Abstract: A diffusion tip coupled to the end of an optical fiber for directing laser energy outwardly in a cylindrical or other desired radiation pattern. The diffusion tip includes a core, a cladding around the core and a jacket around the cladding. The cladding has an index of refraction that is lower than that of the core and has a thickness selected to transmit a portion of the laser radiation that is carried through the optical fiber so that laser radiation penetrates through the cladding and the jacket over the length of the diffusion tip. The thickness of the cladding is about the same as or slightly less than the penetration depth of the evanescent field in the cladding. The cladding can be tapered along the length of the diffusion tip to provide a uniform radiation pattern. The diffusion tip is particularly useful in a laser balloon catheter utilized in coronary angioplasty.

Abstract: A movable core guidewire for use in guiding a catheter to an internal body location includes an elongate, flexible helical coil having a lumen extending longitudinally therethrough for receiving a movable core wire. The movable core wire has a flexible polymeric element extending from the distal end which facilitates smooth movement of the movable core wire within the lumen of the helical coil. The use of this polymeric element provides a movable core guidewire that has a better feel for the physician when the movable core is slid longitudinally through the lumen of the helical coil and by reducing the force necessary to push or pull the core wire through the lumen of the helical coil and also reduces the risk of the core wire striking through the helical coil.

Abstract: A small diameter balloon dilatation catheter having a shaft formed from hypodermic tubing is provided with a detachable luer fitting on its proximal end. The luer fitting may be removed and an extension wire attached to the proximal end of the catheter. A larger diameter catheter then may be advanced over the smaller catheter utilizing the smaller catheter to guide the larger catheter to the stenosis being treated. In another aspect of the invention, a guiding sheath assembly is provided which permits catheter exchanges involving such small diameter catheters having integral guidewires. In one protocol such a catheter may be exchanged for a conventional balloon dilatation catheter with a movable guidewire by removing the dilatation catheter, advancing the sheath over the guidewire, then removing the guidewire and inserting the replacement catheter.

Abstract: Disclosed is an apparatus for occluding resilient tubing which effectively and conveniently occludes tubing without damage to the tubing, even after repeated clamping. Included in embodiments of the invention are a clamping structure and a protective sleeve formed from a resilient material which is interposed between the tubing to be occluded and the clamp. Also included are structures to prevent the application of the clamp immediately adjacent to the ends of the tubing. Moreover, the clamp can be applied at any one of a plurality of positions along the tube so that no one location along the length of the tube is subject to excessive fatigue. The protective sleeve and the clamp are joined together such that the clamp cannot be applied to the tube without the protective sleeve interposed therebetween. The embodiments of the present invention prevent damage to tubing, such as fragile silicone rubber tubing used in medical applications, even when subjected to repeated clampings.

Abstract: A guide wire system for use in catheter exchanges avoids the need for a separate exchange wire. Instead of the conventional practice in which the initial guide wire is removed and replaced with a longer exchange wire, a guide wire extension is attached to the proximal end of the initial guide wire thereby increasing its effective length so that it may be used to perform a catheter exchange. The initial guide wire remains in place in the patient's vasculature. The proximal end of the guide wire and the distal end of the exchange wire are formed to define a connection which may be crimped to effect the connection between the two wires. A crimping tool is provided to hold the mating ends of the guide wire and extension wire together while effecting the crimp.

Abstract: A method for providing a medical apparatus with a protective, lubricious coating is described. The method comprises providing a coating solution which contains a protective compound such as a urethane, a slip additive such as a siloxane, and optionally, a crosslinking agent for the protective compound such as a polyfunctional aziridine, coating the solution onto a surface of a medical apparatus and allowing the coating to set. The resulting surface coating is lubricious, tough and flexible. The coating is well suited for use with materials used as components of balloon catheters.

