located distally to the distal end of the elongate member. The medical device may also include an actuating member coupled to the distal end piece and extending between the plurality of legs and through the lumen. The reciprocal movement of the actuating member may be configured to reversibly move the plurality of legs from a first position to a second position. The medical device may also include a stopping member coupled to the actuating member and configured to limit a movement of the actuating member.

Abstract: A method and apparatus for treating an intraosseous nerve. The method includes positioning a hollow shaft through the cortical shell of a vertebral body and into a cancellous bone region of the vertebral body. The hollow shaft includes an annular wall having a longitudinal bore therein, a proximal portion and a distal portion, and a first window extending transversely through the annular wall. An electrosurgical probe is advanced within the longitudinal bore from the proximal portion toward the distal portion. The electrosurgical probe includes a first treatment element at a distal end of the probe, wherein the first treatment element being in electrical connection with a power supply. The first treatment element is slidably disposed within the longitudinal bore so that the first treatment element is advanced radially outward from the window and shaft to affect treatment of the intraosseous nerve within the cancellous bone region.

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: A magnetically-guided catheter 100 includes a tip positioning magnet in the distal electrode assembly configured to interact with externally applied magnetic fields for magnetically-guided movement. A magnetically-guided mapping catheter 100 includes an electrically-conductive capsule in the form of a casing 146 that includes a distal ablation surface and isolates the positioning magnet from bio-fluids to prevent corrosion. An open irrigation ablation catheter includes an isolated manifold that isolates the positioning magnet from contact with irrigation fluid to prevent corrosion.

Abstract: A system and method for treating the skin by heating at least one discrete skin volume, comprising at least one treatment tip reversibly connectable to at least one applicator. The treatment tip comprises one or more electrodes, with the electrodes having one or more spaced apart protruding conducting elements. The protruding conducting elements are characterized by dimensions of height A and hypotenuse B, where the ratio A/B is in a predetermined range, and the protruding conducting elements penetrate the skin surface at discrete locations. The electrodes are configured to apply energy to skin volumes around the discrete locations so as to heat the skin volumes. The applicator comprises an energy generator configured to apply energy to the skin volumes by means of the electrodes and the spaced apart protruding conducting elements.

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: A method of treating a BORG expressing cancer includes administering a therapeutically effective amount of at least one BORG inhibiting agent to the BORG overexpressing cancer cells of the subject.

Abstract: An ablation catheter assembly includes an elongate catheter body having a proximal portion, a distal portion and a lumen therethrough. A helical structure associated with the catheter distal portion carries a plurality of independently operable electrodes and is transformable between a low-profile configuration wherein a straightening element is positioned in the lumen and an expanded configuration wherein the straightening element is at least partially retracted from the spiral structure. When the helical structure is in the expanded configuration, a laterally offset tip portion extends distally therefrom.

Abstract: Apparatus and methods are provided for treating a human condition by providing an appendage chamber having a thermal exchange member. Negative pressure may be applied to a human appendage when placed within the appendage chamber. Blood flowing through the arteriovenous anastomosis (AVA) of the appendage may be heated or cooled at the thermal exchange member for therapeutic application of thermal energy to adjust blood viscosity in the human to alleviate symptoms associated with a number of autoimmune, circulatory, neurological, lymphatic, and endocrinal maladies. A load sensor may be coupled to the thermal exchange member and configured to measure a force of the appendage applied to the thermal exchange member. In addition, a negative pressure sensor may measure pressure within the appendage chamber.

Abstract: Disclosed methods and devices treat lower back pain from degenerated or injured intervertebral discs. Electrodes connected to a pulse generator deliver electrical impulses to nerves located within the posterior longitudinal ligament and posterior annulus fibrosus of lumbar intervertebral discs. Percutaneous and paddle leads containing the electrodes are disclosed. The percutaneous lead, designed to prevent inappropriate stimulation of the thecal sac, is inserted in the anterior epidural space using a special cannula and lead blank. Paddle leads are configured individually for implantation in each patient. The electrical stimulation may reduce back pain reversibly, with or without the simultaneous use of non-thermal irreversible electroporation.

