Abstract: Methods and systems are disclosed for detecting overheating in an optical device before harmful consequences, such as severe local heating, can result. In one embodiment of the invention, a blackbody emitter is disposed in close proximity to a therapeutic optical fiber to absorb therapeutic radiation at a fault and re-emit blackbody (infrared) radiation. The emitter can be coupled to the fiber but, during normal operation, lies outside the optical path between the output of the laser radiation and the site of treatment. Systems and catheters incorporating such emitters are also described for effective monitoring of the laser power transmitted along the optical fiber within the phototherapy device.

Abstract: The present invention is directed to an anchoring balloon structure for use with catheters. The anchoring balloon structure contains an expandable balloon disposed about a port on a catheter, and a pressure-relief valve for regulating the pressure in the balloon and for providing irrigation to a body lumen. The pressure-relief valve is located external to the expandable balloon. The balloon, when filled with fluid, expands and is engaged in direct contact with the tissue. The increase in pressure caused by the balloon against the tissue causes any additional fluid to migrate into the valve region, whereby excess pressure is released and irrigation is provided to the body lumen.

Abstract: Malleable surgical ablation instruments are disclosed for creating lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. The hand held instruments are especially useful in open chest or port access cardiac surgery for rapid and efficient creation of curvilinear lesions to serve as conduction blocks. The malleable instruments disclosed are well adapted for use in or around the intricate structures of the heart. In one example, the distal end of the instrument can have a malleable shape or be in the shape of an open loop so as to allow the loop to be placed around at least one a pulmonary vein or artery. Such instruments can incorporate various ablative elements such as ablative radiation, RF heating, cryogenic cooling, ultrasound, microwave, ablative fluid injection and the like.

Abstract: Surgical ablation instruments are disclosed for creating circumferential lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. These photoablative instruments include an elongate housing and an ablation element disposed within a lumen of the housing. A connecting element associated with the elongate housing brings together the proximal and distal ends of the elongate housing to form a loop, thereby creating an encircling lesion to be formed with the ablation energy.

Abstract: Surgical ablation instruments are disclosed for creating lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. These photoablative instruments include a housing and an ablation element disposed within a lumen of the housing. An irrigation system associated with the instruments enables a cooling fluid to be introduced to the ablation element during delivery of the ablation energy.

Abstract: An apparatus and method are disclosed for ablation of diseased tissue. The method includes introducing a flexible elongate member into a predetermined tissue site with a flexible elongate member having a proximal end, a distal end and a longitudinal first lumen extending therebetween. A slidable conductor is positioned through the lumen proximate to the tissue site and energy is transmitted to the distal end of the elongate member through the conductor. A deflection member fixedly attached to the distal end of the elongate member can be manipulated to cause the distal end of the elongate member to bend. The target tissue is ablated, coagulated or photochemically modulated without damaging surrounding tissue. The apparatus can be energy transparent and include deflection members to manipulate distal portions of the apparatus. Suitable types of energy for ablation include ultrasound and laser energy.

Abstract: An apparatus and method for phototherapy are described in which laser light or other radiation is projected from within a catheter, through a balloon member, and toward the surface of tissue. The light reflected from body fluids or the tissue surface is captured by a collecting device located within the catheter, e.g., within the balloon member, and the intensity of the reflected light is ascertained. The apparatus and method provides for accurately positioning the apparatus against the tissue treatment site.

Abstract: Surgical ablation instruments are disclosed for creating lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. The hand held instruments are especially useful in open chest or port access cardiac surgery for rapid and efficient creation of curvilinear lesions to serve as conduction blocks. Photoablative instruments are disclosed that can achieve rapid and effective photoablation through the use of distributed (e.g., diffuse or defocused) radiant energy.

Abstract: Ablation methods and instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias and the like. Percutaneous ablation instruments in the form of coaxial catheter bodies are disclosed having at least one central lumen therein and having one or more balloon structures at the distal end region of the instrument. The instruments include an energy emitting element which is independently positionable within the lumen of the instrument and adapted to project radiant energy through a transmissive region of a projection balloon to a target tissue site. The instrument can optionally include at least one expandable anchor balloon disposed about, or incorporated into an inner catheter body designed to be slid over a guidewire. This anchor balloon can serve to position the device within a lumen, such as a pulmonary vein.

Abstract: Methods and systems are disclosed for detecting overheating in an optical device before harmful consequences, such as severe local heating, can result. In one embodiment of the invention, a blackbody emitter is disposed in close proximity to a therapeutic optical fiber to absorb therapeutic radiation at a fault and re-emit blackbody (infrared) radiation. The emitter can be coupled to the fiber but, during normal operation, lies outside the optical path between the output of the laser radiation and the site of treatment. Systems and catheters incorporating such emitters are also described for effective monitoring of the laser power transmitted along the optical fiber within the phototherapy device.

Abstract: An apparatus and method for phototherapy are described in which laser light or other radiation is projected from within a catheter, through a balloon member, and toward the surface of tissue. The light reflected from body fluids or the tissue surface is captured by a collecting device located within the catheter, e.g., within the balloon member, and the intensity of the reflected light is ascertained. The apparatus and method provides for accurately positioning the apparatus against the tissue treatment site.

