Abstract: A TMR system including a handpiece with a barrel having a passage for transmitting a laser beam, a heart tissue contacting portion at one of the barrel, and at least one ECG electrode associated with the handpiece. An ECG unit is responsive to the ECG electrode for generating an ECG signal, a laser provides the laser beam, and a processing circuit is configured to fire the laser in response to the ECG signal.

Abstract: Shock-waves are applied using a combination lithotripsy probe/balloon system, comprising a needle and cannular balloon which can be inserted through the skin at a point between the ribs into the cavity beneath the chest wall and overlying the heart. Alternatively, the shock-wave can be administered extracorporally or via a catheter. A fluid injector is connected to the balloon, allowing it to be inflated with saline or other appropriate fluid to fill the space (for transmission of shock waves and/or to displace tissue—such as lung) and contact the surface of the heart. A shock-wave (acoustic) generator is used to generate shock-waves through the lithotripsy probe, through the fluid and into the myocardial tissue. The fluid provides a uniform medium for transmission of the acoustic energy, allowing precise focus and direction of the shock-wave to induce repeatable cavitation events, producing small fissures which are created by the cavitation bubbles.

Abstract: An endovascular laser treatment device preferably includes a catheter having a hub at its proximal end, an optical fiber for insertion into the catheter, a fiber connector attached to the optical fiber at a selected distance from the distal end of the optical fiber, and a temporary stop removably mounted around the optical fiber. The treatment device has two positions: a protective position and an operating position. As the fiber is inserted through the catheter, the temporary stop rests against the hub and places the fiber tip in the protective position where the distal end of the optical fiber is positioned near the distal end of the catheter, but is still disposed inside the catheter. When the temporary stop is removed and the fiber connector is coupled with the catheter hub, the fiber tip is in the operating position where the distal end of the optical fiber extends past the distal end of the catheter by a predetermined distance to expose the fiber tip.

Abstract: A method and apparatus for reducing the thickness of arterial walls is disclosed. Ablation of the exterior layer of the arterial walls is performed using mechanical or laser ablation techniques. Surveying is preferably carried out during the procedure to ensure optimal ablation. The ablation reduces the effective thickness of the arterial walls and increases flexibility so that the walls distend under normal blood pressure, thereby improving blood flow. Advantageously, the procedure is carried out without invasion of the blood vessel lumen and without damage to the inner layer of the artery wall.

Abstract: An artery blockage removal system including a hollow plastic tube with IR optical fibers extending longitudinally between its inner and outer walls, the end of the tube having a metal clad tip ring preferably of gold abutting against the end of the IR optical fibers, and the outer surface of the hollow plastic tube having curved arterial guards molded into its outer circumference to hold the inner walls of the artery away from the hollow plastic tube and metal clad tip ring to avoid physical and thermal damage to the inner artery walls, whereby arterial blockage is removed through application of the metal clad tip ring heated by the IR optical fibers and a vacuum applied through the center of the hollow tubing.

Abstract: A fiber optic laser catheter assembly for use in removing, or largely debulking, obstructions or occlusions from a lumen in a living body. The catheter assembly includes an outer tubular sheath, an optical fiber extending through the sheath, and a fiber guide for holding the fiber within the sheath. In all of the disclosed embodiments, the obstructions are removed by controllably positioning an optical fiber's distal tip in a succession of selected radial and circumferential positions so as to sculpt away the obstruction without substantial risk of mechanically or thermally damaging the vessel. Several of the embodiments are configured such that the portion of the occlusion that can be reliably sculpted away has a radius greater even than the radius of the catheter assembly itself.

Abstract: A thrombolysis catheter apparatus is disclosed comprising: (a) an elongated thrombolysis catheter portion comprising a plurality of independently controllable electroactive polymer actuators, which provide a curvature to the thrombolysis catheter based upon received control signals; (b) a control unit coupled to the plurality of actuators and sending the control signals to the plurality of actuators; and (c) an occlusion removal device. Also disclosed is a method of treating an arterial occlusion by advancing the thrombolysis catheter portion through the arterial vasculature of a patient to a position proximate the occlusion, while controlling the shape of the thrombolysis catheter portion using the control unit. The occlusion is then removed using the occlusion removal device.

