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.

Systems for enabling delivery of very high peak power laser pulses through optical fibers for use in ablation procedures preferably in contact mode. Such lasers advantageously emit at 355 nm wavelength. Other systems enable selective removal of undesired tissue within a blood vessel, while minimizing the risk of damaging the blood vessel itself, based on the use of the ablative properties of short laser pulses of 320 to 400 nm laser wavelength, with selected parameters of the mechanical walls of the tubes constituting the catheter, of the laser fluence and of the force that is applied by the catheter on the tissues. Additionally, a novel method of calibrating such catheters is disclosed, which also enables real time monitoring of the ablation process. Additionally, novel methods of protecting the fibers exit facets are disclosed.

A tissue-treating portion of a surgical instrument includes a body defining a cavity and a light-energy transmissible sphere captured within the cavity such that a portion of the light-energy transmissible sphere protrudes from the body. The light-energy transmissible sphere is capable of unlimited rotation in all directions relative to the body. The light-energy transmission cable extends through the body to a position spaced-apart from the light-energy transmissible sphere. The light-energy transmission cable is configured to transmit light energy to the light-energy transmissible sphere. The light-energy transmissible sphere, in turn, is configured focus the light energy towards tissue to treat tissue.

An optical fibre for an ultrafast laser endoscope including at least the following structures: a hollow core, the periphery of which has an order of symmetry of at least six when considering axes of symmetry passing through the centre of the core and through the centre of convex shapes, seen from the centre of the core, the convex shapes at least partly making up the periphery of the core; an intermediate layer of cellular structure surrounding the core; a light conducting peripheral structure surrounding the intermediate layer of cellular structure; and an outer sheath surrounding the light-conducting peripheral structure. A particular advantage of the optical fibre is that it optimizes the emission of a high-power flux associated with fluorescence collection.

A catheter system for treating a treatment site includes an energy source, a balloon, an energy guide, and a pressure sensor. The balloon is positionable substantially adjacent to the treatment site. The balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The energy source generates energy that is received by the energy guide so that the energy guide can guide the light energy into the balloon interior. The pressure sensor senses a balloon pressure of the balloon fluid. A method for disrupting calcification at the treatment site includes the steps of generating energy with an energy source, positioning a balloon substantially adjacent to the treatment site, the balloon having a balloon wall that defines a balloon interior, the balloon interior being configured to receive a balloon fluid, receiving energy from the energy source with an energy guide, guiding the energy from the energy source into the balloon interior with the energy guide; and sensing a balloon pressure of the balloon fluid with a pressure sensor.

The present disclosure relates to a laser probe assembly coupled to a laser system through an optical fiber cable. In one example, the laser probe assembly comprises a probe tip coupled to the probe body, the probe tip housing multiple fibers. Each of the multiple fibers comprises a proximal end that couples to the laser system and a distal end that terminates in the probe tip, a single core for transporting a laser beam provided by the laser system, and a cladding surrounding the core. The laser probe assembly also comprises a lens for projecting multiple laser beams provided by the multiple fibers on to a surgical site. Within the probe tip, parts of outer surfaces of portions of any two adjacent fibers of the multiple fibers touch. Also, the multiple fibers are at least substantially centered with respect to the lens.

A catheter system for treating a vascular lesion within or adjacent to a vessel wall includes an energy source, a plurality of energy guides and a system controller. The energy source generates energy. The plurality of energy guides receive energy from the energy source. The system controller controls the energy source so that the energy is sequentially directed to each of the plurality of energy guides in an advancing wavefront. The system controller controls a firing rate of the energy source to each of the plurality of energy guides. The system controller can control a firing sequence to the plurality of energy guides so that the advancing wavefront is generated toward the vascular lesion from near the balloon proximal end and from near the balloon distal end. The system controller can control the energy source so that light energy from the energy source is alternatively directed to at least two of the plurality of energy guides at a different firing energy level from one another. The energy level can be based on pulse width, wavelength and/or amplitude of the energy pulse(s).

The present invention is directed toward a method for treating a vascular lesion within or adjacent to a vessel wall. The method includes the steps of generating energy with an energy source; receiving the energy with a plurality of energy guides; and controlling the energy source with a system controller of a catheter system so that the energy from the energy source is sequentially directed to each of the plurality of energy guides in a first firing sequence. The method can include the system controller controlling a firing rate of the energy source to each of the plurality of energy guides. The method can include the system controller controlling a firing sequence to the plurality of energy guides so that an advancing wavefront is generated toward the vascular lesion from near a balloon proximal end and/or from near a balloon distal end. The system controller can control a firing energy level, which can be dependent at least partially upon the pulse width, the wavelength and/or the amplitude of the energy pulses.

A catheter system for treating a treatment site within or adjacent to a vessel wall includes a light source, a balloon, a light guide, and an optical analyzer assembly. The light source generates light energy. The balloon is positionable substantially adjacent to the vascular lesion. The balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The light guide receives light energy from the light source at a guide proximal end and guides the light energy toward a guide distal end and into the balloon interior. The optical analyzer assembly is configured to optically analyze light energy emitted from the guide proximal end of the light guide.

A method for treating a treatment site within or adjacent to a vessel wall or a heart valve, includes the steps of (i) generating light energy with a light source; (ii) positioning a balloon substantially adjacent to the treatment site, the balloon having a balloon wall that defines a balloon interior that receives a balloon fluid; (iii) receiving the light energy from the light source with a light guide at a guide proximal end; (iv) guiding the light energy with the light guide in a first direction from the guide proximal end toward a guide distal end that is positioned within the balloon interior; and (v) optically analyzing with an optical analyzer assembly light energy from the light guide, wherein the light energy that is analyzed moves in a second direction that is opposite the first direction.