Abstract: In accordance with an embodiment of the present invention, a system for widening passages in the body of a patient includes a member extendable into a patient with a proximal end and a distal end with a tip and a hollow interior extending therebetween; bristles adjacent the distal end of the member such that rotation of the proximal end of the member causes rotation of the bristles to remove material from walls of pre-existing passages in the patient and, all of the bristles are inclined away from the tip of the distal end as they extend out from the distal end; a guide wire having a proximal end and a distal end disposed within the hollow interior and extendable into the patient; and a non-rotating capture member coaxially aligned with and fixed near the guide wire distal end to be disposed within the hollow interior and extendable into the patient.

Abstract: Tissue of a patient is tested for dangerous characteristics by using a laser that stimulates fluorescence in the tissue. The laser energy is applied to the tissue by from an opening in a catheter, which catheter supplies clear flushing solution out the same opening. The clear solution therefore provides a clear path for the laser energy and for the fluorescent light from the tissue. An optical fiber carries the laser energy to a distal end of the catheter and carries back fluorescent light to a proximal end of the catheter. The fluorescent light is checked for fluorescent peaks by a detection subsystem by the proximal end. The detection subsystem may include an optical channel analyzer (OMA). The distal end of the catheter has a dual hood design to best provide for the passage of light and clear flushing solution through the same opening. A balloon is used in some embodiments to maintain the clear path for the light for a longer time period than otherwise possible or appropriate.

Abstract: An apparatus and associated method provides for the application of a cell treatment agent, such as genetic material or drugs to be inserted within the cells of a patient in vivo. The apparatus may be a catheter arrangement with various embodiments for applying heat to a patient's cells in vivo in order to improve transfection efficiency or application efficiency. Laser beams may be applied directly to the cells. Alternately, the cells may be heated by electrical heating, chemical heating, radio frequency heating, microwave heating, infrared heating, ultrasound heating, or indirect laser heating. Further, the treatment agent may be heated prior to its application to the patient such that the treatment agent heats the cells of the patient.

Abstract: An apparatus and associated method provides for the application of a cell treatment agent, such as genetic material or drugs to be inserted within the cells of a patient in vivo. The apparatus may be a catheter arrangement with various embodiments for applying heat to a patient's cells in vivo in order to improve transfection efficiency or application efficiency. Laser beams may be applied directly to the cells. Alternately, the cells may be heated by electrical heating, chemical heating, radio frequency heating, microwave heating, infrared heating, ultrasound heating, or indirect laser heating. Further, the treatment agent may be heated prior to its application to the patient such that the treatment agent heats the cells of the patient.

Abstract: A system and method removes material from the wall of a passage, such as a vein or artery, in a patient's body with a series of bristles that are rotated. The bristles are part of a sweep catheter having a proximal end and a distal end with a tip thereon. Bristles next to the tip extend out from the distal end a shorter distance than the bristles further from the tip. The bristles, which have smaller bristles or sub-bristles thereon, are inclined away from the tip as they extend out from the distal end of the sweep catheter. The bristles push removed materials away from the tip and towards a suction channel of a guide catheter whereby the materials are removed.

Abstract: A catheter uses a steerable outer catheter with an inner catheter rotatable and extendable with respect to the outer catheter. The outer catheter may be positioned within a patient's heart and a portion of the outer catheter may provide movement like that of a windshield wiper by manipulation of a spring. By combining the windshield wiper type movement with the extension and rotation of the inner catheter relative to the outer catheter, a large area within a patient's heart may be readily mapped for conduction tissue and be subjected to laser ablation if appropriate. Various configurations provide flexibility in relatively positioning of windows used to apply laser energy and ring electrodes used to sense conduction tissue. Various anchoring techniques are described.

