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Depth stop apparatus and method for laser-assisted transmyocardial revascularization and other surgical applications
| Details |
Inventors: Mueller, Richard L.;
Assignee: Eclipse Surgical Technologies, Inc. (Sunnyvale, CA)
Primary Examiner: Jaworski; Francis
Assistant Examiner:
Attorney, Agent or Firm: Shahani; Ray K., Sears; Christopher N.
Improved methods and apparatuses related to laser-assisted transmyocardial revascularization, and more particularly, to improved methods and apparatuses for precisely positioning a fiber-optic or other waveguide adjacent the area or areas to be lased, including at positions adjacent the posterior epicardial and endocardial surfaces of the heart and at trans-septal positions within the chambers of the heart, thereby making possible the creation of channels in myocardial tissue at precisely the positions in the heart where ischemia or infarction or other have rendered such treatment desirable or necessary. These methods and apparatuses can be adapted for use in surgical applications throughout the human body or in animals for transmitting laser energy precisely, at predetermined positions and to predetermined depths. A catheter device for performing laser-assisted transmyocardial revascularization (TMR), the device particularly adapted for delivery of laser energy via a laser delivery device or manipulation of some other apparatus inside a body cavity or organ chamber where the depth of delivery of the laser energy is critical to the procedure, the device comprising an outer lumen and a depth stop, the depth stop having a deploying device, such that when the catheter device is placed adjacent tissue to be lased and the depth stop is deployed, the spatial reference of the position of the catheter device and the laser delivery device or other apparatus used in the catheter device is maintained in a predetermined position relative to the position of the distal end of the outer lumen. Deployment of the depth stop consists of inflating a balloon tip, or there may also be an inner lumen such that deployment comprises slightly retracting the inner lumen such that an expanding mechanism such as a braided basket or "moly bolt" device increases the diameter of the end of the catheter device, thereby providing a contacting surface for performing the surgical procedure, whether it be laser ablation, visualization, or other. A method of use is also described. |
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DETAILED DESCRIPTION A surgical device for performing laser-assisted transmyocardial revascularization (TMR), the device particularly adapted for delivery of laser energy via a laser delivery means or manipulation of some other apparatus inside a body cavity or organ chamber where the depth of delivery of the laser energy is important to the procedure, the device comprising an outer lumen, the outer lumen ("lumen " is shorthand for referencing a structural sleeve member in this specification) having a proximal end and a distal end, the outer lumen defining the central axis of the surgical device, a depth stop, the depth stop disposed at a point on the outer lumen adjacent the distal end of the outer lumen, the depth stop having a deploying means, such that when the surgical device is placed adjacent tissue to be lased and the depth stop is deployed, the spatial reference of the position of the surgical device and the laser delivery means or other apparatus used in the surgical device is maintained in a predetermined position relative to the position of the distal end of the outer lumen.
In a preferred embodiment, the surgical device is adapted for use as a catheter device, the catheter device useful for use in vascular channels and organ chambers.
In a preferred embodiment, the distal end of the outer lumen extends slightly past the depth stop thereby providing a distally extending end portion.
In a preferred embodiment, the distally extending end portion is tapered and able to penetrate tissue.
In a preferred embodiment the distally extending end portion is mechanically sharpened.
In a preferred embodiment the outer lumen is rigid.
In a preferred embodiment the outer lumen is flexible.
In a preferred embodiment the depth stop comprises a balloon tip such that deployment of the depth stop consists of inflating the balloon tip.
In a preferred embodiment there is also an inner lumen, the inner lumen disposed inside the outer lumen, the inner lumen having a proximal end and a distal end, the distal end connected to the distal end of the outer lumen
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