Abstract: A dilatation catheter having an inflatable member and a method of using same to restore patency to an obstructed portion of the lacrimal system. The catheter is inserted into the lacrimal system and its inflatable member is positioned in the obstructed portion. The inflatable member is inflated to dilate the obstructed portion to restore patency to the lacrimal system. Preferably, the catheter includes one or more visually perceivable markers having a known spaced relationship to one of the ends of the inflatable member. Positioning of the inflatable member is assisted by aligning the marker relative to an opening into the lacrimal system.

Abstract: A hot tip device, typically used for melting and plowing through stenotic deposits in a coronary artery, is provided with optical diagnostic capabilities. The device includes an elongated, flexible member, a filter glass heating element attached to the distal end of the flexible member and an optical fiber extending through the flexible member and optically coupled to the heating element. The filter glass heating element absorbs a first range of wavelengths for heating and passes a second range of wavelengths for irradiating the artery through the filter glass heating element. In a preferred embodiment, the flexible member is a steerable guidewire, and the filter glass heating element is heated by infrared radiation. Ultraviolet or visible radiation is used to stimulate fluorescence from deposits in the artery.

Abstract: A grasping forceps including a handle and an elongate cable with resiliently outwardly flared claws at the leading end thereof. The cable is of a fixed length relative to the handle. A closure sleeve surrounds the cable and is selectively manipulated from the handle, for movement to an extended position, relative to the handle, wherein the forward portion of the closure sleeve envelops and inwardly collapses all but the leading end portions of the claws. The closure sleeve in the retracted position, allowing for an outward springing of the claws into grasping position. The closure sleeve is surrounded by a sheath selectively extensible and relative to the handle and moveable to an extended position fully enclosing the closure sleeve and collapsed claws, the sheath projecting slightly forward thereof whereby the claw tips are recessed relative to the forward end of the sheath and are completely protectively enclosed thereby.

Abstract: A catheter and guidewire exchange system in which the guideware is contained within a guidewire leumen in the indwelling portion of the catheter and with the guidewire and catheter being separated externally of the patient. The catheter includes a guidewire lumen which is slit longitudinally along the length of the catheter. The guide member is carried by the catheter and serves to spread the slit of the lumen to guide the guidewire into or out of the slit guidewire lumen. The guide member may be advanced along the catheter and guidewire in zipper-like fashion so that the proximal ends of the guidewire and catheter will be separated while the distal portions will be merged.

Abstract: A blood reservoir having a rigid shell portion defining a cavity and a flexible membrane attached with a liquid tight seal to the shell portion around the periphery of the shell. The assembled reservoir forming a liquid tight and variable volume with blood inlet and outlet ports integrally formed in the rigid shell portion. The shell portion further including a rib member laterally extending across the bottom of the rigid shell. The rib member is positioned adjacent the blood outlet port to force the flexible membrane to bridge the blood outlet port to further facilitate drainage from the reservoir.

Abstract: A small diameter steerable guidewire that is used to guide a catheter in transluminal coronary angioplasty is provided with a pair of electrodes for measuring the cross-sectional area of a blood vessel and for measuring blood flow. The guidewire includes a shaft and a tip attached to the distal end of the shaft. The shaft is torsionally rigid along its length and includes a conductive tube and a wire extending through the tube. The tip, which can be bent to a prescribed curve when relaxed, is sufficiently flexible to adapt to and follow the contours of a blood vessel. The tip includes a tapered extension of the wire in the shaft. A proximal electrode and a distal electrode are coaxially mounted on the tapered wire and are electrically connected to the tube and the wire, respectively. The electrodes are axially spaced apart by a predetermined distance. Each electrode is preferably a conductive, helically-wound spring. The outside diameter of the steerable guidewire preferably does not exceed about 0.

