Abstract: Improved laser energy delivery devices, providing greater transmission efficiency, longevity of use and safety are described. In one embodiment, a device for delivering laser energy includes a conventional optical fiber within a metal or plastic cannula provided with a laser energy emission window. A reflective material is disposed in a space between the distal end portion of a metal or plastic sheath and the optical fiber, as well as about any extension or endpiece of the distal end of the sheath. The reflective material reflects aberrant emissions of laser energy from the optical fiber as it erodes, and laser energy backscattered from the target tissue away from the distal end of the sheath back into the optical fiber or out of the distal end of the sheath, thereby preventing damage due to overheating. Other embodiments include devices that transmit laser energy more safely, efficiently and durably laterally from the axis of the optical fiber.

Abstract: The invention relates to a catheter device including an optical fiber whose distal end is disposed within a hollow tube with a sharp or needle shaped distal end, which can penetrate tissue. The distal end of the optical fiber and the hollow tube are configured so as to emit, by refraction (total internal reflection) or reflection from a metal surface, laser energy at an angle of about 80° to about 90° relative to the longitudinal axis of the optical fiber and hollow tube. The hollow tube is mounted to a housing and may be surrounded by a sheath.

Abstract: An optical fiber device for ablating a channel through a plaque deposit or a clot in a blood vessel is described. Laser energy is transmitted through one or a bundle of optical fibers to a quartz or fused silica cylinder, whose distal end surface has been made into a desired shape and sandblasted or carbon coated or both. The cylinder is received with a pocket defined in a sheath which surrounds the optical fibers. Moreover, the cylinder includes a circumferential recess and the sheath includes a circumferential rib which engages into the recess for securing the lens in the pocket. In one embodiment, the cylinder has a cavity formed therein and the distal end of the optical fiber extends into the cavity. In a further embodiment, the device is adapted to be guided along a wire extending through the pocket and an aperture defined in the sheath and/or a channel defined in the cylinder.

Abstract: The invention relates to a catheter device including an optical fiber whose distal end is disposed within a hollow tube with a sharp or syringe shaped distal end, which may be inserted into tissue. The distal end of the optical fiber and the hollow tube are configured so as to emit, by refraction (total internal reflection) or reflection from a metal surface, laser energy at an angle of about 80° to about 90° relative to the longitudinal axis of the optical fiber and hollow tube. A first fluid channel within the distal end portion of the tube enables fluid to be infused to cool the distal end of the tube and to cool and clean the emission face of the optical fiber. A second, relatively larger diameter fluid channel in the tube enables the fluid, flowing through said first channel along with hot gasses from the vaporization of tissue, to exit the device through a second port in the tube, away from the tissue being treated.

Abstract: A catheter device suitable for shrinking chordae tendineae of the human heart is provided having an energy conduit and a positioning device that facilitates the delivery of thermal energy, including coherent (laser) or non-coherent light, RF, microwave or ultrasound energy, to a predetermined region of the chordae tendineae or other collagen-containing tissue, such as the female urethra or the esophagus near the sphincter. The device comprises a tubular catheter containing an energy conduit, such as a fiber optic cable, adapted for delivering thermal energy to the tissue. The tubular catheter also contain a stabilizing device, disposed at its distal end, such as an asymmetrically shaped balloon or a retractable flexible metal hook. With the distal end of the catheter device positioned within a human heart, application of thermal energy to the chordae tendineae results in a shrinkage of the chordae, providing a treatment for primary mitral valve regurgitation.

Abstract: An optical fiber device for ablating a channel through a plaque deposit or a clot in a blood vessel is described. Laser energy is transmitted through one or a bundle of optical fibers to a quartz or fused silica cylinder, whose distal end surface has been made into a desired shape and sandblasted or carbon coated or both. The cylinder is received with a pocket defined in a sheath which surrounds the optical fibers. Moreover, the cylinder includes a circumferential recess and the sheath includes a circumferential rib which engages into the recess for securing the lens in the pocket. In one embodiment, the cylinder has a cavity formed therein and the distal end of the optical fiber extends into the cavity. In a further embodiment, the device is adapted to be guided along a wire extending through the pocket and an aperture defined in the sheath and/or a channel defined in the cylinder.

Abstract: The invention relates to a catheter device including an optical fiber whose distal end is disposed within a hollow tube with a sharp or syringe shaped distal end, which may be inserted into tissue. The distal end of the optical fiber and the hollow tube are configured so as to emit, by refraction (total internal reflection) or reflection from a metal surface, laser energy at an angle of about 80° to about 90° relative to the longitudinal axis of the optical fiber and hollow tube. A first fluid channel within the distal end portion of the tube enables fluid to be infused to cool the distal end of the tube and to cool and clean the emission face of the optical fiber. A second, relatively larger diameter fluid channel in the tube enables the fluid, flowing through said first channel along with hot gasses from the vaporization of tissue, to exit the device through a second port in the tube, away from the tissue being treated.

