CN-122005077-A - Laser device for vascular and in-vivo procedures and method of use thereof

Abstract

A laser atherectomy device includes a sensor-equipped light delivery catheter for monitoring physical characteristics of a laser application site. An integrated control unit utilizing data from the sensors is provided to optimally adjust laser energy parameters and safely and effectively ablate vascular obstructions.

Inventors

• Pavel v. everkin

Assignees

• 帕维尔·V·埃弗雷金

Dates

Publication Date

20260512

Application Date

20191204

Priority Date

20190604

Claims (6)

1. 1. A laser surgical guidance system for guiding a laser surgical instrument, comprising: A guide means formed by a wall formed as a truncated cone defining a hollow body extending between an input region and an output region, the input region being of greater cross section than the output region, the output region being provided with an output opening, a cut-out portion, the wall extending longitudinally to the hollow body between the input region and the output region, a top wall extending to the input region and having at least first and second apertures, a chamber formed within the hollow body, the first aperture guiding a laser surgical instrument therethrough having a light transmitting tip, a handle connected to the second aperture and extending outwardly from the top wall, a suction catheter connected to the chamber through the second aperture and through the handle, a proximal end of the suction catheter connected to a vacuum device creating a vacuum at its distal end and located within the chamber, and in use, the light transmitting tip through the output opening being positioned at a treatment site when the laser surgical instrument is inserted into the chamber through the first aperture, wherein the debris is caused to be evacuated through the output opening and the suction catheter.
2. 2. The laser surgical guidance system of claim 1, further comprising a plurality of additional devices disposed at the aspiration catheter to prevent blockage of the evacuation system.
3. 3. The laser surgical guidance system of claim 2, wherein the plurality of additional devices are selected from the group consisting of filters, screens, nets, shields, and other barriers associated with the catheter.
4. 4. The surgical guidance system of claim 1, further comprising a viewing instrument disposed at the output region.
5. 5. The laser surgical guidance system of claim 4, wherein the laser surgical instrument is a laser delivery rod, the light delivery tip being positioned to an optimal angle at a patient's body cavity by manipulating the laser delivery rod within the output opening while the light delivery tip is viewed through the viewing instrument.
6. 6. A surgical guidance system according to claim 1, wherein the top wall is integral with the input region.

Description

Laser device for vascular and in-vivo procedures and method of use thereof Technical Field The devices and methods of the present invention relate generally to in vivo surgery and treatment of occluded body cavities. More particularly, the present invention relates to an improved laser system for optimally generating and providing laser energy through a catheter for removing obstructive material in blood vessels and other body cavities. Background The laser systems, devices and methods of the present invention are suitable for use in a variety of in vivo procedures including, but not limited to, cutting, fracturing, coagulating, vaporizing any body tissue (including, but not limited to, soft tissue including tendons, ligaments, fascia, skin, fibrous tissue, fat and synovium; and muscle, nerves and blood vessels (not connective tissue) and hard tissue/bone and connective tissue), involving access to target tissue through body passages including, but not limited to, blood vessels, ureters, esophagus, stomach and duodenum (gastroesophageal gastroduodenal), small intestine (enteroscope), large intestine/colon (colonoscopy, sigmoidoscopy), or incising body tissue (laparoscopic procedure). While laser systems, devices and methods for removing obstructive material from blood vessels and other body lumens are described in more detail below, it should be apparent that these laser systems, devices and methods are some of the many possible applications of the present invention. The laser system, apparatus and method of the present invention are applicable to a variety of types of in vivo procedures as described above, including but not limited to general surgery, cardiology, plastic surgery, urology and gastrointestinal procedures. Cardiovascular disease is often caused by the build-up of atheromatous material on the walls of the lumen of blood vessels, particularly the coronary lumen and other vasculature, including Coronary Artery Disease (CAD) where plaque accumulates in the heart arteries, such as well as Peripheral Arterial Disease (PAD) -peripheral arterial narrowing that serves the legs, stomach, arms and head, leading to a condition known as atherosclerosis. Atherosclerosis and other vascular deposits can restrict blood flow and may lead to ischemia, which in acute situations can lead to myocardial infarction or heart attacks. Atherosclerotic deposits may have widely varying characteristics, some of which are relatively soft, while others are fibrous and/or calcified. Where the deposit is fibrous and/or calcified, the deposit is often referred to as plaque. Atherosclerosis is a natural result of aging, but may also be exacerbated by factors such as diet, hypertension, heredity, vascular damage, and the like. Atherosclerosis can be treated in a variety of ways, including drugs, bypass surgery, and a variety of catheter-based procedures that rely on intravascular enlargement or removal of atherosclerotic material or other material that occludes the blood vessel. Catheter-based interventions include angioplasty, atherectomy, laser ablation, stent implantation, and the like. In most cases, the catheters used for these interventions are introduced over a guidewire and the guidewire is placed over the lesion prior to placement of the catheter. However, the initial placement of the guidewire into the twisted area of the vasculature may be somewhat difficult or even impossible to achieve. In addition, placement of the guidewire can also become difficult if the lesion is complete or nearly complete, i.e., the lesion blocks the lumen of the vessel to the point where the guidewire cannot travel across the lesion. Vascular occlusion can be caused by a variety of substances including hard bones such as calcium deposits, soft blood clots, or fat deposits. Multiple types of obstructions may be present in the same vessel. Different tools are currently used to remove different types of obstructions. The surgeon may need to remove one type of catheter and replace it with another type of catheter in order to successfully treat a different type of occlusion. This lengthens the treatment time, greatly increases the cost, and increases the risk to the patient. The present invention provides a more optimal and complete solution to this problem, including a method of analyzing the type of blocking substance present and then adjusting the function of the blocking removal device accordingly. In the prior art, rotational atherectomy systems are known that use diamond bits/rotary files to polish hard calcified plugs into very small particles. While some discussion considers that ablating plaque into microparticles by a 20 mm diamond bit rotary file produces particles of smaller size (about 5 mm) than red blood cells (8 mm), it is also known that larger debris particles are produced during the breaking of obstructions. Such larger particles can clog capillaries and cause serious side effects. However, even if the occluding particles are a