Abstract: A catheter introduction apparatus provides an optical assembly for emission of laser light energy. In one application, the catheter and the optical assembly are introduced percutaneously, and transseptally advanced to the ostium of a pulmonary vein. An anchoring balloon is expanded to position a mirror near the ostium of the pulmonary vein, such that light energy is reflected and directed circumferentially around the ostium of the pulmonary vein when a laser light source is energized. A circumferential ablation lesion is thereby produced, which effectively blocks electrical propagation between the pulmonary vein and the left atrium.

Abstract: An apparatus and method for stabilization of aneurysm is disclosed. The apparatus comprises an ultraviolet radiation generator for generating UV radiation having a wavelength, strongly absorbed by the DNA and a catheter including means for delivering the ultraviolet radiation to the aneurysm. The distal end of the catheter is placed inside the aneurysm. Stabilization of the aneurysm is achieved by forming a mural arterial thrombus inside the aneurysm. To make irradiation possible, the blood is displaced from the aneurysm by a steady stream of UV radiation transparent fluid. The injury to the endothelium that triggers the thrombus formation is caused by UV radiation delivered to the aneurysm. In several days after intervention the thrombus becomes fully organized, leaving on the inside surface of the aneurysm a thick layer of fibrotic tissue that stabilizes the aneurysm.

Abstract: A method and apparatus of providing endovascular therapy. The steps include arranging optical fibers within a catheter, the catheter having a tip whose length is at least 1 cm and whose diameter of less than 1 millimeter, connecting an excimer laser to the optical fibers; and delivering laser energy from the excimer laser in excess of a fluence of 60 -mJ/mm2 at 40 Hertz through the optical fibers. The delivering of the laser energy may be to non-calcified or calcified deposits of an atherosclerotic lesion to ablate the same. The method also includes the step of inserting the catheter through an artery by pushing the same until the tip is in within laser energy striking distance of the atherosclerotic lesion.

Abstract: A method and apparatus for reducing the thickness of arterial walls is disclosed. Ablation of the exterior layer of the arterial walls is performed using mechanical or laser ablation techniques. Surveying is preferably carried out during the procedure to ensure optimal ablation. The ablation reduces the effective thickness of the arterial walls and increases flexibility so that the walls distend under normal blood pressure, thereby improving blood flow. Advantageously, the procedure is carried out without invasion of the blood vessel lumen and without damage to the inner layer of the artery wall.

Abstract: Apparatus and methods are provided for thermally or mechanically treating tissue, such as valvular structures, to reconfigure or shrink the tissue in a controlled manner, thereby improving or restoring tissue function. The apparatus comprises a catheter in communication with an end effector. The end effector induces a temperature rise in an annulus of tissue surrounding the leaflets of a valve sufficient to cause shrinkage of the tissue, thereby reducing a diameter of the annulus and causing the valves to close more tightly. Alternatively, the end effector selectively induces a temperature rise in the chordae tendineae sufficient to cause a controlled degree of shortening of the chordae tendineae, thereby enabling the valve leaflets to be properly aligned. In another alternative, the end effector is configured to mechanically shorten the effective length of the chordae tendineae by forcing the tendineae through a tortuous path, again properly aligning the valve leaflets.

Abstract: An endovascular laser treatment device includes an optical fiber and a protective sleeve covering the optical fiber. The optical fiber and the protective sleeve are sized to be axially movable relative to one another between a protected state wherein the distal end of the optical fiber is protected within the sleeve and an operating state wherein the distal end of the optical fiber is outside of the sleeve. The optical fiber is in the protected state during insertion into the vessel or a sheath positioned within the vessel, and once it is inserted, the optical fiber is positioned in the operating state ready for application of laser energy to the target vessel.