Abstract: Method for treating chronic rhinosinusitis in a human patient. In the method a photosensitizing agent such as indocyanine green can be applied to color a nasal or sinal treatment site harboring infectious microorganisms. The photosensitizing agent can have an energy absorption peak in a near infrared wavelength region of the electromagnetic spectrum. The method can also include applying light energy from a laser source at a near infrared wavelength or wavelengths to the colored treatment site, for a duration sufficient to control the microorganisms. Apparatus for performing the method is also disclosed.

Abstract: Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

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: A method and apparatus for treating masses, such as prostate or breast cancer, or any other soft tissue cancerous or benign mass, employs a unique, three-dimensional software-controlled electronic amplifier array using arbitrary waveforms that dynamically and proportionally steer electrical currents by using two or more current vector paths, sequentially or simultaneously, through a mass containing electrically-conductive ionic solutions so as to obtain 100% thermal heating or hyperthermia through the mass, and destroying it with a minimally-invasive treatment which requires no radiation or chemotherapy which could be harmful to the patient.

Abstract: An agent for the prophylaxis or treatment of stress urinary incontinence, which contains a substance that activates a serotonin 5-HT2C receptor, an agent for the prophylaxis or treatment of stress urinary incontinence, which contains a substance that stimulates an androgen binding site, and a method of screening for a drug for the prophylaxis or treatment of abdominal pressure incontinence, which includes electrostimulating the abdominal muscles or a nerve controlling them of an animal to increase the abdominal pressure, and measuring the leak point pressure at that time.

Abstract: Disclosed are methods and devices for stimulating hair regrowth by causing localized heating in an area of skin using electrodes to deliver localized electrical energy.

Abstract: A method of nonsurgical orbital fat reduction includes providing an electromagnetic energy system that includes an electromagnetic energy source and a patient interface coupled to the electromagnetic energy source. The patient interface includes an elongate member configured to deliver electromagnetic energy generated by the electromagnetic energy source to tissue of a medical patient. The method also includes inserting at least a distal portion of the elongate member into an orbital fat pad of the medical patient and delivering a sufficient amount of electromagnetic energy from the electromagnetic energy source to the orbital fat pad to cause the orbital fat pad to shrink in volume.

Abstract: A system and method are provided for assessing the compliance of internal patient tissue for purposes of catheter guidance and/or ablation procedures. Specifically, the system/method provides for probing internal patient tissue in order to obtain force and/or tissue displacement measurements. These measurements are utilized to generate an indication of tissue elasticity. In one exemplary embodiment, the indication of elasticity is correlated with an image of the internal tissue area and an output of this image including elasticity indications is displayed for a user.

Abstract: Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

Abstract: An ablation catheter assembly includes an elongate catheter body having a proximal portion, a distal portion and a lumen therethrough. A helical structure associated with the catheter distal portion carries a plurality of independently operable electrodes and is transformable between a low-profile configuration wherein a straightening element is positioned in the lumen and an expanded configuration wherein the straightening element is at least partially retracted from the spiral structure. When the helical structure is in the expanded configuration, a laterally offset tip portion extends distally therefrom.

Abstract: NMES systems and methods for stimulating muscle tissue, and in some embodiments deep muscle tissue. The impedance near the surface of the skin is controllably increased to increase the percentage of energy delivered to a subject that stimulates muscle tissue.

Abstract: A treatment system includes a power source for heat generation which outputs power for heat generation, a grasping member having a heating element which applies the power for heat generation as thermal energy to a grasped living tissue, a storage section storing a power decrease pattern which is a prediction about a change state of the power for heat generation, and a control section which performs pattern control on the power source for heat generation on the basis of the power decrease pattern acquired from the storage section.

