| CPC A61M 25/0133 (2013.01) [A61B 17/22 (2013.01); A61B 18/245 (2013.01); A61B 18/26 (2013.01); A61L 27/20 (2013.01); A61M 25/0009 (2013.01); A61M 25/0155 (2013.01); A61M 25/09 (2013.01); A61B 2017/22062 (2013.01); A61B 2018/0022 (2013.01); A61B 2018/00285 (2013.01); A61B 2018/2261 (2013.01); A61B 2018/2266 (2013.01); A61B 2018/2277 (2013.01); A61B 2018/2294 (2013.01); A61B 2018/263 (2013.01); A61B 2090/306 (2016.02); A61L 2400/12 (2013.01); A61M 2025/09008 (2013.01); A61M 2025/09183 (2013.01); A61M 2202/0415 (2013.01); A61M 2205/3592 (2013.01); A61M 2205/587 (2013.01)] | 20 Claims |

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1. A catheter system for imparting pressure to induce fractures in a treatment site within or adjacent a vessel wall, comprising:
a catheter configured to advance to the treatment site, the catheter comprising an elongate shaft and a balloon coupled to the elongate shaft, the balloon having a balloon wall;
a first light guide disposed along the elongate shaft and positioned at least partially within the balloon, the first light guide being in optical communication with a light source and a balloon fluid, the first light guide including a distal portion that is positioned within the balloon fluid; and
a first focusing element located at the distal portion of the first light guide, the first focusing element being in optical communication with the light source, the first focusing element being configured to direct light from within the first light guide to a first location at a first distance away from the distal portion of the first light guide so that plasma formation in the balloon fluid is initiated away from the distal portion of the first light guide and so that rapid bubble formation occurs, thereby imparting pressure waves upon the treatment site.
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