Abstract: Catheters for photoablating plaque build-up in blood vessels are described. In one form, the catheter includes a catheter body having a first group of optic fibers and a second group of optic fibers. The first group of optic fibers is adjacent the second group of optic fibers, and each group of optic fibers includes at least one optic fiber having a first end and a second end. The second ends of the respective optic fibers form a substantially rounded hemispherical catheter head. A control element is coupled to the catheter body and is configured to selectively transmit energy through either the first group of optic fibers, or the second group of optic fibers, or both the first and second groups of optic fibers.

Abstract: A myocardial revascularization device has a catheter suitable for use in a myocardial revascularization procedure, the catheter including an elongate body having a proximal end and a distal end, and tissue-ablating means housed at least partially within the catheter and capable of effectuating tissue ablation adjacent the distal end of the catheter. The device further has an optical reflectance fiber housed within the catheter and coupled to an optical reflectance system. The device is operative to transmit a reflectance signal in the optical reflectance fiber, the reflectance signal including either short optical pulses or low-coherence light. The optical reflectance system is operative to gauge tissue ablation, measure a thickness of tissue adjacent the catheter, and/or determine a position of the distal end relative to adjacent tissue using either of optical time-domain reflectance or optical coherence interferometry.

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 system for treating atrial fibrillation includes a stent and a delivery catheter for carrying the stent to a treatment site. The stent is self-expanding, for example, being formed of a shape memory alloy, and is configured to lodge against the interior wall of a pulmonary vein. The stent may be formed as a loop, helix, progressively wound helix or other suitable shape, and in one embodiment has an exposed proximal portion including an ablation region that contacts and subtends a circumference of the vein, or contacts endocardial wall tissue along a circumferential path at the ostium. The proximal portion is attached to an energy delivery line in the catheter to energize the stent and ablate tissue in the circumferential region, forming a lesion to block conduction across the ostium or preventing trigger signals originating in the pulmonary vein from initiating or sustaining fibrillation in the atrium.

Abstract: A catheter device for treating a vascular disease is provided. The catheter device includes an energy delivery device such as an optical fiber for delivering laser energy and a catheter. The catheter lumen receives the optical fiber and a fluid such as an anesthetic agent or vasoconstricting agent. According to the invention, a plurality of exits are formed in the sidewall of the catheter. The exits are in communication with the catheter lumen and administer the fluid into the blood vessel. By administering the fluid from within the catheter lumen, the present catheter device eliminates the need to make numerous external punctures to deliver fluid injections.

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: A novel device and method for preventing restenosis and streamlining the angioplasty procedure. The device and method provide a fiberoptic guidewire, or, alternatively, a light-conducting catheter, to decrease the size of the angioplasty device, decrease the overall time of the procedure, and increase the safety of the procedure. The present invention delivers radiation to a sclerotized area after balloon angioplasty treatment to prevent restenosis Radiation delivered via the catheter or fiberoptic guidewire discourages the cell proliferation and cell growth after angioplasty, thereby improving the chances of avoiding restenosis.

Abstract: A suction cup for body fat reduction which brings about an improved fat reduction effect. The suction cup for body fat reduction has a tube section 3 to be attached tightly at an open end to a part of the body where fat reduction is desired, and sucks in the part of the body as an inside area of the suction cup is decompressed. The tube section 3 is made of a deflectable material and provided with thin portions 27, 27 and 29, 29 at opposite sides. This structure allows at least the open end of the tube section 3 to deflect elastically into a flat shape and press the sucked-in part of the body from opposite sides when the inside area of the suction cup is decompressed.

Abstract: An apparatus for stimulating revascularization of myocardium tissue in the ventricular wall of a human heart is disclosed. The apparatus includes means for moving the distal end of an optical fiber element forwardly through the epicardium of the heart and into the myocardium and emitting relatively low power bursts of laser energy from the distal end to form stimulus injury zones that promote capillary growth and tissue revascularization. Each penetration of the optical fiber element may produce multiple stimulus zones spaced radially from or in line with the axis of the optical fiber element. Apparatus for moving the optical fiber element and controlling the laser emissions in a predetermined manner is also disclosed.

