Intracorporeal expandable shock wave reflector

1. An intracorporeal pressure shock wave apparatus comprising:

a guide catheter sized to fit within a human or animal blood vessel or body lumen wherein the guide catheter is configured to be positioned a distance from a blood clot or occlusion;

a shock waves catheter sized to fit within the guide catheter and including an expandable and retractable pressure shock wave reflector coupled at a distal end of the shock waves catheter, wherein the pressure shock wave reflector expands to provide a frontal exposure relative to the distal end of the shock waves catheter; and

a pressure shock wave generating device operatively coupled adjacent the pressure shock wave reflector, wherein the pressure shock wave reflector is configured to produce focused shock waves to a focal volume that intersects the blood clot or occlusion without the focused shock waves passing through any balloon.

2. The intracorporeal pressure shock apparatus of claim 1 , wherein the pressure shock wave reflector includes a temperature memory metal.

3. The intracorporeal shock wave apparatus of claim 2 , wherein the pressure shock wave reflector includes a plurality of leaves.

4. The intracorporeal shock wave apparatus of claim 3 , wherein the temperature memory metal is nitinol.

5. The intracorporeal pressure shock wave apparatus of claim 2 , wherein the temperature memory metal is nitinol.

6. The intracorporeal shock wave apparatus of claim 1 , further comprising an occlusion balloon coupled to the guide catheter, and wherein the distal end of the shock waves catheter is distal to the occlusion balloon.

7. The intracorporeal shock wave apparatus of claim 6 , further comprising a radio-opaque marker coupled to the guide catheter configured to provide positioning of the shock wave reflector relative to the blood clot or occlusion in combination with fluoroscopy.

8. The intracorporeal shock wave apparatus of claim 7 , wherein the pressure shock wave reflector is crimped to an inner member within the shock waves catheter.

9. The intracorporeal shock wave apparatus of claim 1 , further comprising a forward and backward movable sheath of the shock waves catheter, wherein said sheath covers the pressure shock wave reflector in a retracted state.

10. The intracorporeal shock wave apparatus of claim 3 , further comprising a thin polymeric membrane on the outside of the shock wave reflector controlling extension of the leaves under dynamic pressure generated by pressure shock waves from the pressure shock wave generating device.

11. The intracorporeal shock wave apparatus of claim 10 , wherein the guide catheter includes a suction area between the guide catheter and the sheath.

12. The intracorporeal shock wave apparatus of claim 11 , wherein the reflector includes nitinol.

13. The intracorporeal shock wave apparatus of claim 1 , further comprising a radio-opaque marker coupled to the guide catheter configured to provide positioning of the pressure shock wave reflector relative to the occlusion or blood clot in combination with fluoroscopy.

14. The intracorporeal pressure shock wave apparatus of claim 13 , wherein the pressure shock wave reflector is foldable and includes a plurality of leaves, and further comprising a forward and backward movable sheath of the shock waves catheter, wherein said sheath covers the pressure shock wave reflector in a folded state.

15. The intracorporeal pressure shock wave apparatus of claim 14 , further comprising a thin polymeric membrane on the outside of the pressure shock wave reflector controlling extension of the leaves under dynamic pressure generated by pressure shock waves from the pressure shock wave generating device.

16. The intracorporeal pressure shock wave apparatus of claim 15 , wherein the pressure shock wave reflector includes nitinol.

17. The intracorporeal pressure shock wave apparatus of claim 14 , wherein the guide catheter includes a suction area between the guide catheter and the sheath.

18. The intracorporeal pressure shock wave apparatus of claim 17 , further comprising an occlusion balloon coupled to the guide catheter, and wherein the distal end of the shock waves catheter is distal to the occlusion balloon.

19. An intracorporeal pressure shock wave apparatus comprising:

a guide catheter sized to fit within a human or animal blood vessel or body lumen, wherein the guide catheter is configured to be positioned a distance from a blood clot or occlusion;

a shock waves catheter sized to fit within the guide catheter and including a foldable pressure shock wave reflector including a plurality of leaves that include nitinol and coupled at a distal end of the shock waves catheter, wherein the pressure shock wave reflector has a frontal exposure relative to the distal end of the shock waves catheter when the reflector is unfolded;

a forward and backward movable sheath being part of the shock waves catheter, wherein said sheath covers the pressure shock wave reflector in a folded state;

an inner member within the sheath crimped to the foldable pressure shock wave reflector;

a radio-opaque marker coupled to the guide catheter configured to provide positioning of the pressure shock wave reflector in combination with fluoroscopy relative to a blood clot or occlusion;

a suction area between the guide catheter and sheath;

an occlusion balloon coupled to the guide catheter, wherein the distal end of the shock waves catheter is distal to the occlusion balloon; and

a pressure shock wave generating device adjacent the foldable pressure shock wave reflector, wherein the foldable pressure shock wave reflector is configured to produce focused shock waves to a focal volume that intersects the blood clot or occlusion without the focused shock waves passing through any balloon.

20. A method of treatment comprising applying intracorporeal shock waves from the apparatus of claim 1 to an occlusion or blood clot in combination with one or both of (i) applying extracorporeal shock waves to the occlusion or blood clot and (ii) administering a drug that causes dissolution of the blood clot or destruction of the occlusion.