Energy delivery devices and methods

Abstract

This relates to methods and devices for achieving contact between the wall of a cavity or passageway and a medical device when used in tortuous anatomy.

1 - 25 . (canceled) 
     
     
         26 . A method of treating a lung, the method comprising:
 stimulating tissue surrounding an airway of the lung to constrict the airway by contacting the tissue with a pharmacological agent;   after stimulating the tissue, measuring a parameter of the airway;   identifying a treatment site based on the measured parameter by selecting the contacted tissue to receive energy from an electrode;   delivering a liquid to the airway and exterior of the medical device to electrically couple the electrode to the contacted tissue;   applying energy to the contacted tissue from the electrode, through the liquid, to damage nerve tissue while simultaneously delivering the liquid to and withdrawing the liquid from the airway to absorb heat from the contacted tissue, and   after applying energy to the contacted tissue, determining an effectiveness of the applying energy to the contacted tissue by determining whether the contacted tissue has a reduced ability to respond to a stimulus as compared to an ability to respond to the stimulus prior to the applying energy.   
     
     
         27 . The method of  claim 26 , further including damaging the contacted tissue. 
     
     
         28 . The method of  claim 27 , wherein the contacted tissue includes mucosal tissue. 
     
     
         29 . The method of  claim 26 , wherein applying energy includes applying RF energy. 
     
     
         30 . The method of  claim 26 , wherein the pharmacological agent is a bronchoconstricting agent. 
     
     
         31 . The method of  claim 30 , wherein the bronchoconstricting agent is histamine or methacholine. 
     
     
         32 . A method of treating a lung, the method comprising:
 circulating a liquid between an interior of a medical device, and exterior of the medical device within an airway of the lung, the medical device including a catheter and an electrode, to electrically couple the electrode to tissue surrounding the airway; and   while circulating the liquid, applying energy from the electrode, through the liquid, to damage the tissue, wherein circulating the liquid reduces a temperature of the tissue surrounding the airway.   
     
     
         33 . The method of  claim 32 , wherein the medical device further includes an expandable balloon. 
     
     
         34 . The method of  claim 32 , further including:
 stimulating the tissue surrounding the airway in the lung to constrict the airway,   after stimulating the tissue, measuring a parameter of the airway; and   identifying a treatment site based on the measured parameter, wherein the energy is applied to the treatment site.   
     
     
         35 . The method of  claim 34 , wherein:
 stimulating the tissue includes contacting the tissue with a pharmacological agent to induce constriction of the airway; and   identifying the treatment site includes selecting the contacted tissue to receive energy from the electrode.   
     
     
         36 . The method of  claim 34 , wherein stimulating the tissue includes electrically stimulating the tissue, mechanically stimulating the tissue, or stimulating the tissue by delivering a pharmacological agent to the tissue. 
     
     
         37 . The method of  claim 32 , further including, after applying energy, determining an effectiveness of applying energy by determining whether the lung has a reduced ability to produce at least one symptom of reversible obstructive pulmonary disease as compared to an ability to respond to the stimulus prior to the applying energy. 
     
     
         38 . The method of  claim 32 , wherein damaging tissue of the lung includes damaging nerve tissue. 
     
     
         39 . A method of treating a lung, the method comprising:
 contacting tissue surrounding an airway of the lung with an agent to induce constriction of the airway, wherein the medical device includes a catheter, a balloon disposed at a distal end of the catheter, and an electrode;   after contacting the tissue, measuring a parameter of the airway;   identifying a treatment site based on the measured parameter by selecting the contacted tissue to receive energy from the electrode;   delivering an electrically-conductive liquid to the airway;   applying energy to the contacted tissue from the electrode, through the liquid, to damage the contacted tissue and nerve tissue disposed radially outward of the contacted tissue;   simultaneous with applying energy to the contacted tissue, cooling the contacted tissue, and   after applying energy to the contacted tissue, determining an effectiveness of the applying energy to the contacted tissue.   
     
     
         40 . The method of  claim 39 , wherein the contacted tissue includes mucosal tissue. 
     
     
         41 . The method of  claim 39 , wherein applying energy includes applying RF energy. 
     
     
         42 . The method of  claim 39 , wherein the medical device includes a plurality of circumferentially spaced electrodes. 
     
     
         43 . The method of  claim 39 , wherein the agent is a bronchoconstricting agent. 
     
     
         44 . The method of  claim 43 , wherein the bronchoconstricting agent is histamine or methacholine. 
     
     
         45 . The method of  claim 39 , wherein the parameter is constriction of the airway.