Abstract: Laser catheter systems include catheters, mandrels, guidewires, and fiber optics configured to reduce or remove occlusions in a lumen or vessel of a patient. Rotation or translation of a mandrel, a guidewire, or a catheter can induce relative rotational or translational movement between the mandrel or guidewire and the catheter body, and can cause the distal end of the catheter body to rotate or traverse off of a central axis, such as a central longitudinal axis of a proximal or unbent portion of the catheter body, so as to cause ablation energy from the optical fibers to move in an arc or path.

Abstract: Systems and methods for separating an object such as a pacing lead from a patient tissue involve a flexible and torqueable shaft having an internal lumen sized to receive the object, and a hard separating mechanism for separating the object from the tissue. Typically the shaft and separating mechanism are advanced along or toward the object, and the separating mechanism is contacted with the tissue. The shaft is rotated to effect separation between the object and the tissue. The systems and methods are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Abstract: Methods of advancing a laser catheter across an occlusion are described. They may include the steps of advancing a guidewire through a first proximal lumen and a distal lumen of the catheter into a first region of the occlusion, retracting the guidewire from the distal lumen, and advancing a diagnostic device from a second proximal lumen of the catheter to examine the occlusion. The methods may also include retracting the diagnostic device from the distal lumen and advancing the guidewire through the distal lumen. The laser catheter may be activated to create a lumen through the occlusion.

Abstract: A method for detaching an object from a patient includes providing a tool having a sheath, and a separating assembly operably coupled to a distal end of the sheath. The separating assembly includes a separator moveably coupled to a tip via a threadable connection. The separating assembly is placed near patient tissue that is attached to the object, the sheath is rotated to move the separator distal to the tip, and the separator is applied to the patient tissue that is attached to the object, so as to separate the tissue. A separating system includes a sheath, and a separator threadably coupled with a distal end of the sheath. The separator is adapted to switch between a first configuration where a separating means is deployed, and a second configuration where the separating means is undeployed.

Abstract: Embodiments of the present invention comprise a fiber optic guidewire having a hypotube with a plurality of openings that provide variable stiffness and tracking characteristics between at least one proximal segment and one distal segment of the guidewire. In some embodiments, the guidewire further comprises a mandrel disposed within the hypotube, the mandrel cooperating with the optical fibers to permit the distal end of the hypotube to be shaped as desired by a user. Methods of manufacturing and using the guidewire are also disclosed.

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 lead locking device has a lead insertion member having a proximal end and a distal end and has a lead engaging assembly. The lead insertion member defines a lumen extending along a longitudinal axis between the distal end and the proximal end of the lead engaging assembly. A mandrel disposed in the lumen of the lead engaging assembly extends along substantially the entire length of the lumen and protrudes beyond the most proximal end of the lead insertion member. The mandrel includes a distal portion in slidable contact with at least a portion of the lead engaging assembly. The lead engaging assembly has a first configuration while being inserted into a lumen of a lead and a second configuration while engaging the lead from within the lumen of the lead. The lead engaging member has at least two expansion jaws that, in the first configuration, define a substantially cylindrical body.

Abstract: A lead locking device has a lead insertion member having a proximal end and a distal end and has a lead engaging assembly. The lead insertion member defines a lumen extending along a longitudinal axis between the distal end and the proximal end of the lead engaging assembly. A mandrel disposed in the lumen of the lead engaging assembly extends along substantially the entire length of the lumen and protrudes beyond the most proximal end of the lead insertion member. The mandrel includes a distal portion in slidable contact with at least a portion of the lead engaging assembly. The lead engaging assembly has a first configuration while being inserted into a lumen of a lead and a second configuration while engaging the lead from within the lumen of the lead. The lead engaging member has at least two expansion jaws that, in the first configuration, define a substantially cylindrical body.

Abstract: A lead locking device has a lead insertion member having a proximal end and a distal end and has a lead engaging assembly. The lead insertion member defines a lumen extending along a longitudinal axis between the distal end and the proximal end of the lead engaging assembly. A mandrel disposed in the lumen of the lead engaging assembly extends along substantially the entire length of the lumen and protrudes beyond the most proximal end of the lead insertion member. The mandrel includes a distal portion in slidable contact with at least a portion of the lead engaging assembly. The lead engaging assembly has a first configuration while being inserted into a lumen of a lead and a second configuration while engaging the lead from within the lumen of the lead. The lead engaging member has at least two expansion jaws that, in the first configuration, define a substantially cylindrical body.

Abstract: A lead locking device has a lead engaging member with a mandrel extending along a lumen and attached to the distal end of the lead engaging member such that it extends beyond the proximal end of the lead engaging member. The lead locking device also has a loop handle attached to the proximal end of the mandrel. The lead engaging member has a first configuration which is narrower than a second configuration and is sufficiently long to extend along substantially the entire length of a lead to be removed from a patient's body. Methods of removing a lead from a patient's body include attaching a lead locking device along substantially the entire length of the lead and applying traction to the proximal end of the lead locking device.

Abstract: A lead locking device has a lead engaging member with a mandrel extending along a lumen and attached to the distal end of the lead engaging member such that it extends beyond the proximal end of the lead engaging member. The lead locking device also has a loop handle attached to the proximal end of the mandrel. The lead engaging member has a first configuration which is narrower than a second configuration and is sufficiently long to extend along substantially the entire length of a lead to be removed from a patient's body. Methods of removing a lead from a patient's body include attaching a lead locking device along substantially the entire length of the lead and applying traction to the proximal end of the lead locking device.

