Devices and methods for directed, interstitial ablation of tissue

• US 6,802,838 B2
• Filed: 04/22/2002
• Issued: 10/12/2004
• Est. Priority Date: 04/22/2002
• Status: Expired due to Term

• Current Assignee: Catheter Ablation Solutions LLC (Acacia Research Corporation)
• Original Assignee: Trimedyne Incorporated (InnovaQuartz, LLC)
• Inventors: Loeb, Marvin P., Crawford, L. Dean, Pergl, James W., Graham, Randy P.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): ROANE, AARON F
• Application Number:
  US10/127,382
• Publication Number:
  US 20030199860A1
• Time in Patent Office: 904 Days
• Field of Search: 606/13, 606/14, 606/15, 606/16, 607/88, 607/89
• US Class Current: 606/13
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/2005 with beam delivery through an interstitially insertable device, e.g. needle
• CPC Class Codes: A61B 2018/2277 with refractive surfaces

Abstract

The invention relates to a catheter device including an optical fiber whose distal end is disposed within a hollow tube with a sharp or syringe shaped distal end, which may be inserted into tissue. The distal end of the optical fiber and the hollow tube are configured so as to emit, by refraction (total internal reflection) or reflection from a metal surface, laser energy at an angle of about 80° to about 90° relative to the longitudinal axis of the optical fiber and hollow tube. A first fluid channel within the distal end portion of the tube enables fluid to be infused to cool the distal end of the tube and to cool and clean the emission face of the optical fiber. A second, relatively larger diameter fluid channel in the tube enables the fluid, flowing through said first channel along with hot gasses from the vaporization of tissue, to exit the device through a second port in the tube, away from the tissue being treated. A vacuum can be applied to the second fluid channel to more effectively remove the infused, cooling fluid and hot gasses from the tissue being treated. Alternatively, the tube can incorporate a distal end portion which can be articulated to allow the insertion of the device into tissue perpendicular to the tissue'"'"'s surface, from which laser energy can be emitted forwardly.

Claims

1. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube defining first and second spaced-apart ports;

b) a flexible energy conduit adapted for connection to a laser energy source, extending through said tube and including a distal end adapted to emit laser energy to a predetermined tissue site and the distal end portion thereof defining a channel in said tube in fluid flow communication with said first and second ports respectively; and

c) a fluid conduit for passing a fluid or creating a vacuum through said first and second ports and through said channel for cooling said distal end portion and cleaning said distal end of said energy conduit;

wherein said first and second ports in said tube define fluid inlet and outlet ports respectively and said conduit for passing a fluid comprises a fitting defining an interior cavity in fluid flow communication with a fluid source, said tube extending through said fitting;

whereby said inlet port in said tube is located in fluid flow communication with said cavity in said fitting and the fluid flows through said channel and exits through said outlet port.

2. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube defining first and second spaced-apart ports;

b) a flexible energy conduit adapted for connection to a laser energy source, extending through said tube and including a distal end adapted to emit laser energy to a predetermined tissue site and the distal end portion thereof defining a channel in said tube in fluid flow communication with said first and second ports respectively; and

c) a fluid conduit for passing a fluid or creating a vacuum through said first and second ports and through said channel for cooling said distal end portion and cleaning said distal end of said energy conduit;

wherein said first and second ports in said tube comprise fluid inlet and outlet ports respectively and said fluid conduit for passing a fluid includes a handpiece defining an interior cavity in fluid flow communication with a source of fluid, said tube extending into said handpiece;

whereby said inlet port in said tube is located in fluid flow communication with said interior cavity and fluid flows through said channel and exits through said outlet port.

3. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube defining first and second spaced-apart ports;

b) a flexible energy conduit adapted for connection to a laser energy source, extending through said tube and including a distal end adapted to emit laser energy to a predetermined tissue site and the distal end portion thereof defining a channel in said tube in fluid flow communication with said first and second ports respectively; and

c) a fluid conduit for passing a fluid or creating a vacuum through said first and second ports and through said channel for cooling said distal end portion and cleaning said distal end of said energy conduit;

wherein said fluid conduit for creating a vacuum comprises a fitting defining an interior cavity in fluid flow communication with a vacuum source, said tube extending into said fitting;

whereby said first port in said tube is located in fluid flow communication with said cavity in said fitting and said fluid flows successively through said second port, said channel and then through said first port in response to the creation of a vacuum in said tube.

4. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube defining first and second spaced-apart ports;

b) a flexible energy conduit adapted for connection to a laser energy source, extending through said tube and including a distal end adapted to emit laser energy to a predetermined tissue site and the distal end portion thereof defining a channel in said tube in fluid flow communication with said first and second ports respectively; and

c) a fluid conduit for passing a fluid or creating a vacuum through said first and second ports and through said channel for cooling said distal end portion and cleaning said distal end of said energy conduit;

wherein said fluid conduit for creating a vacuum comprises a handpiece defining an interior cavity in fluid flow communication with a vacuum source, said tube extending into said handpiece whereby said first port in said tube is located in fluid flow communication with said cavity in said handpiece and fluid is guided successively through said second port and said channel and then through said first port in response to the vacuum in said tube.

5. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube defining first and second spaced-apart ports;

b) a flexible energy conduit adapted for connection to a laser energy source, extending through said tube and including a distal end adapted to emit laser energy to a predetermined tissue site and the distal end portion thereof defining a channel in said tube in fluid flow communication with said first and second ports respectively; and

c) a fluid conduit for passing a fluid or creating a vacuum through said first and second ports and through said channel for cooling said distal end portion and cleaning said distal end of said energy conduit;

wherein said first and second ports in said tube define fluid inlet and outlet ports respectively, said fluid conduit for passing a fluid comprising a handpiece defining an interior cavity in fluid flow communication with a fluid source and said tube extends into said handpiece and said fluid inlet port thereof is in fluid flow communication with said cavity in said handpiece, said fluid conduit for creating a vacuum comprising a fitting including an interior cavity in fluid flow communication with a vacuum source, said tube extending into said fitting and said fluid outlet port being in fluid flow communication with said cavity in said fitting whereby fluid is guided successively through said inlet port in said tube and said channel and then through said outlet port in said tube in response to the introduction of fluid through said inlet port and the vacuum through said outlet port.

6. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube defining first and second spaced-apart ports;

b) a flexible energy conduit adapted for connection to a laser energy source, extending through said tube and including a distal end adapted to emit laser energy to a predetermined tissue site and the distal end portion thereof defining a channel in said tube in fluid flow communication with said first and second ports respectively; and

c) a fluid conduit for passing a fluid or creating a vacuum through said first and second ports and through said channel for cooling said distal end portion and cleaning said distal end of said energy conduit;

wherein each said tube and said energy conduit includes opposed side surfaces and said opposed side surfaces of said tube are crimped respectively against said opposed side surfaces of said energy conduit to define a first upper passage and a second lower passage in said tube together defining said channel in said tube.

7. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube including a closed distal end and a distal peripheral end portion defining a port;

b) an energy conduit extending longitudinally through said tube including a distal end spaced from and parallel to said port and adapted to emit laser energy; and

c) means for directing the laser energy emitted from said distal end of said energy conduit outwardly through said port in said tube in a direction generally perpendicular to the longitudinal axis of said tube and said energy conduit;

wherein said tube includes a peripheral wall defining first and second ports therein defining fluid inlet and outlet ports respectively and said conduit is spaced from said wall to define a fluid channel in said tube, said device further comprising a fitting in fluid flow communication with a source of fluid and adapted for connection to said first port whereby fluid is adapted to flow through said channel and exit through said second port in said tube.

8. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube including a closed distal end and a distal peripheral end portion defining a port;

b) an energy conduit extending longitudinally through said tube including a distal end spaced from and parallel to said port and adapted to emit laser energy; and

c) means for directing the laser energy emitted from said distal end of said energy conduit outwardly through said port in said tube in a direction generally perpendicular to the longitudinal axis of said tube and said energy conduit;

wherein said tube includes a peripheral wall defining first and second ports therein defining fluid inlet and outlet ports respectively and said conduit is spaced from said wall to define a fluid channel in said tube, said device further comprising a handpiece defining an interior cavity in fluid flow communication with a source of fluid, said tube extending into said cavity of said handpiece such that said inlet port in said tube is located in fluid flow communication with said cavity whereby said fluid is adapted to flow through said inlet port and said channel and exits through said outlet port in said tube.

9. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube including a closed distal end and a distal peripheral end portion defining a port;

b) an energy conduit extending longitudinally through said tube including a distal end spaced from and parallel to said port and adapted to emit laser energy; and

c) means for directing the laser energy emitted from said distal end of said energy conduit outwardly through said port in said tube in a direction generally perpendicular to the longitudinal axis of said tube and said energy conduit;

wherein said tube includes a peripheral wall defining first and second ports and said conduit is spaced from said wall to define a fluid channel in said tube, said device further comprising a fitting in fluid flow communication with a vacuum source and adapted for connection to said first port;

whereby fluid is adapted to flow successively through said second port;

said channel and then through said first port in response to the creation of a vacuum in said tube.

10. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube including a closed distal end and a distal peripheral end portion defining a port;

b) an energy conduit extending longitudinally through said tube including a distal end spaced from and parallel to said port and adapted to emit laser energy; and

c) means for directing the laser energy emitted from said distal end of said energy conduit outwardly through said port in said tube in a direction generally perpendicular to the longitudinal axis of said tube and said energy conduit;

wherein each said tube and said energy conduit includes opposed side surfaces and said opposed side surfaces of said tube are crimped respectively against said opposed side surfaces of said energy conduit to define a first upper and a second lower passageway in said tube together defining a channel in said tube in fluid flow communication with respective inlet and outlet ports formed in said tube.

11. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) an elongate hollow tube including a closed distal end and a distal peripheral end portion defining a port;

b) an energy conduit extending longitudinally through said tube including a distal end spaced from and parallel to said port and adapted to emit laser energy; and

c) means for directing the laser energy emitted from said distal end of said energy conduit outwardly through said port in said tube in a direction generally perpendicular to the longitudinal axis of said tube and said energy conduit;

wherein said distal end of said conduit is covered by a capillary tube including a closed distal end.

12. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) a laser energy source;

b) an elongate hollow tube defining first and second spaced-apart ports;

c) a flexible energy conduit extending through said tube and including a proximal end adapted for connection to the laser energy source and a distal end adapted to emit laser energy to a predetermined tissue site, the distal end portion thereof defining a channel in said tube in fluid flow communication with said first and second ports respectively; and

d) a fluid conduit for passing a fluid or creating a vacuum through said first and second ports and through said channel for cooling said distal end portion and cleaning said distal end of said energy conduit;

wherein said first and second ports in said tube define fluid inlet and outlet ports respectively and said fluid conduit for passing a fluid comprises a fitting defining an interior cavity in fluid flow communication with a fluid source, said tube extending through said fitting;

whereby said inlet port in said tube is located in fluid flow communication with said cavity in said fitting and the fluid flows through said channel and exits through said outlet port.

13. A catheter device adapted for delivering laser energy to a body tissue comprising:

a) a laser energy source;

b) an elongate hollow tube defining first and second spaced-apart ports;

a flexible energy conduit extending through said tube and including a proximal end adapted for connection to the laser energy source and a distal end adapted to emit laser energy to a predetermined tissue site, the distal end portion thereof defining a channel in said tube in fluid flow communication with said first and second ports respectively; and

d) a fluid conduit for passing a fluid or creating a vacuum through said first and second ports and through said channel for cooling said distal end portion and cleaning said distal end of said energy conduit;

wherein said first and second ports in said tube comprise fluid inlet and outlet ports respectively and said fluid conduit for passing a fluid includes a handpiece defining an interior cavity in fluid flow communication with a source of fluid, said tube extending into said handpiece;

whereby said inlet port in said tube is located in fluid flow communication with said interior cavity and fluid flows through said channel and exits through said outlet port.

14. The catheter device of claim 13 wherein the laser energy source is selected from the group consisting of an argon laser, a KTP laser, a Nd:

YAG laser, a diode laser, an Alexandrite laser, and a holmium;

YAG laser.

15. The catheter device of claim 13 wherein the laser energy source is a holmiumYAG laser.