Abstract: The present disclosure relates to a system and method for providing laser energy through a catheter towards a second end portion of the catheter. Based on a characteristic of the laser energy multiple types of ablation therapy may be implemented. A first ablation therapy is directed at the target site when the laser energy at the second end portion of the laser energy delivery system has a first characteristic. A second ablation therapy is directed at the target site when the laser energy at the second end portion of the laser energy delivery system has a second characteristic. The first ablation therapy may be an optical ablation therapy wherein the laser energy is directed at the target site as optical energy and the second ablation therapy may be a pressure wave ablation therapy wherein pressure waves are directed at the target site as pressure wave energy.

Abstract: Devices, methods and systems for removing unwanted tissue from within a patient's vasculature system are provided. Specifically, a laser ablation catheter having a tip with an open, arched-shaped cross section is described. The cross section of the tip enhances the catheter's ability to ablate, separate, and/or dilate the various layers within a patient's vasculature, thereby facilitating the removal undesirable lesions and fibrous tissue within a patient's vasculature.

Abstract: Methods and devices for separating an implanted object, such as a pacemaker lead, from tissue surrounding such object in a patient's vasculature system. Specifically, the surgical device includes a handle, an elongate sheath and a circular cutting blade that extends from the distal end of the sheath upon actuating the handle. The circular cutting blade is configured to engage the tissue surrounding an implanted lead and cut such tissue in a coring fashion as the surgical device translates along the length of the lead, thereby allowing the lead, as well as any tissue remaining attached to the lead, to enter the device's elongate shaft. The surgical device has a barrel cam cylinder in the handle assembly that imparts rotation of the blade and a separate cam mechanism in the tip of outer sheath assembly that imparts and controls the extension and retraction of the blade.

Abstract: Devices for removing implanted objects from body vessels are provided. A device includes a sheath assembly having a cutting tip. The cutting tip includes a cutting surface that is adapted to cut tissue coupled to an implanted object as the cutting tip rotates. The sheath assembly further includes an outer shield carried outside of the cutting tip. The outer shield includes a distal opening, and the outer shield is translatable relative to the cutting tip from a first position to a second position and vice versa. In the first position the cutting surface of the cutting tip is disposed within the outer shield, and in the second position the cutting tip extends through the distal opening and the cutting surface is at least partially disposed outside of the outer shield.

Abstract: A device for removing an implanted object from a body vessel includes an actuator having an elongated sheath extending therefrom, the elongated sheath including a proximal portion and a distal portion. A tubular outer member has a proximal end attached to the distal portion of the elongated sheath, with a ramped surface at a distal end of the tubular outer member which constricts a diameter of a bore formed in the tubular outer member. A tubular inner member is located within the tubular outer member, the tubular inner member including a proximal end operably connected to the actuator and a distal end opposite the proximal end, the distal end of the tubular inner member including a plurality of resiliently flexible blades positioned to interact with the ramped surface of the tubular outer member such that the ramped surface is operable to deflect the resiliently flexible blades radially inwardly as the tubular inner member is advanced distally within the tubular outer member.

Abstract: Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting apparatus is configured to engage formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting apparatus is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting apparatus causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The slitting apparatus is supported by a distal end support device configured to lock onto the lead. While supported, a slitting element of the apparatus places fibers of the formed tissue under tension and performs a lifting cut operation. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Abstract: Catheter devices for ablation and removal of occlusions from blood vessels and methods of using the same are provided. Catheter devices are useful to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Distal features of the catheter devices comprise arrangements of laser ablative or mechanical cutting features that generally provide enhanced surface areas and cutting functions. Spiral or helical arrangements are provided to aid in cutting operations.

Abstract: A system includes a laser catheter and a rotating optical member to receive a laser beam along an optical path and rotate to a selected position to redirect the laser beam from the optical path onto one or more selected optical fibers of a laser catheter, wherein a distal end of the laser catheter irradiates an endovascular structure.

Abstract: Catheters for ablation and removal of occlusions from blood vessels are provided. Laser cutting systems and mechanical cutting systems are provided in catheter devices, the cutting systems operable to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. A helical or partially-helical inner surface structure is provided in the catheter, the structure operable to remove or translate dislodged material(s).

Abstract: A system and devices for ablation and removal of occlusions from blood vessels is provided. Laser cutting systems and mechanical cutting systems are provided in catheter devices, the cutting systems operable to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Catheter systems comprise distal end features adapted to cut and remove at least portions of an occlusion that generally correspond to dimensions of an inner lumen of a catheter.