Abstract: A system and method for percutaneous myocardial revascularization uses laser energy emitted from the distal end of a catheter. A technique for controlling beam direction allows the creation of channels in a patient's heart tissue with the channels having different orientations relative to the distal end. An arrangement provides for the creation of a plurality of channels at one time by simultaneous application of a plurality of beams of laser energy. A navigation arrangement uses two non-coplanar magnetic sensing coils in the distal end of the catheter cooperating with three sets of three magnetic field generating external coils (i.e., external to the patient). Each of the three sets is sequentially energized and the sensing coils in the distal end sense the magnetic fields established. A computer compares the sensed fields with the known sequence of energizing the external coils and thereby determines the position of the distal end.

Abstract: A catheter uses a steerable outer catheter with an inner catheter rotatable and extendable with respect to the outer catheter. The outer catheter may be positioned within a patient's heart and a portion of the outer catheter may provide movement like that of a windshield wiper by manipulation of a spring. By combining the windshield wiper type movement with the extension and rotation of the inner catheter relative to the outer catheter, a large area within a patient's heart may be readily mapped for conduction tissue and be subjected to laser ablation if appropriate. Various configurations provide flexibility in relatively positioning of windows used to apply laser energy and ring electrodes used to sense conduction tissue. Some embodiments provide only laser ablation (no mapping).

Abstract: A catheter uses a steerable outer catheter with an inner catheter rotatable and extendable with respect to the outer catheter. The outer catheter may be positioned within a patient's heart and a portion of the outer catheter may provide movement like that of a windshield wiper by manipulation of a spring. By combining the windshield wiper type movement with the extension and rotation of the inner catheter relative to the outer catheter, a large area within a patient's heart may be readily mapped for conduction tissue and be subjected to laser ablation if appropriate. Various configurations provide flexibility in relatively positioning of windows used to apply laser energy and ring electrodes used to sense conduction tissue. Some embodiments provide only mapping (no ablation) or with ablation by other then Various anchoring techniques are described.

Abstract: A laser treatment device provides an output operating laser beam having a single wavelength which is highly absorbed by tissue of a patient and which beam is non-diverging. The laser treatment device may be a catheter which is inserted into a patient for performing endovascular myocardial revascularization (i.e., creating new channels for blood flow from within the interior of the patient's heart). The use of the highly absorbed wavelength and the non-diverging character of the beam are possible by having a distal laser at a distal end of the catheter. The distal laser is pumped by a source of laser energy supplied by an array of diode lasers and passed along an optical fiber from a proximal end of the catheter.

Abstract: An apparatus and associated method provides for the application of a cell treatment agent, such as genetic material or drugs to be inserted within the cells of a patient in vivo. The apparatus may be a catheter arrangement with various embodiments for applying heat to a patient's cells in vivo in order to improve transfection efficiency or application efficiency. Laser beams may be applied directly to the cells. Alternately, the cells may be heated by electrical heating, chemical heating, radio frequency heating, microwave heating, infrared heating, ultrasound heating, or indirect laser heating. Further, the treatment agent may be heated prior to its application to the patient such that the treatment agent heats the cells of the patient.

Abstract: A catheter uses a steerable outer catheter with an inner catheter rotatable and extendable with respect to the outer catheter. The outer catheter may be positioned within a patient's heart and a portion of the outer catheter may provide movement like that of a windshield wiper by manipulation of a spring. By combining the windshield wiper type movement with the extension and rotation of the inner catheter relative to the outer catheter, a large area within a patient's heart may be readily mapped for conduction tissue and be subjected to laser ablation if appropriate. Various configurations provide flexibility in relatively positioning of windows used to apply laser energy and ring electrodes used to sense conduction tissue.

Abstract: A catheter uses a steerable outer catheter with an inner catheter rotatable and extendable with respect to the outer catheter. The outer catheter may be positioned within a patient's heart and a portion of the outer catheter may provide movement like that of a windshield wiper by manipulation of a spring. By combining the windshield wiper type movement with the extension and rotation of the inner catheter relative to the outer catheter, a large area within a patient's heart may be readily mapped for conduction tissue and be subjected to laser ablation if appropriate. Various configurations provide flexibility in relatively positioning of windows used to apply laser energy and ring electrodes used to sense conduction tissue.

