Fiber optic laser catheter and method of using it

• US 7,125,404 B2
• Filed: 04/02/2003
• Issued: 10/24/2006
• Est. Priority Date: 08/06/1990
• Status: Expired due to Fees

• Current Assignee: Jeffrey I. Levatter
• Original Assignee: Jeffrey I. Levatter
• Inventors: Levatter, Jeffrey I.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US10/406,140
• Publication Number:
  US 20040092915A1
• Time in Patent Office: 1,301 Days
• Field of Search: 606/7, 606 13- 15
• US Class Current: 606/7
• CPC Class Codes: A61B 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2017/22061 for spreading elements apart
• CPC Class Codes: A61B 2017/22062 to be filled with liquid
• CPC Class Codes: A61B 2017/22074 the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 2018/2238 with means for selectively laterally deflecting the tip of the fibre
• CPC Class Codes: A61B 2090/3933 Liquid markers

Abstract

A fiber optic laser catheter assembly for use in removing, or largely debulking, obstructions or occlusions from a lumen in a living body. The catheter assembly includes an outer tubular sheath, an optical fiber extending through the sheath, and a fiber guide for holding the fiber within the sheath. In all of the disclosed embodiments, the obstructions are removed by controllably positioning an optical fiber'"'"'s distal tip in a succession of selected radial and circumferential positions so as to sculpt away the obstruction without substantial risk of mechanically or thermally damaging the vessel. Several of the embodiments are configured such that the portion of the occlusion that can be reliably sculpted away has a radius greater even than the radius of the catheter assembly itself.

Claims

1. A method for removing an obstruction from a lumen of a living body, the method comprising:

providing a catheter including a tubular outer sheath sized to be received within the lumen of the living body, the sheath including a longitudinal axis and a distal end, and an optical fiber line extending through the sheath, the optical fiber line disposed in an optical fiber guide located within the sheath;

arranging the distal end of the sheath to be located proximal to the obstruction;

generating a pulsed laser beam using a laser, the pulsed laser beam comprising laser pulses having a repetition rate, the optical fiber line in the sheath including an inlet end that receives the pulsed laser beam and an outlet end located proximal to the obstruction, the optical fiber guide configured to support at least the outlet end of the optical fiber line;

displacing the outlet end of the optical fiber line a radial distance from the longitudinal axis of the sheath;

rotating the fiber guide about the longitudinal axis of the sheath so that the outlet end of the optical fiber line follows a circumferential pathway within the lumen;

adjusting the rotation rate of the fiber guide based on the pulse repetition rate of the pulsed laser beam so that successive laser pulses do not substantially spatially overlap on the circumferential pathway of the outlet end of the optical fiber line; and

varying the radial distance of the outlet end of the optical fiber line from the longitudinal axis of the sheath.

2. The method of claim 1, wherein the step of varying the radial distance includes controllably inflating a bladder to laterally bias a distal tip of the optical fiber line within a radially-aligned slot formed in the optical fiber guide.

3. The method of claim 1, wherein the bladder is configured to expand and to compressively engage the optical fiber guide towards a portion of a wall of the lumen proximal to the obstruction to be removed.

4. The method of claim 1, wherein the step of varying the radial distance includes placing the optical fiber line in at least one of a plurality of channels formed in the optical fiber guide, each channel including a distal end located at a different radial position.

5. The method of claim 1, wherein the step of varying the radial distance includes placing the optical fiber line in at least one of a plurality of separate optical fiber guides, each guide including a distal end located at a different radial position.