a focal catheter is used that does not include an expandable element the expansion chamber may be within a lumen within the catheter that is in thermal communication to a treatment element at for example the distal portion of the catheter the system 10 generally includes a medical device 12 that may be coupled to a control unit or operating console 20 the medical device 12 may generally include one or more treatment regions for example one or more cryoballoons 16 for energetic or other therapeutic interaction between the medical device 12 and a treatment site although the system 10 described herein is used at least for cryogenic treatments the system 10 may also be configured to deliver for example radiofrequency energy microwave energy ultrasound energy or provide other energetic transfer with a tissue area in proximity to the treatment regions including cardiac tissue the medical device 12 may include an elongate body 22 passable through a patient 39 s vasculature and or proximate to a tissue region for diagnosis or treatment such as a catheter sheath or intravascular introducer the elongate body 22 may define a proximal portion 24 and a distal portion 26 and may further include one or more conduits 28 30 disposed within the elongate body 22 thereby providing fluid mechanical and or electrical communication between the proximal portion 24 of the elongate.