Abstract: A catheter arrangement and associated method provides for the application of a cell treatment agent, such as genetic material or drugs to be inserted within the cells of a patient in vivo. The catheter arrangement uses an optical fiber having a prism at its tip. Laser energy from the optical fiber is directed by the prism through a window portion on a side of the catheter. The window portion has a plurality of holes so as to divide the laser energy into a plurality of microbeams. The microbeams potate cell walls of the patient's cells. A treatment agent channel in the catheter allows the treatment agent to be provided directly to the same holes through which the microbeams pass such that the treatment agent is very efficiently applied to the porations in the cell walls.

Abstract: A catheter arrangement and associated method provides for the application of a cell treatment agent, such as genetic material or drugs to be inserted within the cells of a patient in vivo. The catheter arrangement uses an optical fiber having a prism at its tip. Laser energy from the optical fiber is directed by the prism through a window portion on a side of the catheter. The window portion has a plurality of holes so as to divide the laser energy into a plurality of microbeams. The microbeams porate cell walls of the patient's cells. A treatment agent channel in the catheter allows the treatment agent to be provided directly to the same holes through which the microbeams pass such that the treatment agent is very efficiently applied to the porations in the cell walls.

Abstract: An apparatus for performing ablation upon a patient using laser energy. The apparatus advantageously provides for a laser beam to directly strike the tissue of a patient by having the laser beam pass out an opening in an outer hood. To prevent the apparatus from becoming fouled by burnt red blood cells or other materials, flushing solution is fed under pressure into the interior of the outer hood so as to flow out through the opening. The outer hood may include a plurality of openings and the apparatus may emit more than one laser beam, each laser beam going through a corresponding opening and having the flushing solution provided through the same opening such that the flushing is advantageously provided directly at the location where it is needed. Additionally, an auxiliary opening may be provided without any corresponding laser beam, the auxiliary opening allowing flushing solution to exit therfrom so as to stabilize the positioning of the apparatus within the vessel or other part of the patient.

Abstract: Cardiac conditions such as blockages in arteries caused by plaque build-up are treated intravascularly with laser radiation using an optical fiber having a heat conducting end cap on its distal end. A spherical lens within the end cap focuses a small portion of the laser energy directly into the plaque which is in contact with the tip of the end cap and disperses the remaining energy into the end cap for heating it up. The direct laser energy vaporizes part of the plaque so that the end cap can be easily forced through the blockage, and the tissue in contact with the heated end cap is burned away. A diffuser catheter for the ablation of electrical conduction tissue in the heart employs spaced electrodes for detecting the presence of the conduction tissue, and directs laser energy outwardly through the side of the catheter for vaporizing the tissue.

Abstract: An angioscopic system includes image processing so as to determine the dimensions of an unknown dimensional feature within the field of view of the angioscope. The system is calibrated by placing a series of known images at known separation distances from the tip of the angioscope and measuring the size of the image which is produced upon a video monitor. This provides a series of data indicating the relationship between the actual size of the feature, the apparent size in pixels on the image, and the known separation distance from the tip of the scope to the feature plane in which the dimensional feature is disposed. Collection of this data allows one to generate, by curve fitting techniques, a functional relationship such that the size of an unknown dimensional feature may be determined when the angioscope is used upon an actual patient.

Abstract: Cardiac conditions such as blockages in arteries caused by plaque build-up are treated intravascularly with laser radiation using an optical fiber having a heat conducting end cap on its distal end. A spherical lens within the end cap focuses a small portion of the laser energy directly into the plaque which is in contact with the tip of the end cap and disperses the remaining energy into the end cap for heating it up. The direct laser energy vaporizes part of the plaque so that the end cap can be easily forced through the blockage, and the tissue in contact with the heated end cap is burned away. A diffuser catheter for the ablation of electrical conduction tissue in the heart employs spaced electrodes for detecting the presence of the conduction tissue, and directs laser energy outwardly through the side of the catheter for vaporizing the tissue.