Abstract: Embodiments of the invention include a method and a device for increasing blood flow and controlling the temperature of a mammal by applying a desired pressure to extremities of a mammal. The device generally includes one or more collapsible and pliant body elements, capable of expanding from a first volume into an expanded second volume so the device can receive a portion of an extremity of the mammal therein and then be reduced from the expanded second volume into a pressurized third volume to conformably enclose the portion of the extremity. One or more thermal exchange units can be positioned in the one or more collapsible and pliant body elements. Accordingly, the temperature of the extremity of a mammal can be regulated by providing a heated or cooled fluid medium or electric thermal energy to the one or more thermal exchange units.

Abstract: The present invention provides devices and methods for preventing or significantly reducing the risk of thrombus formation. More specifically, the devices and methods of the present invention provide energy to blood flowing within a chamber or vessel to prevent or reduce blood stasis and thereby prevent or significantly reduce the risk of thrombus formation. The present invention is ideally suited for prevention or reduction of risk of blood clot formation in the atria in patients with atrial fibrillation, in blood vessels of patients at risk of clot formation, in areas adjacent to, or on, artificial heart valves or other artificial cardiovascular devices, and the like.

Abstract: A method for performing a surgical procedure within lungs of a patient. The method comprising the steps of providing a plurality of surgical instruments and providing a housing. Attaching a flexible, elongated shaft with distal and proximal ends to the housing. Engaging at least one working end to the distal end of the housing, the working end including a plurality of tubes disposed therein that define a corresponding plurality of working channels for housing a corresponding plurality of surgical instruments. Controlling an actuator to engage at least one of the corresponding plurality of surgical instruments, wherein rotation of the working end with respect to a longitudinal axis of the elongated shaft engages at least one of the plurality of surgical instrument with the actuator to deploy the at least one surgical instrument to the lung as needed during a surgical procedure.

Abstract: A device for delivering caloric vestibular stimulation to an individual, includes: (a) an earpiece configured to be at least partially insertable into the ear canal of the individual for delivering said caloric vestibular stimulation; (b) a power supply operatively associated with said earpiece; and (c) a controller operatively associated with said power supply and said earpiece for configuring said caloric vestibular stimulation as at least a first and second time-varying waveform. Preferably, the waveforms are actively controlled waveforms.

Abstract: Devices and methods for providing therapeutic heating are disclosed herein. In one embodiment, the system includes a device body configured to provide heat to a portion of skin. The device body also includes a low-level heating region and a high-level heating area. The low-level heating region provides a continuous amount of heat at a first temperature, and the high-level heating area provides an intermittent amount of heat at a second temperature greater than the first temperature.

Abstract: A surgical instrument for supplying energy to tissue can comprise a jaw member comprising an electrode, wherein the electrode is configured to generate heat when electrical energy is supplied to the electrode, and wherein the electrode comprises a top surface. The surgical instrument can further comprise an insulator positioned adjacent to the electrode, wherein the insulator comprises a top surface movable between a first position and a second position relative to the top surface of the electrode, and wherein the top surface of the insulator is closer to the top surface of the electrode when the insulator is in the first position than when the insulator is in the second position.

Abstract: A family of catheter electrode assemblies includes a flexible circuit having a plurality of electrical traces and a substrate; a ring electrode surrounding the flexible circuit and electrically coupled with at least one of the plurality of electrical traces; and an outer covering extending over at least a portion of the electrode. A non-contact electrode mapping catheter includes an outer tubing having a longitudinal axis, a deployment member, and a plurality of splines, at least one of the plurality of splines comprising a flexible circuit including a plurality of electrical traces and a substrate, a ring electrode surrounding the flexible circuit and electrically coupled with at least one of the plurality of electrical traces; and an outer covering extending over at least a portion of the ring electrode. A method of constructing the family of catheter electrode assemblies is also provided.

Abstract: Methods and apparatus are provided for treating contrast nephropathy, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.

