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.

An end-firing surgical laser fiber suitable for Thulium Laser Fiber lithotripsy applications includes an internally reflective tube that extends beyond the distal end surface of the fiber to provide a standoff sleeve, and that is welded or otherwise fixed to an end section of the fiber. The standoff sleeve may be made of silica glass or sapphire, a reflective metal, and/or may include a reflectivity-enhancing coating or structure on an inner surface of the tube. In addition, the reflective standoff sleeve may be tapered to increase or decrease a diameter of a distal end of the sleeve to control output power density, and may include index matched fillers or structures that absorb, transmit, or scatter energy away from the fiber cladding, and/or an energy blocking or absorbing structure positioned at an upstream end of the sleeve. Still further, the laser output may be modified by adding relatively low power, extended duration pulses to a high frequency pulse train in order to clear suspended dust particles from an interior of the sleeve during a lithotripsy procedure, and prevent buildup of the particles on the inside diameter of the sleeve.

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, the distal end including 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.

A laser delivery device may include a connector portion at a proximal end of the laser delivery device and an optical fiber connecting the connector portion to a distal end of the laser delivery device. The connector portion may include a capillary at least partially surrounding a proximal portion of the optical fiber, and the capillary may include dimples on at least a portion of a circumferential surface thereof.

Described is a method and device for dilating a tubular anatomical structure. The device and method can be useful for extracting a blood clot in an artery of a mammal by concentrically irradiating an inner wall of the occluded artery using an ultraviolet (UV) laser beam delivered by an optical fiber having an external or inverted conical tip. Dilation results from photophysical production and release of nitric oxide from the cells lining the arterial wall when UV laser light is projected as a ring beam onto the inner arterial wall. This “minimal contact persistent dilation system” prepares the artery for safer mechanical extraction by thrombectomy, owing to decrease in friction and dissolution of chemical bonding.

Disclosed is a device for interstitial laser therapy. The device comprises an optical waveguide extending about a central longitudinal axis and having an optical output end; an optical diffuser optically coupled to, optically associate with, or positioned about the optical output end, wherein the optical diffuser comprises a housing having an open end for receiving the optical output end and a first longitudinal portion of the optical waveguide; and a temperature sensor interposed, positioned or located between the central longitudinal axis and an exterior surface of the housing, and preferably within the longitudinal extent of the first longitudinal portion of the optical waveguide. The optical diffuser can be provided with one or more holes, one or more slits, one or more openings, and/or one or more vents. The device can also include a second temperature sensor. Also disclosed is a system for interstitial laser therapy.

An example multi-fiber, multi-spot laser probe comprises a plurality of fibers extending from a proximal end of the laser probe to at least near a distal end of the laser probe, where the proximal end of the laser probe is configured to be coupled to a laser source via an adapter interface, and a cannula having a distal end and surrounding the plurality of fibers along at least a portion of the laser probe at or near the distal end of the laser probe, where a distal end of each of the plurality of fibers is angle-polished so that the distal end of each fiber is angled relative to a longitudinal axis of the cannula and relative to a plane perpendicular to the longitudinal axis of the cannula. Additional embodiments employ lensed fibers, a distal window, ball lens, lens array, or faceted wedge.

A catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (108A) or a heart valve includes a light source (124), a first light guide (122A), a second light guide (122A), and a guide bundle (152). The light source (124) generates light energy. The first light guide (122A) receives the light energy from the light source (124) and has a guide proximal end (122P). The second light guide (122A) receives the light energy from the light source (124) and has a guide proximal end (122P). A guide bundle (152) is in optical communication with the light source (124). The guide bundle (152) bundles the first light guide (122A) and the second light guide (122A). The guide bundle (152) includes a first ferrule (778) that engages the guide proximal end (122P) of the first light guide (122A) and a second ferrule (778) that engages the guide proximal end (122P) of the second light guide (122A). At least one of the ferrules (778) can be formed at least partially from a ceramic material or a metallic material.

In one aspect, recording instruments, probes, probe sheaths, and probe sleeves may include one or more recording elements, such as one or more ECG wires, EEG wires, and/or SEEG wires. A recording element may be used for lesion localization and assessment at the time of cryotherapy, thermal therapy, or temperature modulation therapy. A recording element may be used to provide positioning and monitoring during functional neurosurgery; to apply local tissue stimulation responsive to detection of an abnormal event to regulate cellular behaviors during treatment; to effect deep brain stimulation during a neurosurgical operation; to monitor internal electrical signals and identify abnormalities. Recording instruments may be deployed in vivo for hours or days while monitoring and analyzing signals. For signal analysis, leads disposed between recording element contact surfaces and along a shaft of the recording instrument may deliver recorded signals to a controller external to the patient for analysis.

A probe of a target identification system can be extended via a first lumen of a viewing instrument, such as for illuminating an area beyond a distal end of the viewing instrument via an optical path of the viewing instrument. An optical response to the illumination of the area can be received via an optical path of the probe and can be split from other optical signals of the optical path. The optical response information can be used to identify characteristics of a target and to adjust parameters of a working instrument such as a working instrument contemporaneously using the probe.