Abstract: A urethral stent is disclosed for the nonsurgical management of bladder outlet obstruction caused by an enlarged prostate. The stent is sufficiently rigid to provide support to assure patency of an intact but contracted urethral lumen but is sufficiently flexible to accommodate the natural anatomical bend of the prostatic urethra. The stent further includes means for frictionally engaging the urethral walls to anchor the device within the prostatic urethra and to prevent migration back into the bladder or down the urethra. When the need arises, the stent is easily and nonsurgically removed from the prostatic urethra.

Abstract: A procedure for targeting body cavity stones for shockwave treatment including positioning a target-defining catheter mounted balloon adjacent a stone, inflating the balloon with air, focusing a shockwave generator by ultrasound on the target balloon and area immediately adjacent thereto, and deflating the target balloon.

Abstract: The present invention briefly refers to a driving unit for a device for tissue-sampling. The device comprises in addition to the driving unit a needle unit comprising a hollow outer needle and slidably disposed therein an inner needle, the driving unit being used to propel the needles. The driving unit comprises a driving device device for each mechanism adapted to be pre-tensioned. The driving unit in addition comprises an inner guide sleeve containing two successive needle holders adapted to be shifted in relation to each other in the longitudinal direction of the sleeve and adapted to be pretensioned in the same direction for propelling the needles with the aid of one spring each and which are provided with releasable locking means. A manual triggering device is provided for releasing the one needle holder which in turn is adapted during the final phase of its propulsion to release the other needle holder.

Abstract: Laser energy produced by a laser operating in the mid-infrared region (approximately 2 micrometers) is delivered by an optical fiber in a catheter to a surgical site for biological tissue removal and repair. Disclosed laser sources which have an output wavelength in this region include: Holmium-doped Yttrium Aluminum Garnet (Ho:YAG), Holmium-doped Yttrium Lithium Fluoride (Ho:YLF), Erbium-doped YAG, Erbium-doped YLF and Thulium-doped YAG. For tissue removal, the lasers are operated with relatively long pulses at energy levels of approximately 1 joule per pulse. For tissue repair, the lasers are operated in a continuous wave mode at low power. Laser output energy is applied to a silica-based optical fiber which has been specially purified to reduce the hydroxyl-ion concentration to a low level. The catheter may be comprised of a single optical fiber or a plurality of optical fibers arranged to give overlapping output patterns for large area coverage.

Abstract: A balloon dilation catheter having a biaxially oriented, flexible, polymeric balloon having a wall thickness to diameter ratio of less than 5.0.times.10.sup.-3 and a radial tensile strength greater than 35.000 psi.

Abstract: The present invention briefly refers to a driving unit (1) for a device for tissue-sampling. The device comprises in addition to the driving unit a needle unit comprising a hollow outer needle (7a) and slidably disposed therein an inner needle (7b), the driving unit (1) being used to propel the needles (7a, 7b). The driving unit comprises a driving device for each needle and each driving device in turn comprises a spring mechanism adapted to be pre-tensioned. The driving unit in addition comprises an inner guide sleeve (3) containing two successive needle holders (4a, 4b) adapted to be shifted in relation to each other in the longitudinal direction of the sleeve and adapted to be pre-tensioned in the same direction for propelling the needles (7a, 7b) with the aid of one spring (5a, 5b) each and which are provided with releasable locking means (33a, 33b).

Abstract: A device for tissue sampling by thick needle punctuation including a needle assembly including a hollow first needle and second needle extending through the hollow first needle. The needle assembly is contained in a housing having an opening through which the needles extend. Compressed springs in the housing are caused to expand to urge the needles away from the housing during the sampling of tissue. A rod is provided extending from the housing to simultaneously place the springs in a compressed condition.

Abstract: A device for tissue sampling by thick needle punctuation including a needle assembly including a hollow first needle and second needle extending through the hollow first needle. The needle assembly is contained in a housing having an opening through which the needles extend. Compressed springs in the housing are caused to expand to urge the needles away from the housing during the sampling of tissue. A rod is provided extending from the housing to simultaneously place the springs in a compressed condition.