Intravascular lithotripsy systems, devices and methods

A catheter configured to be in operative and electrical communication with a voltage pulse generator, the catheter comprising:

• an elongated carrier;
• an inflatable balloon comprising a material and disposed near a distal end of the elongated carrier, wherein the inflatable balloon is configured to be inflated with a fluid;
• a plurality of pairs of spaced-apart electrodes operatively associated with the elongated carrier and within the inflatable balloon, wherein each pair of the plurality of pairs of spaced-apart electrodes comprises a spark gap,
• wherein each one of the plurality of pairs of spaced-apart electrodes is electrically associated with the voltage pulse generator, wherein the voltage pulse generator is configured to generate and apply a plurality of voltage pulses to at least one of the plurality of pairs of spaced-apart electrodes;
• the catheter being configured to be associated with a current monitor configured to monitor the magnitude of a first current flowing between one of the plurality of pairs of spaced-apart electrodes, the first current resulting from a first voltage pulse, and
• a processor operatively associated with the voltage pulse generator and comprising programmed instructions configured to initiate and control the voltage pulses generated and applied by the voltage pulse generator, the processor in operative communication with the current monitor,
• wherein the processor is configured to determine the magnitude of a second voltage pulse to be applied to one or more of the plurality of pairs of spaced-apart electrodes based on the magnitude of the monitored current resulting from the first voltage pulse.

A method for delivering pressure waves to a calcified lesion comprising:

• advancing a catheter to a calcified lesion, wherein the catheter is in operative and electrical communication and connection with a voltage pulse generator, the method comprising:
• providing an elongated carrier;
• providing an inflatable balloon disposed near a distal end of the elongated carrier, and configured to be inflated with a fluid;
• providing a pair of spaced-apart of electrodes operatively associated with the elongated carrier and within the inflatable balloon, wherein a distance between the spaced-apart pair of electrodes comprises a spark gap;
• and
• providing a processor operatively connected to the voltage pulse generator and comprising programmed instructions configured to control and operate the voltage pulse generator, the processor in operative communication with a voltage monitor and a current monitor;
• actuating the voltage pulse generator to apply at least one voltage pulse with a voltage magnitude to the pair of spaced-apart electrodes to cause current to flow across the spark gap;
• monitoring the voltage applied by the voltage pulse generator for each of the at least one voltage pulses;
• and
• determining the voltage magnitude to be applied to the pair of spaced-apart electrodes for the next voltage pulse based on the monitored voltage.

A method for delivering pressure waves to a calcified lesion comprising:

• advancing a catheter to a calcified lesion, wherein the catheter is in operative and electrical communication and connection with a voltage pulse generator;
• providing the catheter with an elongated carrier;
• providing the catheter with an inflatable balloon disposed near a distal end of the elongated catheter, and configured to be inflated with a fluid;
• providing a pair of spaced-apart of electrodes operatively connected with the elongate carrier and within the inflatable balloon, wherein a distance between the spaced-apart pair of electrodes comprises a spark gap;
• and
• providing a processor operatively connected to the voltage pulse generator and comprising programmed instructions configured to control and operate the voltage pulse generator, the processor in operative communication with a voltage monitor and a current monitor;
• actuating the voltage pulse generator to apply at least one voltage pulse with a voltage magnitude to the pair of spaced-apart electrodes to cause current to flow across the spark gap;
• monitoring the current flowing between the proximal electrode and the distal electrode for each of the at least one voltage pulses;
• and
• determining the voltage magnitude to be applied to the pair of spaced-apart electrodes for a subsequent voltage pulse based on the monitored current.