Abstract: Improved catheters for clot removal. A catheter-containing light guide may be passed through a clot. Light may emanating from the light guide as the light guide is passed forward through the clot and/or is drawn back through the clot in order to ablate the clot. In one set of embodiments, the invention provides for methods and systems for delivering the light guide through the clot and for drawing it back through the clot to irradiate and/or ablate the clot. The invention provides, in another set of embodiments, methods and systems to deliver the light energy or radiation to the clot to perform ablation, for example during a single pass. The invention also provides, in yet another set of embodiments, methods and systems to increase the efficiency of the ablation, for example, by increasing the spot size.

Abstract: A long pulse alexandrite laser for treating dermatological specimens is disclosed. The use of alexandrite allows operation in the near-infrared, specifically in a 50 nm range surrounding 755. Infrared in this range allows good penetration while still achieving an acceptable ratio of hemoglobin to melanin absorption. In operation, the laser generates pulses having a durations between 5 and 100 msec and fluences between 10 and 50 J/cm2. A light delivery system is provided that transmits the laser light output pulse to dermatological targets of a patient. The invention is also directed to a hair removal system. Here, it is desirable to use an index-matching application on the skin sections to be treated, and a visual indicator is thermo- or photo-responsive or otherwise responsive to the laser light pulse to generate a visible change. Also, the invention is directed to a combined sclerotherapy and light treatment method and kit for unwanted veins.

Abstract: Disclosed is a radiation-crosslinkable thermoplastic polymer composition, a process for the preparation thereof, an angioplasty balloon made using such a composition, and a method of using the angioplasty balloon. The composition contains a reactive monomer cross-linker, that facilitates cross-linking of the reaction product upon contact of the cross-linker-containing composition with a particle beam from a radiation source.

Abstract: A heart-synchronized pulsed laser system includes a laser; means for sensing the contraction and expansion of a beating heart to be synchronized with the laser; means, responsive to the means for sensing, for generating a trigger pulse; means for positioning the leading edge of the trigger pulse; means for positioning the leading edge of the trigger pulse during the contraction and expansion cycle of the heartbeat; means for defining the width of the trigger pulse to occur during the heartbeat cycle; and means responsive to the trigger pulse for firing the laser to strike the beating heart at the time indicated by the trigger pulse position and for the period indicated by the width of the trigger pulse.

Abstract: A guiding catheter system for delivering an elongated therapeutic or diagnostic device into a patient's left ventricle which includes a first guiding catheter with a shaped distal extremity configured to be aligned with or parallel to a longitudinal axis or long dimension of the patient's left ventricle and a second guiding catheter slidably and rotatably disposed within an inner lumen of the first guiding catheter which has a shaped distal shaft section and an inner lumen configured to slidably receive an elongated therapeutic or diagnostic device such as a tissue ablation device, e.g. an optical fiber connected to a laser source, an ultrasonic energy emitting device or a radio frequency energy emitting device. The shaped distal section of the first guiding catheter is shaped or is shapable within the patient's heart chamber.

Abstract: A catheter system for use in bypassing a block in an artery comprises four components. These components are an arterial catheter, an intravenous ultrasound catheter, a guide wire system, and finally a covered stent used as graft. The bypassing of the block in the artery which extends along a vein comprises the steps of forming a first connection between said artery and said vein proximal to the block in the artery, forming a second connection between said artery and said vein distal to the block in the artery, introducing a covered stent through said artery proximal to the block therein, through said first connection into said vein, via said vein to and through said second connection, and into said artery distal to the block therein, such that a proximal end of the covered stent is positioned in the artery proximal to the block therein and a distal end of the covered stent is positioned in the artery distal to the block therein, and fixing the proximal and distal ends of the covered stent within the artery.