Abstract: The invention provides a system and method for achieving the cosmetically beneficial effects of shrinking collagen tissue in the dermis or other areas of tissue in an effective, non-invasive manner using an array of electrodes. Systems described herein allow for improved treatment of tissue. Additional variations of the system include array of electrodes configured to minimize the energy required to produce the desired effect.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example method may include a method for heating a body tissue region adjacent to a body lumen. The method may include positioning an energy delivery portion of a catheter within the lumen and engaging the body lumen with the energy delivery portion. Engaging the body lumen may complete a plurality of circuits. The method may also include determining a pulse characteristic in response to a thermal property of a first tissue type and applying controlled pulsed electrical energy with the pulse characteristic from the energy delivery portion through the plurality of circuits.

Abstract: This relates to methods and devices for achieving contact between the wall of a cavity or passageway and a medical device under conditions in which an access path and the subject anatomy are not aligned.

Abstract: Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues.

Abstract: Methods and apparatuses are disclosed for potentiating a favorable brain state that is associated with relief in symptoms of a brain condition. Techniques include monitoring one or more brain signals and detecting an episode of a favorable brain state based on the one or more brain signals, the favorable brain state associated with a decrease in one or more symptoms of a brain condition of the patient. Then, in response to the detection of the favorable brain state episode, electrical stimulation that potentiates the favorable brain state is delivered to the brain of the patient, the electrical stimulation delivered within a window of time opened for detection of each favorable brain state episode.

Abstract: Various embodiments of an implantable system for delivering therapy comprise at least one of a heat sink or source to either reduce or increase temperature of excitable tissue, a pulse generator and at least one stimulation electrode to deliver electrical stimulation to excitable tissue, a memory and a controller. The memory has instructions for performing at least one stimulation routine and at least one thermal routine, and further has integration instructions for integrating the thermal routine(s) with the stimulation routine(s). The controller is configured to operate on the instructions to perform the stimulation routine(s) using the pulse generator and the at least one stimulation electrode, to perform the thermal routine(s) using the heat sink or the heat source, and to operate on the integration instructions to integrate thermal routine(s) with the stimulation routine(s).

Abstract: A conforming electrode for delivering ablative energy to tissue generally includes a plurality of flexible metal tubes, each having a longitudinal axis, a proximal end, and a distal end. The flexible metal tubes are arranged in a bundle with their longitudinal axes aligned parallel to each other. In addition, the flexible metal tubes are electrically coupled to a conductor for transferring ablative energy to the flexible metal tubes. The conductor may be a loop around the flexible metal tubes and to which the flexible metal tubes may be secured. The proximal ends of the flexible metal tubes may be secured to the distal end of a catheter shaft.

Abstract: A system and method of treating urinary incontinence including a catheter and injection guide operatively disposed together. At least one needle is operatively disposed within at least one lumen and at least one channel extending through the catheter and injection guide respectively. The injection guide is transformable from a pre-injection configuration for placement in the bladder to an injection configuration for injection of a pharmaceutical such as botulinum toxin into the bladder tissue. Upon introduction of the pharmaceutical to the bladder tissue, symptoms of incontinence are alleviated.

Abstract: A system and method of monitoring, controlling and/or detecting events during the removal of heat from subcutaneous lipid-rich tissue is described. In some examples, the system detects an increase in temperature at a treatment device in contact with the skin of a subject, determines that the increase in temperature is related to a treatment event, and performs an action based on the determination. In some examples, the system shuts off the treatment device, alerts an operator, or reduces the cooling in response to a determined treatment event.

Abstract: System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a radial opening at or near the distal end of the trocar. The system includes a curveable cannula sized to be received in the central channel, the curveable cannula comprising a curveable distal end configured to be extended laterally outward from the radial opening in a curved path extending away from the trocar. The curveable cannula has a central passageway having a diameter configured allow a probe to be delivered through the central passageway to a location beyond the curved path.

Abstract: Methods and systems for modulating intraosseous nerves (e.g., nerves within bone) are provided. For example, the methods and systems described herein may be used to modulate (e.g., denervate, ablate) basivertebral nerves within vertebrae. The modulation of the basivertebral nerves may facilitate treatment of chronic back pain. The modulation may be performed by a neuromodulation device (e.g., an energy delivery device).

