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 side-firing laser system with a standoff catheter includes an optical fiber configured to emit therapeutic laser radiation in a direction generally transverse to an axis of the fiber; and a catheter through which the optical fiber is inserted during a surgical procedure. The catheter includes a transparent end section through which the therapeutic laser radiation passes to vaporize tissue outside the catheter, an open distal end to permit exit of irrigation fluid from the catheter, and an opening in a side of the end section, the opening having dimensions that are approximately equal to or less than cross-sectional dimensions of the therapeutic laser radiation. When the fiber is moved to a position at which the therapeutic laser radiation passes through the opening, the laser radiation causes coagulation or vaporization of tissues.

The present disclosure relates to a system and method for coordinated laser delivery and imaging during an interventional procedure. A method may include activating an imaging source to provide a pulsed imaging signal and activating a laser source to provide a pulsed laser signal while the imaging source remains activated. The method may include coordinating the pulsed laser signal and the pulsed imaging signal to output each pulse of the pulsed laser signal and each pulse of the pulsed imaging signal in non-overlapping time windows. A system may include a controller in communication with the laser source and the imaging source for coordinating the output of the laser signal and the imaging signal.

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.

A nephroscope can include a body that is at least partially insertable into a kidney of a patient. An articulation controller on a grippable proximal portion of the body can adjust a position of a flexible distal portion of the body to locate a kidney stone when the body is inserted into the kidney of the patient. The articulation controller can optionally releasably lock the articulation of the flexible distal portion, to fixedly position the flexible distal portion at a specified location proximate the kidney stone. The distal end of the body can include an illuminator to illuminate the kidney stone, a camera to provide a video image of the illuminated kidney stone, an optical fiber to deliver laser light that ablates the kidney stone, and an irrigation lumen and a suction lumen to flush the kidney stone and remove kidney stone fragments.

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.

The invention provides methods for diagnosing and treating deep vein thrombosis and other conditions associated with occluded or constricted vessels. According to certain aspects, methods of the invention involve inserting a sensing device into a vessel having a thrombus therein, assessing, with the sensing device, one or more functional parameters within the vessel, determining an interventional therapy for treating the thrombus based on the assessing step; and performing the interventional therapy.