Abstract: A catheter for use with a radioactive source within the catheter to irradiate a selected area of a blood vessel in combination with angioplasty procedures, to prevent restenosis of that area of the blood vessel. The catheter has a guidewire channel formed near its distal end to facilitate use of the catheter as a rapid exchange catheter, allowing insertion of the catheter over a guidewire also used in performance of an angioplasty procedure. The catheter also has a radiation lumen with a sealed end to retain the radioactive source within the catheter. The radiation lumen is sufficiently longer than the guidewire channel to extend into a non-sterile field, keeping the radiation source segregated from the blood, allowing the use of a non-sterile radiation source. The catheter can also be provided with a centering balloon or a set of centering wire loops to center the radioactive source radially within the blood vessel.

Abstract: A tip of a needle is inserted into large vein of a patient. The needle is mounted in a butterfly device axially engaged to a generally cylindrical housing containing a Y-connector. A pharmaceutically acceptable solution is fed to the needle through the Y-connector to the housing. A quartz optic fiber is fed through the housing and needle to the tip of the needle in the patient's venous system. A source of UV and visible light directs both UV and visible light alternatively through the optic fiber to the patient's venous system to kill pathogens in the venous system.

Abstract: Expandable laser catheters for utilizing laser energy to remove obstructions from body passages are described. In one embodiment, the laser catheter includes a shaftway having a distal end including a flexible portion configured in a series of radial folds. Multiple optical fibers, configured to transmit laser energy, extend along the shaftway and are attached to the flexible portion. An inflatable, ring-shaped balloon is attached to the catheter within the flexible portion. In use, the catheter is inserted into a body passage such as an artery, and advanced until the distal end is adjacent to an obstruction. The balloon is inflated to expand the flexible portion and to bring the optical fibers nearer the inner wall of the body passage. Laser energy is directed by the optical fibers toward targeted regions of the obstruction. As the catheter is advanced and the process repeated, a core is formed from the obstruction and contained within the flexible portion.

Abstract: An elongated catheter device with a distal balloon assembly is adapted for endovascular insertion. Coolant injected through the device may, in different embodiments, directly cool tissue contacting the balloon, or may cool a separate internal chamber. In the first case, the coolant also inflates the balloon, and spent coolant is returned to the handle via a return passage extending through the body of the catheter. Plural balloons may be provided, wherein a secondary outer balloon surrounds a primary inner balloon, the primary balloon being filled with coolant and acting as the cooling chamber, the secondary balloon being coupled to a vacuum return lumen to serve as a robust leak containment device and thermal insulator around the cooling chamber. Various configurations, such as surface modification of the balloon interface, or placement of particles, coatings, or expandable meshes or coils in the balloon interface, may be employed to achieve this function.

Abstract: A method and apparatus for treating gum disease includes a light producing dental appliance that is accessible exteriorly of the body for placement within the mouth of the patient to expose the mouth to light radiation of a selected wavelength and in an amount that is effective for killing or debilitating pathogenic microorganisms and especially Porphyromona gingivalis within the mouth of the patient such that the bacterial load carried to the heart is diminished thereby reducing or eliminating the symptoms of coronary artery disease, atherosclerosis vascular inflammation and plaque formation.

Abstract: The variable stiffness electrically conductive catheter shaft includes one or more electrically conductive members, and at least one coaxial layer of heat shrink polymer disposed over the one or more electrically conductive members of a length shorter than the one or more electrically conductive members, to provide variations in stiffness along the length of the shaft. The variable stiffness electrically conductive catheter shaft preferably includes a plurality of coaxial layers of heat shrink polymer encapsulating the one or more electrically conductive members, extending from the proximal end of the one or more electrically conductive members toward the distal end, the plurality of coaxial layers having different lengths to provide the electrically conductive catheter shaft with varying stiffness over the length of the electrically conductive catheter shaft.