Abstract: The invention provides a system and method for achieving the cosmetically beneficial effects of shrinking collagen tissue in the dermis or other areas of tissue in an effective, non-invasive manner using an array of electrodes. Systems described herein allow for improved treatment of tissue. Additional variations of the system include array of electrodes configured to minimize the energy required to produce the desired effect.

Abstract: An ablation probe and method of manufacturing the ablation probe are provided. The probe comprises a probe shaft and a unibody electrode element. The unibody electrode element comprises a common electrode base located at the distal end of the shaft, and a plurality of electrode tines distally extending from the electrode base. The electrode element may be created by forming divisions (such as slits or slots) from a first end of an electrically conductive elongate member towards an opposing second end of the elongate member. Alternatively, the divisions can be formed from a first end of an electrically conductive sheet towards an opposing second end of the sheet, and then bent or rolled to form the elongate member. In either case, the common electrode base can either be separately mounted to a probe shaft, or the probe shaft can be formed from the elongate member, in which case, the electrode base will be integrated with the probe shaft as a unibody structure. The electrode tines can be optionally shaped, e.g.

Abstract: At least one thermoelectric assembly controlled by a microprocessor and disposed on a thermal conduction pad configured to conduct energy to and from the thermoelectric assembly and adjacent the treatment area positioned with removable electronics and a breathable liner. The hot intensity, cold intensity and time delay between sequences can also be selected as well as alternating temperature sequences with both vibration and tension monitoring to promote blood flow and speed up healing.

Abstract: A spinal surgical system comprising a plurality of surgical components for cooperating with a electrosurgical handpiece comprising an elongated tubular member housing an electrode, with the tubular member configured to fit within and be extended down a standard sized cannula in a MIS procedure. The system components comprise one or more cannulas, straight or beveled; one or more guide wires, with and without pointed ends for piercing tissue; a tapered dilator; a trephine; and one or more depth control stops for mounting on the cannula for monitoring its depth. The system is especially useful for performing a discectomy.

Abstract: Methods and systems for heating a body tissue region adjacent a body lumen using selective accumulation of energy without knowledge of tissue topography. Methods include positioning an energy delivery portion of a catheter within the lumen adjacent the body tissue region, determining a pulse characteristic in response to a thermal property of a first tissue type and applying pulsed energy with the characteristic to treat a second tissue type within the region by drawing heat from the first tissue at a rate that inhibits thermal damage to the first tissue while building-up heat in the second tissue. Systems include a catheter body having an energy delivery portion processor configured to control a pulse characteristic of pulsed energy to therapeutically treat the second tissue by drawing heat from the first tissue at a rate that inhibits thermal damage to the first tissue while building-up heat in the second tissue.

Abstract: The use of non-thermal plasma to treat mucus membrane bleeding is described herein. A non-thermal plasma is generated using an apparatus having a first electrode that receives alternating electrical potentials from a power supply. When placed in an appropriate location proximate to tissue, a non-thermal plasma is generated, the second electrode being human tissue, blood, etc. To reduce the likelihood of an arc being generated, potentially causing tissue damage or pain, the first electrode is partially encapsulated by a dielectric. The non-thermal plasma is applied to the area of bleeding for treatment.

Abstract: A method and apparatus for treating masses, such as prostate or breast cancer, or any other soft tissue cancerous or benign mass, employs a unique, three-dimensional software-controlled electronic amplifier array using arbitrary waveforms that dynamically and proportionally steer electrical currents by using two or more current vector paths, sequentially or simultaneously, through a mass containing electrically-conductive ionic solutions so as to obtain 100% thermal heating or hyperthermia through the mass, and destroying it with a minimally-invasive treatment which requires no radiation or chemotherapy which could be harmful to the patient.

Abstract: Methods and systems for modulating intraosseous nerves (e.g., nerves within bone) are provided. For example, the methods and systems described herein may be used to modulate (e.g., denervate, ablate) basivertebral nerves within vertebrae. The modulation of the basivertebral nerves may facilitate treatment of chronic back pain. The systems may include energy delivery probes and bone channeling instruments.