Abstract: A laser energy delivery catheter emits energy laterally relative to the longitudinal axis of the catheter. The catheter distal end is a cylindrical housing provided with a sidewall aperture. Within the housing is mounted a prism spaced from the distal end of a fiber optic. The refractive index of the prism is higher than the refractive indices of the fiber optic and the coupling liquid medium. A liquid medium is utilized to cool the device when in use, and may also be utilized to optically couple the fiber optic and the prism. The catheter can be configured as a rigid or semi-rigid, hand held surgical instrument, or as a flexible device that can be inserted into body lumens through an endoscope.

Abstract: A catheter suitable for the delivery of laser energy to an obstruction in a body lumen is provided, which has an expandable, elastic distal end portion containing optical fibers whose exposed distal end faces are arranged in two or more substantially concentric arrays that merge into a narrower band array of a larger diameter upon radial expansion of the elastic distal end portion. The distal end portion of the catheter is more elastomeric than the catheter body.

Abstract: A method for removing unwanted material in a body lumen, cavity or organ provides the steps of using an endoscope or other viewing system to position a suitably sized lateral-lasing fiber optic device axially at one or more places in a body lumen, cavity or organ and delivering a predetermined amount of light energy for a predetermined period of time laterally in one or more directions, while delivering a biocompatible fluid at a predetermined rate of flow. The distal end of the lateral-lasing fiber optic device includes a reflectively-coated metal tip, which is capable of directing, by reflection, the light energy from the optical fiber laterally from the longitudinal axis of the light energy carrying optical fiber and outwardly toward a target tissue region.

Abstract: Optical coupling devices for an improved coupling efficiency of light energy, without damage to the optical components, are disclosed. An optical system divides an input beam of light energy into two or more output beams of lesser energy, each of which is focused toward a focal point in space. Individual optical fibers are positioned with their proximal end faces at the focal points of each of the lesser output beams. Means for dividing the light energy and aligning the components are disclosed.

Abstract: A laser device is provided for the co-axial positioning of plural laser beams of same or different wavelengths along a single axis. At least two laser oscillators are provided, each producing a laser beam. A rotary reflector is positioned for intercepting at least one of the produced laser beams and directing the intercepted laser beam separately from, but along a single axis defined by another laser beam.

Abstract: A method and device are provided for directing laser radiation to a body cavity site. A hollow, elongate, optical fiber is advanced, usually in a containing device, to the vicinity of the site and coupled to a laser source with a distal end region of the fiber extending along a longitudinal axis. The fiber terminates in an energy delivery surface for emitting laser radiation transmitted by the fiber. The radiation is intercepted at a location axially aligned with the energy delivery surface and is reflected in a beam radiating substantially transversely of, and substantially circumferentially around, the axis. A reflector member or block is provided for reflecting the radiation and is mounted in an open end of the catheter at a selected axial position along the axis. A fluid, such as a flushing fluid, can be directed between the end of the fiber, against the reflector member, and to the body site.

Abstract: A method and device are provided for directing laser radiation to a body cavity site. A hollow, elongate, optical fiber is advanced to the vicinity of the site and coupled to a laser source with a distal end region of the fiber extending along a longitudinal axis. The fiber terminates in a transverse, substantially flat, annular, energy delivery surface for emitting laser radiation transmitted by the fiber generally parallel to the axis. The radiation is intercepted axially adjacent the energy delivery surface and is reflected in a beam radiating substantially transversely of, and substantially around, the axis. A reflector block is provided for reflecting the radiation and is connected to an actuator for locating the reflector block at selected axial positions along the axis whereby the beam irradiates the body site along the axis.

Abstract: A catheter for ablating obstructing material within a corporal lumen includes a fiber optic member through which radiant energy can be transmitted to a distal end adjacent the site of the obstructing material. Beveled surfaces carried on the distal end of the fiber optic member provide output beams of radiant energy oriented in a direction on the order of 45.degree. with respect to an axis of the member. The laterally deflected radiant energy beams impinge upon regions of plaque or obstructing material in the lumen and have an effective radius greater than the radius of the fiber optic member. By rotating the fiber optic member, a circular locus within the lumen can be ablated or vaporized to create a channel in the lumen with a diameter greater than the diameter of the fiber optic member.

Abstract: A coupling system for coupling a beam of radiant energy from a laser to a fiber optic cable includes a secondary transmission path which surrounds the input end of the fiber optic cable and provides an optical path for energy which is not transmitted by the fiber optic core but is lost. Displaced from an output end of the secondary transmission path is a multi-faceted reflector. The reflector is displaced sufficiently from the output end of the secondary transmission path so that the power density of the radiation incident thereon is reduced sufficiently so as to not damage the facets thereof. The coupling system is contained within a heat sink which receives the reflected and lost radiant energy harmlessly converting same to heat.

Abstract: A fiberoptic includes a guide for light or other electromagnetic energy which has a single fiber core with a ring-shaped cross-section and defines an outer cylindrical surface and an inner cylindrical surface. A cylindrical central hollow channel extends between the ends of the fiberoptic through the center of the single fiber ring-shaped core. Various devices including coherent fiber viewing bundles, hollow tubular transport channels and the like may be slidingly disposed through the center channel of the core.

Abstract: An implantable medical device and system for percutaneous (e.g., peritoneal as well as subcutaneous) administration of a medication from an external source is disclosed. Continuous, variable rate, or intermittent administration of medication can be effected without the need for repeated puncturing of the patient's skin. The present device includes an implant that is transcutaneously anchored to the patient, an insert releasably mounted on the implant, and a seal means on the implant which seals an implant cavity that receives the insert upon removal of the insert so that the patient is protected from infection while the insert is replaced.

Abstract: The present invention teaches a medical device which mixes a primary medication with a secondary medication before administration to a patient. The device is also capable of automatically sequentially administering the primary medication alone to the patient. The device includes a medication chamber which is reduced in volume to deliver the secondary medication for mixing with the primary medication.

Abstract: A sequential medication delivery device for intravenous administration of plural medications is disclosed. A secondary medication can be administered to a patient followed by an automatic resumption of the delivery of the primary medication at a predetermined flow rate. The disclosed medication delivery device includes an internal valving system and an associated medication chamber that contains the secondary medication to be delivered. While the medication chamber contains such secondary medication, the flow of primary medication to the patient is interrupted. However, once the medication chamber has been substantially emptied the flow of primary medication to the patient is resumed automatically.

Abstract: A biochemically active matrix for use in a bio-artificial organ is disclosed. The biochemically active matrix has an enzyme covalently bonded to a matrix of organochemically cross-linked fibrin. The matrix may be suspended in a medium of agarose which irreversibly solidifies below 37.degree. C. The bio-artificial organ is useful for extracorporeal treatment of blood to remove excess substrate from the blood. .

Abstract: A bio-artificial organ containing a biochemically active matrix is disclosed. The biochemically active matrix includes biochemically active enzyme-containing microcapsules entrapped within a gel matrix. An extracorporeal blood flow can be passed through the organ and over the biochemically active matrix to permit the enzyme to perform its enzymatic function on a substrate in the blood.

Abstract: A lymphapheresis or lymph filtration system is disclosed for removing lymph from a patient, separating the lymph into a liquid fraction and a cellular component fraction and returning the liquid fraction to the patient. The system includes an input pump to pump lymph from the patient into a filtration cell having a membrane which filters the lymph into fractions. The liquid fraction is removed from the cell by a reversible pump and is returned to the patient. As the membrane becomes plugged the reversible pump is reversed to backflush the membrane to return it to a high filtration rate. The cellular component fraction which includes lymphocytes is disposed of.