Abstract: A catheter device suitable for shrinking chordae tendineae of the human heart is provided having an energy conduit and a positioning device that facilitates the delivery of thermal energy, including coherent (laser) or non-coherent light, RF, microwave or ultrasound energy, to a predetermined region of the chordae tendineae or other collagen-containing tissue, such as the female urethra or the esophagus near the sphincter. The device comprises a tubular catheter containing an energy conduit, such as a fiber optic cable, adapted for delivering thermal energy to the tissue. The tubular catheter also contain a stabilizing device, disposed at its distal end, such as an asymmetrically shaped balloon or a retractable flexible metal hook. With the distal end of the catheter device positioned within a human heart, application of thermal energy to the chordae tendineae results in a shrinkage of the chordae, providing a treatment for primary mitral valve regurgitation.

Abstract: A medical device applies radiant energy to tissue surrounding or underlying the surface of a duct, hollow organ or body cavity. The energy is emitted through an expandable, energy-transmissive balloon in which a fluid coolant is circulated to cool the surface of the duct, hollow organ or body cavity and the tissue immediately underlying the surface of the duct, hollow organ or body cavity. The device includes an elongated transmission line extending through a catheter, having a proximal end portion, which is connectable to a source of radiant energy, and a distal end portion, to which a radiant energy emitter is coupled. The balloon is mounted on the distal end of the catheter and extends over the emitter. The catheter contains an inlet confined fluid passageway and an outlet confined fluid passageway to provide fluid coolant circulation through the balloon. Microscopic albumen microspheres or particles of quartz or silica are suspended in the fluid coolant to more uniformly diffuse the radiant energy.

Abstract: A lasing device for performing a myringotomy or like procedure is provided. The distal end portion of an optical fiber used to transmit a laser energy beam to the surgical site is covered with a disposable, removably mounted sheath, whose distal end is substantially transparent to the wavelength of laser energy being emitted through the optical fiber. Optionally, a relatively low power aiming beam can be emitted coaxially with the laser energy beam.

Abstract: A surgical device is provided for forming a channel through or into tissue utilizing radio-frequency electrical energy. The device includes a cannula having an open bore. Mounted within the bore is an insulated mono-polar electrical lead, the distal end of which is not insulated, for forming the channel by mechanically advancing through the tissue and emitting radio-frequency energy. Alternatively, the device can have bipolar electrical leads.

Abstract: A surgical device is provided for forming a channel through or partially through vascular tissue, including vascular tissue, utilizing both mechanical and laser energy, and, if desired, depositing a therapeutic agent therein. The device includes an optical fiber for transmission of laser energy, a housing, and a hollow guide attached to the housing through which the optical fiber extends. A needle is attached to the distal end of the optical fiber in fluid communication with a catheter surrounding the optical fiber. Additionally, an actuator is included operably connected to the optical fiber for selectively extending the needle and/or fiber from the hollow guide. Finally, a laser control device is contemplated operably connected to the optical fiber, transmitting laser energy from the distal end of the fiber after the needle has penetrated a layer of selected distance into the tissue.

Abstract: A surgical device is provided for forming a channel through or into tissue utilizing both mechanical energy and laser energy. The device includes a needle for forming the first part of the channel. The needle has an open bore. Mounted within the bore is an optical fiber for emitting laser energy to form the balance of the channel.

Abstract: A laser energy delivery catheter emits energy laterally relative to the longitudinal axis of the catheter. The catheter distal end is a cylindrical housing provided with a sidewall aperture. Within the housing is mounted a prism spaced from the distal end of a fiber optic. The refractive index of the prism is higher than the refractive indices of the fiber optic and the coupling liquid medium. A liquid medium is utilized to cool the device when in use, and may also be utilized to optically couple the fiber optic and the prism. The catheter can be configured as a rigid or semi-rigid, hand held surgical instrument, or as a flexible device that can be inserted into body lumens through an endoscope.

Abstract: A coupling system for coupling a beam of radiant energy from a laser to a fiber optic cable includes a secondary transmission path which surrounds the input end of the fiber optic cable and provides an optical path for energy which is not transmitted by the fiber optic core but is lost. Displaced from an output end of the secondary transmission path is a multi-faceted reflector. The reflector is displaced sufficiently from the output end of the secondary transmission path so that the power density of the radiation incident thereon is reduced sufficiently so as to not damage the facets thereof. The coupling system is contained within a heat sink which receives the reflected and lost radiant energy harmlessly converting same to heat.