LASER ABLATION PROCESS AND APPARATUS
First Claim
1. A laser catheter for arterial insertion and treatment of arterial tissue or obstructions located in arterial fluid comprising:
- a) a catheter;
b) a fiber optic means disposed within the catheter including ast one optical fiber;
c) an optical shield means the distal end of the catheter for providing an optically transparent enclosure over the end of the catheter and a distal surface for displacing arterial fluid such that direct contact can be made by said distal surface with such tissue or obstructions.
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Accused Products
Abstract
A laser catheter is disclosed wherein optical fibers carrying laser light are mounted in a catheter for insertion into an artery to provide controlled delivery of a laser beam for percutaneous intravascular laser treatment of atherosclerotic disease. A transparent protective shield is provided at the distal end of the catheter for mechanically diplacing intravascular blood and protecting the fibers from the intravascular contents, as well as protecting the patient in the event of failure of the fiber optics. Multiple optical fibers allow the selection of tissue that is to be removed. A computer controlled system automatically aligns fibers with the laser and controls exposure time. Spectroscopic diagnostics determine what tissue is to be removed.
340 Citations
79 Claims
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1. A laser catheter for arterial insertion and treatment of arterial tissue or obstructions located in arterial fluid comprising:
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a) a catheter;
b) a fiber optic means disposed within the catheter including ast one optical fiber;
c) an optical shield means the distal end of the catheter for providing an optically transparent enclosure over the end of the catheter and a distal surface for displacing arterial fluid such that direct contact can be made by said distal surface with such tissue or obstructions. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 35, 38, 39, 43, 45, 47, 48, 49)
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30. A laser cannula for insertion into tissue comprising:
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a) a tubular cannula;
b) a fiber optic means disposed within the cannula including an optical fiber having and inner core and an outer cladding;
c) an optical shield means enclosing the distal end of the cannula for providing a light transparent enclosure at or near the end of the cannula and a distal surface such that direct contact can be made by said distal surface with such tissue or obstructions. - View Dependent Claims (31, 32)
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- 33. The laser catheter of claim 33 rein means are provided to bend or change the shape of the distal end of said catheter.
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50. A laser catheter for insertion into a body vessel or cavity comprising:
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a) catheter;
b) a fiber optic means disposed within the catheter including a plurality of optical fibers each having an inner core and an outer cladding;
c) an optical shield means on the distal end of the catheter for providing an optically transparent enclosure over the end of the catheter and a distal surface for displacing fluid such that direct contact can be made by said distal surface with tissue or obstructions which may be found in said vessel or cavity.
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51. A laser catheter for insertion or tunneling into and removal of any body tissue, comprising:
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a) a catheter;
b) a fiber optic means disposed within the catheter including a plurality of optical fibers each having an inner core and an outer cladding;
c) an optical shield means on the distal end of the catheter for providing an optically transparent enclosure over the end of the catheter and a distal surface or displacing fluid such that direct contact tissue can be made by said distal surface with tissue or obstructions.
