an ultrasonic tissue ablation device comprising a transversely vibrating elongated probe , and a coupling assembly for probe attachment detachment that enables the probe assembly and separation from the device body that includes the ultrasound energy source and a sound conductor , and a method of use for removal of vascular occlusions in blood vessels . the coupling assembly enables incorporation of elongated probes with small cross sectional lumens such as a catheter guidewires . the probe detachability allows insertion manipulation and withdrawal independently of the device body . the probe can be used with acoustic and / or aspirations sheaths to enhance destruction and removal of an occlusion . the horn assembly of the device that contains a sound conducting horn functions as an energy regulator and reservoir for the probe , and precludes loss of probe cavitation energy by its bending or damping within the blood vessel .