Abstract: A phototherapy device has a phototherapy handpiece, an optical fiber attached to the phototherapy handpiece, and a laser phototherapy light source. The phototherapy handpiece, has a handpiece body that defines an interior region and has an outer surface which defines a foot of the phototherapy handpiece, an optical fiber drive assembly disposed at least partially within the interior region of the handpiece body has an optical fiber attachment portion that is movable relative to the handpiece body. The optical fiber drive assembly includes a driving component which causes the attachment portion to move relative to the handpiece body, and a damping component which resists the motion of the optical fiber attachment portion such that the optical fiber attachment portion attains a substantially constant speed motion relative to the handpiece body.

Abstract: A catheter for delivering electrical energy to a selectable region of a patient's body has at least one layer of fibers with at least one electrically conductive fiber stranded over a flexible core. Each layer of fibers is stranded over the flexible core and underlying layers opposite in direction from that of the immediately preceding layer so as to provide a catheter with good torque transfer properties in addition to its electrical energy transfer properties. The outermost layer of stranded fibers is electrically conductive and is covered by an electrically insulative outer layer which is mechanically strippable to expose selectable regions of the underlying layer of stranded fibers. Electrical energy is transmitted along the outermost layer of stranded fibers to tissue which is in contact with the exposed contact region of the outermost layer of stranded fibers. The catheter can also deliver electrical energy through a cutting tip for multipolar electro-cautery.

Abstract: A catheter for delivering electrical energy to a selectable region of a patient's body has at least one layer of fibers with at least one electrically conductive fiber stranded over a flexible core. Each layer of fibers is stranded over the flexible core and underlying layers opposite in direction from that of the immediately preceding layer so as to provide a catheter with good torque transfer properties in addition to its electrical energy transfer properties. The outermost layer of stranded fibers is electrically conductive and is covered by an electrically insulative outer layer which is mechanically strippable to expose selectable regions of the underlying layer of stranded fibers. Electrical energy is transmitted along the outermost layer of stranded fibers to tissue which is in contact with the exposed contact region of the outermost layer of stranded fibers.

Abstract: A guide wire for a catheter has a tubular portion with a flexible body fixed to its distal end. The distal end of the body may be composed of a radiopaque material. Optical fibers are disposed within the assembly and terminate in a radiopaque tip at the distal end of the body. The guide wire may have a longitudinal marker wire or mandrel for providing stiffness and radioscopic tracking characteristics, as well as providing torsional control and tip shaping capabilities. The guide wire has a proximal end attached to the tube and a distal end that also terminates in the tip. The wire may be maneuvered in a vascular area like a conventional guide wire and may be used in conjunction with a support catheter to increase its maneuverability. Then, laser energy is conveyed to the vascular area by the optical fibers to ablate an obstruction. The proximal end of the guide wire is then removed and a larger catheter may then be slid over the guide wire to continue the ablation operation.

Abstract: A guide wire for a catheter has a tubular portion with a flexible body fixed to its distal end. The distal end of the body may be composed of a radiopaque material. Optical fibers are disposed within the assembly and terminate in a radiopaque tip at the distal end of the body. The guide wire may have a longitudinal marker wire or mandrel for providing stiffness and radioscopic tracking characteristics, as well as providing torsional control and tip shaping capabilities. The guide wire has a proximal end attached to the tube and a distal end that also terminates in the tip. The wire may be maneuvered in a vascular area like a conventional guide wire and may be used in conjunction with a support catheter to increase its maneuverability. Then, laser energy is conveyed to the vascular area by the optical fibers to ablate an obstruction. The proximal end of the guide wire is then removed and a larger catheter may then be slid over the guide wire to continue the ablation operation.

Abstract: An apparatus for ablating biological tissue having a deflectable ablation area including an elongated catheter having a distal end, a proximal end, and an elongated body portion. A plurality of optical fibers extend between the proximal and distal ends of the catheter. The distal ends of all of the plurality of optical fibers define an ablation area at the distal end of the catheter. The catheter includes a device for selectively deflecting the distal ends of all of the optical fibers so that at least a portion of the ablation area extends beyond an area defined by the cross-sectional area of the catheter while the amount of light energy over the entire ablation area remains constant.

Abstract: A fiber optic catheter has a short guide wire lumen (less than 10 cm) extending in a proximal direction from its distal end and an intermediate portion reinforced with a tapered mandrel which provides optimal steerability and trackability characteristics. The distal end of the mandrel is coextensive with a proximal portion of the guide wire lumen. The intermediate portion of the catheter may have a marker for visual identification, and the tip of the catheter may include a radiopaque tip marker band for fluoroscopic identification. The short guide wire lumen catheter provides superior flexibility, a low profile, and low-friction engagement with the guide wire.

Abstract: A preionization assembly is adapted for use with a laser including a laser vessel, a high voltage electrode and a ground electrode defining a discharge region extending longitudinally within the vessel. A plurality of pin assemblies are arranged in at least one line which extends longitudinally through the vessel along the discharge region. These pin assemblies are generally equally spaced along the line, each including an anode pin and a cathode pin oriented relative to each other so that a spark passing therebetween arcs in a direction which is longitudinal of the vessel along the discharge region. The pin assemblies may be oriented in two parallel lines disposed in equally spaced relationship to the discharge region.

Abstract: A catheter having an outer wall of tubular shape, a cylindrical marker attached to the distal end of the catheter. The marker band includes markings for identifying the axial, rotational and yaw position of the catheter distal end when it is located in a body and viewed fluoroscopically.