A method for identifying material to be removed from a patient may use an imaging device, a display, a control unit, and an insertion device. The method may include obtaining a first set of image data from the imaging device, sending the first set of image data to the control unit from the imaging device, and analyzing the first set of image data based on at least one of a darkness, a contrast, or a saturation. The method may include generating a coded image identifying the material to be removed from the patient to be displayed on the display. The method may further include displaying the coded image on a first screen of the display, and indicating the material to be removed with the insertion device based on the displayed coded image.

A steerable laser probe may include a handle having a handle distal end and a handle proximal end, a plurality of actuation controls of the handle, a flexible housing tube having a flexible housing tube distal end and a flexible housing tube proximal end, and an optic fiber disposed within an inner bore of the handle and the flexible housing tube. An actuation of an actuation control of the plurality of actuation controls may gradually curve the flexible housing tube. A gradual curving of the flexible housing tube may gradually curve the optic fiber. An actuation of an actuation control of the plurality of actuation controls may gradually straighten the flexible housing tube. A gradual straightening of the flexible housing tube may gradually straighten the optic fiber.

Described herein are methods, devices, and support structures for assembling optical fibers in catheter tips and facilitating alignment and structural support. A method for assembling a plurality of optical fibers and lenses in a support structure for an ablation catheter includes providing a support structure with a proximal end, a body, and a distal end, wherein the distal end includes a plurality of alignment orifices or slits. A plurality of optical fibers are threaded through the alignment orifices or slits, such that each optical fiber is threaded through a corresponding alignment orifice or slit. An adhesive material is applied at each alignment orifice or slit to secure the optical fibers, and the plurality of optical fibers are then cleaved at the distal end to remove portions of the fibers extending out of the distal end. Finally, a lens is attached to each of the ends of the plurality of optical fibers.

In some embodiments, without limitation, the invention comprises a catheter having an elongated housing with a channel disposed therein. A laser delivery member is movable and at least partially disposed within the channel. A ramp is disposed within the housing at an angle to its central axis and proximate to its distal end. The ramp is adapted to move the distal end of the laser delivery member outwardly from the central axis of the housing. A guidewire biases the distal end of the laser delivery member generally inwardly toward the central axis of the housing. In some embodiments, without limitation, the offset of the central axis of the tip of the laser delivery member from the central axis of the housing is determined by adjusting the extent to which the laser delivery member travels on the ramp, and disposition of the laser delivery member on the guidewire maintains the offset tip substantially parallel to the central axis of the housing. Thus, in accordance with the invention, the distal end of the laser delivery member may be biased in a desired direction or offset, permitting ablation of an area larger than the area of the distal end of the catheter.

Devices and methods are discussed directed to the use of a low profile laser ablation catheter for use in laser ablation removal of arterial plaque blockages to restore blood flow in the treatment of arteriovenous fistulas. Also discussed are devices and methods directed to packaging, long term storage and sterilization of liquid core ablation catheters.

Embodiments of the present invention include a laser catheter that includes a catheter body, a light guide, and a distal tip that extends beyond the exit aperture of the light guide. In some embodiments, an imaging device is disposed on the distal tip such that the imaging device is distal relative to the exit aperture of the light guide. In some embodiments, the imaging device can be gated to record images during and or slightly beyond periods when the laser catheter is not activated.

A lithotripsy or other medical laser treatment system can include a lateral actuator to laterally displace a distal portion of a laser fiber, such as can be scanned or otherwise controlled to generate a spatial or spatiotemporal sub-targeting pattern without requiring laterally moving an endoscope carrying the laser fiber in a longitudinal passage such as a working channel. A targeted stone can be selectively weakened along the pattern, such as using lower energy pulses, before being fragmented, such as by a higher energy shock pulse.

The invention comprises a system and method for identification and/or characterization of lesions and/or the various type of tissues inside blood vessels, including utilizing a laser system configured to transmit laser radiation towards and/or onto a lesion within a blood vessel, monitoring ablation of the lesion utilizing at least one acoustic sensor; and, using a processor, comparing the signals obtained from the acoustic signal to previously obtained acoustic signals associated with specific lesion types and determine a type of the lesion and/or an efficiency of the ablation process based on the comparison.

Multi-fiber laser probes utilize relative motion of fibers and other laser probe elements to preserve small-gauge compatibility while providing for multi-spot beam deliver, or to provide for the selectively delivery of single-spot or multi-spot beam patterns. An example probe includes fibers having distal ends that are movable as a group onto a distal ramp element affixed to a distal end of a cannula, so that the distal ends of the fibers can be moved between a retracted position, in which the distal ends of the fibers are within the cannula or ramp element, and an extended position, in which distal ends of the fibers are guided by grooves or channels of the ramp so as to extend at least partially through external openings in the distal end of the laser probe and so as to be pointed angularly away from a longitudinal axis of the cannula.

A steerable laser probe may include an actuation structure, a nosecone fixed to the actuation structure by one or more links and one or more link pins, a flexible housing tube, and an optic fiber disposed in the flexible housing tube and the actuation structure. A compression of the actuation structure may be configured to gradually curve the flexible housing tube and the optic fiber. A decompression of the actuation structure may be configured to gradually straighten the flexible housing tube and the optic fiber.