Abstract: A system for delivering medicaments to tissue including a delivery member and an optical fiber formed together into a unitary structure. The optical fiber has an inlet attached to a laser energy source and an outlet for emitting laser energy. The delivery member has an inlet attached to a medicament source and an outlet for injecting medicament. A handpiece is adapted to receive the ablating and injecting device in a controlled and movable relationship and may include at least one tissue stabilizing member thereon. In use, the distal end of the handpiece is placed against tissue to be ablated. The optical fiber is advanced into the tissue while emitting laser energy thereby ablating the tissue and forming a channel therein. During retraction, medicament may be injected into the channel or into the tissue surrounding the channel.

Abstract: A targeting fixture allows for x-y-z movement of a targeting fixture with respect to a grid template. The targeting fixture includes a sheath unit, which accepts a seed implanting device. The sheath unit is maintained at a fixed relation with respect to the grid template.

Abstract: A method and device for causing angiogenesis in the heart including the formation of a pattern of stimulus pockets or zones and channels. Laser energy is deliverable through one or more fiber optic elements at a controlled penetration depth and direction. The fiber element of the device is advanced incrementally within the myocardium. Laser bursts are triggered at intervals to create stimulus zones and/or channels.

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: Methods and apparatus for creating fluid flow from one location to another are disclosed. The fluid flow is created via the absorption of repetitive pulses of radiation in a fluid to generate bubbles that expand and collapse repetitively. This fluid mechanism, or pumping phenomenon, can be used to aid removal of a total or partial occlusion in a body passage by disrupting a surface of the occlusion with acoustic shock and pressure waves and/or by causing mechanical disruption of the occlusive material. Appropriate selection of materials and particular constructions improve apparatus flexibility.

Abstract: Methods are presented for the dissolution of a thrombus which occludes a blood vessel. The methods utilize the vasodilation effect produced by irradiating a blood vessel with UV laser light. The laser-induced vasodilation leads to stretching of the occluding thrombus, which becomes infiltrated with blood and quickly dissolves without the emission of emboli. Some of the methods involve combination of UV laser irradiation with thrombolytic agents, dethrombosing agents, or antiplatelet agents to enhance their effectiveness and reduce side effects.

Abstract: Myocardial revascularization is performed by an apparatus and method which forms channels in the myocardium from inside the ventricular cavity without penetrating the full thickness of the ventricular wall. A catheter has a fiber optic connected at its handling end to a laser, and terminates at the insertable end of the catheter. A servomotor controls the advancing of the fiber to stop positions relative to the catheter. At each stop position another channel is created. An aiming beam aids in directing the channel forming fiber end to different desired channel positions.

Abstract: A tip of a needle is inserted into large vein of a patient. The needle is mounted in a butterfly device axially engaged to a generally cylindrical housing containing a Y-connector. Saline solution is fed to the needle through the Y-connector to the housing. A quartz optic fiber is fed through the housing and needle to the tip of the needle in the patient's venous system. A source of UV and visible light directs both UV and visible light alternatively through the optic fiber to the patient's venous system to kill pathogens in the venous system.

Abstract: Photodynamic therapy (PDT), the light activation of methylene blue or benzoporphyrin derivatives to produce free-radicals, was shown in vivo to inhibit intimal hyperplasia (IH) and restenosis. The present invention provides an effective clinical approach for PDT treatment which modulates the vascular intervention injury healing response.

Abstract: Methods and systems are disclosed for treating in-stent restenosis using radiation having a wavelength sufficient to kill or promote cellular death (e.g., through programmed cell death), or otherwise remove smooth muscle cells which have proliferated, or which might otherwise proliferate, in the proximity of (i.e., within, around or adjacent to) a stent within a body lumen, causing (or potentially causing) at least partial blockage of the lumen. Devices are disclosed for providing such therapeutic radiation at the stent with or without concurrent mechanical (e.g. balloon dilation) angioplasty. Treatment methods are also disclosed which include irradiating smooth muscle cells in the region of the stenosis with non-ablative, cytotoxic radiation, such as UV radiation. A cytotoxic, photoactivatable chromophore may also be delivered to the treatment site prior to irradiation.

