A therapeutic actuator, comprising: a polymeric element; a therapeutic element; a heating and delivery system; and a flexible tube defining a lumen therein, wherein the therapeutic element is configured to fit adjacent the lumen of the flexible tube and to be released at a distal end of the flexible tube; the heating and delivery system comprising an electrical conductor disposed within the lumen of the flexible tube and a resistive heating element also disposed within the lumen of the flexible tube distal to the electrical conductor and electrically connected to the electrical conductor; the polymeric element having a tether portion that secures the therapeutic element to the heating and delivery system and an aggregate portion, wherein the tether portion is adjacent to the resistive heating element and the aggregate portion is positioned inside the therapeutic element and distal to the tether portion; the therapeutic actuator further comprising: an anchor disposed in the aggregate portion of the polymeric element; and a bead on a distal end of the therapeutic element that retains the therapeutic element to the tether portion, the bead maintaining the therapeutic element in a first configuration through a stretch resistant member that secures the bead to the anchor, characterized by a bulb that secures the tether portion of the polymeric element to the resistive heating element. a polymeric element; a therapeutic element; a heating and delivery system; and a flexible tube defining a lumen therein, wherein the therapeutic element is configured to fit adjacent the lumen of the flexible tube and to be released at a distal end of the flexible tube; the heating and delivery system comprising an electrical conductor disposed within the lumen of the flexible tube and a resistive heating element also disposed within the lumen of the flexible tube distal to the electrical conductor and electrically connected to the electrical conductor; the polymeric element having a tether portion that secures the therapeutic element to the heating and delivery system and an aggregate portion, wherein the tether portion is adjacent to the resistive heating element and the aggregate portion is positioned inside the therapeutic element and distal to the tether portion; the therapeutic actuator further comprising: an anchor disposed in the aggregate portion of the polymeric element; and a bead on a distal end of the therapeutic element that retains the therapeutic element to the tether portion, the bead maintaining the therapeutic element in a first configuration through a stretch resistant member that secures the bead to the anchor, characterized by a bulb that secures the tether portion of the polymeric element to the resistive heating element. an anchor disposed in the aggregate portion of the polymeric element; and a bead on a distal end of the therapeutic element that retains the therapeutic element to the tether portion, the bead maintaining the therapeutic element in a first configuration through a stretch resistant member that secures the bead to the anchor, characterized by a bulb that secures the tether portion of the polymeric element to the resistive heating element.