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52. A method for treatment of lesions or obstructions in tissue of a body vessel or cavity comprising the steps of:
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a) with plurality of optical fibers in which the distal end of the catheter is enclosed by an optical shield transparent to optical light radiation and wherein the proximal end of the catheter and optical fibers may be coupled to a laser or other light source of relatively high or low power;
b) inserting said catheter into said body vessel or cavity until the optical shield is brought into contact with a suspected lesion or obstruction;
c) selecting an optical fiber such that radiation will fall on tissue or obstruction to be treated; and
coupling laser radiation of appropriate power and energy into the proximal end of said selected fiber whereby such radiation is transmitted through said fiber to the distal end to irradiate and thereby remove the selected tissue or obstruction;
d) repeating the above steps with other optical fibers until all tissue or obstruction adjacent to the optical shield has been treated and/or removed as needed;
e) repositioning the catheter and optical shield forward or laterally so as to bring it in contact with or adjacent to additional tissue or obstruction to be treated, and repeating the above steps as needed until all the desired tissue or obstruction has been treated or removed. - View Dependent Claims (53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 75)
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74. A method for treatment of arterial tissue of obstructions comprising the steps of:
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a) providing a catheter with a plurality of optical fibers in which the distal end of the catheter is enclosed by an optical shield transparent to light radiation and wherein the proximal end of the catheter and optical fibers may be couple to light sources of optical radiation of relatively high or low power wherein the high power radiation is capable of removing tissue and the low power radiation is capable of exciting fluorescence and scattering light, but not of removing tissue;
b) inserting said catheter into an artery until the optical shield is brought into contact with the suspected arterial lesion;
c) selecting an optical fiber and coupling the low power optical radiation from the light source to the proximal end of said optical fiber whereby the light enters the proximal end of the optical fiber and is transmitted by the selected optical fiber to the distal end of said fiber out the optical shield and impinges on the suspected lesion, and the scattered and flourescent light is returned to th proximal end of the selected optical fiber, and is coupled to a spectral analyzer wherein the fluorescence or scattered light excited by said light is analyzed to determine if the material contacted by the optical shield and, in particular, the portio irradiated by the incident light from th selected optical fiber is healthy arteria tissue or plaque or other material;
d) in the event it is determined that the material is to be removed, coupling the proximal end of said selected optical fiber to the source of relatively high power radiation and coupling said radiation to the proximal end of said selected optical fiber whereby such radiation is transmitted through said fiber to the distal end to irradiate a portion of the tissue;
e) repeating the above steps until the shield is in contact only with healthy tissue.
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76. A method of diagnosis of the type of tissue in the artery, including distinguishing healthy artery wall from atheromateous plaque, comprising the steps of:
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a) providing a catheter with at least one optical fiber in which the distal end of the catheter is enclosed by an optical shield transparent to light radiation and wherein the proximal end of the catheter and optical fibers may be coupled to a light source of optical radiation wherein the radiation is capable of exciting fluorescence and scattering light;
b) inserting said catheter into an artery until the optical shield is brought into contact with the suspected arterial lesion or other tissue to be diagnosed;
c) selecting an optical fiber and coupling the optical radiation from the light source to the proximal end of said optical fiber whereby he light enters the proximal end of the optical fiber and is transmitted by the selected optical fiber to the distal end of said fiber out the optical shield and impinges on the suspected lesion, and the scattered an fluorescent light is returned to the proximal end the selected optical fiber, and is coupled to a spectral analyzer wherein fluorescence or scattered light excited by said light is analyzed to determine if the material contacted by the optical shield and, in particular, the portion irradiated by the incident light from the selected optical fiber is healthy arterial tissue or plaque or other material. - View Dependent Claims (77, 79)
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78. A method for tunneling into and/or treatment of lesions or bodily tissue comprising the steps of:
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a) providing a laser cannula with a plurality of optical fibers in which the distal end of the cannula is enclosed by an optical shield transparent to optical light radiation and wherein the proximal end of the cannula and optical fibers may be coupled to a laser or other light source of relatively high or low power;
b) inserting said cannula into or against said body tissue until the optical shield is brought into contact with a suspected lesion or tissue to be removed;
c) selecting an particular fiber such that radiation will fall on tissue or lesion to be treated; and
coupling laser radiation of appropriate power and energy into the proximal end of said selected fiber whereby such radiation is transmitted through said fiber to the distal end to irradiate and thereby remove the selected tissue or lesion;
d) repeating the above steps with other optical fibers until all tissue or lesion adjacent to the optical shield has been treated and/or removed as needed;
e) repositioning the catheter and optical shield forward or laterally so as to bring it in contact with or adjacent to additional tissue or lesion to be treated, and repeating the above steps as needed until all the desired tissue or obstruction has been treated or removed.
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Specification