Abstract: The invention encompasses methods and flexible apparatus for creating fluid flow from one location to another through the repetitive expansion and collapse of bubbles generated as a result of the absorption of repetitive pulses of radiation in a fluid. This pumping phenomenon can be used to aid removal of a total or partial occlusion in a body passage by disrupting the surface of the occlusion with acoustic shock and pressure waves and/or by causing mechanical disruption of the occlusive material. Flexibility is improved with choice of materials and particular constructions.

Abstract: Devices and methods for creating a series of percutaneous myocardial revascularization (PMR) channels in the heart. One method includes forming a pattern of channels in the myocardium leading from healthy tissue to hibernating tissue. Suitable channel patterns include lines and arrays. One method includes anchoring a radiopaque marker to a position in the ventricle wall, then using fluoroscopy repeatedly to guide positioning of a cutting tip in the formation of multiple channels. Another method uses radiopaque material injected into each channel formed, as a marker. Yet another method utilizes an anchorable, rotatable cutting probe for channel formation about an anchor member, where the cutting probe can vary in radial distance from the anchor. Still another method utilizes a multiple wire radio frequency burning probe, for formation of multiple channels simultaneously. Still another method utilizes liquid nitrogen to cause localized tissue death.

Abstract: In a device for treating blood vessels with a laser, the laser provides a beam in a wavelength range from 750 to 850 nm, preferably 805 nm. The device has a measuring unit which measures the concentration of a chromophore (preferably indocyanine green) administered to the patient in the patient's blood vessels. The device further comprises a control unit which controls the power of the laser in a contrary sense to the measured concentration.

Abstract: Expandable laser catheters for utilizing laser energy to remove obstructions from body passages are described. In one embodiment, the laser catheter includes a shaftway having a distal end including a flexible portion configured in a series of radial folds. Multiple optical fibers, configured to transmit laser energy, extend along the shaftway and are attached to the flexible portion. An inflatable, ring-shaped balloon is attached to the catheter within the flexible portion. In use, the catheter is inserted into a body passage such as an artery, and advanced until the distal end is adjacent to an obstruction. The balloon is inflated to expand the flexible portion and to bring the optical fibers nearer the inner wall of the body passage. Laser energy is directed by the optical fibers toward targeted regions of the obstruction. As the catheter is advanced and the process repeated, a core is formed from the obstruction and contained within the flexible portion.

Abstract: An apparatus and method for creating drug-filled pockets within muscle tissue, such as myocardium of the heart for increasing angiogenesis. More particularly, the apparatus has an excising assembly with a dilator tip for penetrating and advancing through the surface and body of a muscle or organ, such as the heart. Preferably, the dilator tip has a low level laser optical fiber emission to ease the passage of the excising assembly and provide thermal damage which also stimulates angiogenesis. More preferably, the dilator tip also disperses a pharmacologically active substance as the apparatus is passed through the tissue and/or creates pockets. The excising assembly is connected to a hand-held control device from which the operator pushes a switch to activate a punching mechanism within the excising assembly. The punching mechanism cuts a discrete piece of muscle tissue and traps it within the excising assembly leaving a pocket in the remaining muscle tissue.

Abstract: Radioactive coating solutions and sol-gels, and corresponding methods for making a substrate radioactive by the application of the radioactive coating solutions and sol-gels thereto. The radioactive coating solution comprises at least one carrier metal and a radioisotope, which may be soluble or insoluble, and may further comprise a reducing agent. The radioactive sol-gel comprises at least one metal alkoxide and a radioisotope, which may be soluble or insoluble. Methods of making a substrate radioactive by coating with radioactive coating solutions or sol-gels are also disclosed, including electrodeposition, electroless deposition, spin coating and dip coating. In a particular embodiment, the radioactive coating formed by the method is a composite coating. Radioactive substrates are also disclosed, comprising a substrate and one or more radioactive coatings, which coatings may be the same or different.