Abstract: The present invention is directed to a balloon catheter having an irrigation sheath. The balloon catheter has a first expandable membrane forming an occluding balloon. A second membrane forms a sheath about the occluding balloon for providing irrigation to a body lumen. Fluid is provided to the occluding balloon to position the catheter and/or occlude the flow of blood. Fluid is then passed through the sheath to irrigate the target site. In one embodiment of the present invention, the sheath has a plurality of fluid releasing pores.

Abstract: Infrared surgical photoablation instruments are disclosed for creating lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. The hand held instruments are especially useful in open chest or port access cardiac surgery for rapid and efficient creation of curvilinear lesions to serve as conduction blocks. Photoablative instruments are disclosed that emit radiation at a wavelength in a range from about 800 nm to about 1000 nm, and preferably emit at a wavelength in a range of about 915 nm to about 980 nm. Radiation at a wavelength of 915 nm or 980 nm is commonly preferred, in some applications, because of the optimal absorption of infrared radiation by cardiac tissue at these wavelengths.

Abstract: Methods and apparatus are disclosed for forming annular lesions in tissue. The methods include introduction of an optical apparatus proximate to a tissue site, via, for example, a catheter. The optical apparatus includes a pattern-forming optical waveguide in communication with a light transmitting optical fiber. Energy is transmitted through the optical fiber, such that radiation is propagated through the optical fiber and the waveguide projects an annular light pattern, e.g., a circle or a halo.

Abstract: The present invention is directed to a hand held cardiac ablation instrument and methods for irradiating a target ablation site. The instrument can include at least one light transmitting optical fiber and a light diffusing element to create a circumferential or curvilinear lesion. A handle is provided for manual application. The handle can be substantially coaxial or otherwise aligned with the center of the circumferential housing. Light travelling through the light transmitting optical fiber or fibers is scattered in a circular pattern by the light diffusing element. The light diffusing element can include a scattering medium, a reflective end cap, and a reflective surface diametrically opposed to the target ablation site, that interact to provide a substantially uniform distribution of laser radiation throughout the circular target region.

Abstract: Surgical ablation instruments are disclosed for creating lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. The hand held instruments are especially useful in open chest or port access cardiac surgery for rapid and efficient creation of curvilinear lesions to serve as conduction blocks. Photoablative instruments are disclosed that can achieve rapid and effective photoablation through the use of distributed (e.g., diffuse or defocused) radiant energy.

Abstract: Infrared surgical photoablation instruments are disclosed for creating lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. The hand held instruments are especially useful in open chest or port access cardiac surgery for rapid and efficient creation of curvilinear lesions to serve as conduction blocks. Photoablative instruments are disclosed that emit radiation at a wavelength in a range from about 800 nm to about 1000 nm, and preferably emit at a wavelength in a range of about 915 nm to about 980 nm. Radiation at a wavelength of 915 nm or 980 nm is commonly preferred, in some applications, because of the optimal absorption of infrared radiation by cardiac tissue at these wavelengths.

Abstract: An optical transmissive, light-diffusing, fiber tip assembly having a radiation-scattering particles incorporated therein and a reflective end surface is disclosed for use in phototherapy. As radiation propagates through the fiber tip, a portion of the radiation is scattered in a cylindrical (or partially cylindrical) pattern along the length of the fiber tip. Radiation which is not scattered during this initial pass through the tip is reflected by at least one surface of the assembly and returned through the tip. During this second pass, the remaining radiation (or at least a major portion of this returning radiation) again encounters the scatterers which provide further radial diffusion of the radiation. Preferably, the scattering medium and the reflective end cap interact to provide a substantially uniform axial distribution of laser radiation over the length of the tip apparatus.

Abstract: Phototherapeutic instruments are disclosed having a light transmitting optical fiber with a flexible portion that facilitates passage of the instrument through a tortuous lumen within a patient and an outer support sheath slidably mounted about the fiber. In one preferred embodiment, the instrument includes a rigid light-emitting tip. The support sheath is configured to protect the more delicate optical fiber and provide support for the flexible portion of the optical fiber during penetration of the light-emitting tip into a patient's tissue. During insertion of the instrument into a tortuous lumen, the optical fiber is covered by the support sheath, allowing the light-emitting tip to deflect with ease as it travels along the tortuous lumen.

Abstract: A method of sterilizing women is provided wherein a flexible hysteroscope (10), having an operating channel (11), a fluid channel (12), and an optical channel terminating at a lens (13), is passed through the cervix C and uterus to a position adjacent the utero-tubal ostium. An elongated laser catheter (15) having a radially diffusing tip (16) and coupled to a laser generator is extended from the operating channel and through the utero-tubal ostium to a position within the fallopian tube. The laser generator is then energized so as to generate energy sufficient to cause the production of oxygen free radicals which cause necrosis and ultimate fibroses of the fallopian tube.