Abstract: Methods and devices for separating an implanted object, such as a pacemaker lead, from tissue surrounding such object in a patient's vasculature system. Specifically, the tissue separating device includes a handle, an elongate sheath and a circular cutting blade that may extend from the distal end of the sheath upon actuating the handle. The circular cutting blade is configured to engage the tissue surrounding an implanted lead and cut such tissue in a coring fashion as the device translates along the length of the lead, thereby allowing the lead, as well as any tissue remaining attached to the lead, to enter the device's elongate shaft. The tissue separating device includes a cam mechanism at the distal portion of the sheath that allows the user of the device to more accurately control the extension and rotation of the cutting blade upon being actuated by the handle.

Abstract: A system can include a microprocessor executable controller configured, based on one or more of total fiber active area of a laser catheter, imaging information regarding the target and/or non-target endovascular structure(s), target endovascular structure characterization information, current location and/or orientation of a distal tip of the laser catheter, and area of contact of the distal tip with the target and/or non-target endovascular structure to select at least one of a fiber active area for each optical channel, a number of optical channels, a configuration of fibers in an optical channel, an optical channel to be irradiated, and an ordering of optical channel irradiation.

Abstract: A system is provided to determine whether an insulating layer of an implanted lead is damaged.

Abstract: A dilation balloon is wrapped in one or more patterns with a wire or braided material having diamond abrasive or other abrasive material bonded thereto. The wire or braided material is vibrated in one or more ways to enhance the cutting action of the wire abrasive. The wire abrasive may be vibrated using high, low, or even ultrasonic waves transmitted to the wire abrasive via local or remote methods. Alternatively, the dilation balloon may be dilated with a contrast media that exhibits a high absorption to laser light. The contrast material is lased with a laser fiber or fibers inserted into the balloon interior, creating a substantial shockwave that vibrates the balloon and assists in the cracking or abrading of the surrounding plaque in contact with the dilation balloon. The cutting balloon may employ the abrasive coated wires described above or cutting blades.

Abstract: A system for ablation and removal of occlusions from blood vessels is provided. Laser cutting systems and mechanical cutting systems are provided in catheter devices, the cutting systems operable to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Pulsed aspiration systems are further provided, the pulsed aspiration systems operable to remove ablated, cut, or dislodged material without excessive or unnecessary removal of blood and fluid.

Abstract: A coupler for interfacing a light source, such as a laser, and a fiber optic cable is disclosed. The coupler includes a slide mount having a channel that is adapted to receive optical fibers. The channel extends from a proximal end of the slide mount to a distal end of the slide mount. The proximal end of the slide mount is adapted to fit into an aperture of the light source and the distal end of the slide mount is adapted to transmit light to the fiber optic cable. The coupler also includes a clamp that is mounted on the slide mount adjacent to its proximal end. The clamp covers at least a portion of the channel, thereby securing the optical fibers within the channel without the use of an adhesive.

Abstract: A coupler for interfacing a light source, such as a laser, and a fiber optic cable is disclosed. The coupler includes a slide mount having a channel that is adapted to receive optical fibers. The channel extends from a proximal end of the slide mount to a distal end of the slide mount. The proximal end of the slide mount is adapted to fit into an aperture of the light source and the distal end of the slide mount is adapted to transmit light to the fiber optic cable. The coupler also includes a clamp that is mounted on the slide mount adjacent to its proximal end. The clamp covers at least a portion of the channel, thereby securing the optical fibers within the channel without the use of an adhesive.

Abstract: A surgical cutting instrument for removing objects, such as a pacemaker lead or catheter, embedded in biological tissue. The cutting instrument includes a rigid proximal end and a flexible distal end, the flexible distal end having circular opening and a cutting blade disposed longitudinally therein. A control handle connected to the rigid proximal end and extending radially therefrom provides a force applied to an inner member which extends the cutting blade beyond the circular opening and simultaneously rotates the cutting blade to cut tissue exposed to the blade.

Abstract: A method and apparatus for relatively moving energy across an array of optical fibers. The energy may be scanned across the fiber array. A dielectric mirror mounted on a galvanometer scanner is moved so as to cause successive pulses to irradiate different segments of the fiber optic array. As a result, each fiber receives radiation having sufficient fluence while reducing the energy per pulse (or the cw equivalent). Rather, than move the energy across the fiber array, the fiber array itself may be moved. One possible manner of movement is use of a piezo electric stack.

Abstract: The present invention is a turn limiter for a catheter with a twistable tip. The catheter having a flexible wall for use in complex twisting anatomy contains a torque wire or a torquable guide wire lumen. The torque wire or torquable guide wire lumen extends through the length of the catheter and is attached to the catheter at or near the distal end thereof. The proximal end of the torque wire protrudes from the proximal end of the catheter and is attached to a turn limiter. Rotation of the turn limiter imparts a torque to the torque wire or torquable guide wire lumen. The turn limiter allows limited rotation of the proximal end of the torque wire or torquable guide wire lumen without axial dislocation. The turn limiter may have a feature for indicating the amount of torque applied to the torque element.