A device and a method for treating Vulnerable Plaque by pulsed focused energy is described. The present invention describe a device and a method for a) breaking through plaque blocking arteries (totally occluded arteries) so that wires and stents can introduced to open the blocked or totally occluded arteries, and b) applying a controlled amount of energy to VP (possibly with cooling or energy removal applied to the surface layers) so that at least some of the constituents of the VP are stabilized or denatured so they can no longer cause blood clotting or are stabilized to prevent emergence into the blood stream and thus prevent clotting. Additionally an imaging method (for example, OCT, side looking OCT, IVUS, Ultrasound, OCT, thermography, IR imaging, Florence imaging, luminescent imaging, MRI, Videography, or other imaging technologies, allow viewing of the progress of the damage caused to the VP blood clot—causing components or the progress in the stabilization of the VP. Imaging of the said treatment effect on the VP in time and space can thus be made simultaneously with the present invention proposed treatment and provide real time feedback on the progress and effect of the treatment described by the present invention.
