Apparatus for laser-assisted intra-coronary transmyocardial revascularization and other applications

Abstract

Abstract Improved methods and apparatuses related to laser-assisted intra-coronary transmyocardial revascularization (ITMR), and more particularly, to improved methods and apparatuses for directing an interventional catheter device, via percutaneous or other entry into the vasculature, for example at the femoral artery, over the aortic arch, through the ascending aorta and over the coronary ostia such that the laser delivery means can be positioned inside a coronary artery and laser energy is used to create a plurality of small channels through the coronary artery into the tissue of the myocardium. An proximal hub portion and method of using it are described, the proximal hub portion adapted for attachment to a central, elongated lumen portion, the proximal hub portion optionally having a plurality of branched extending arms, the sheath and associated branched arms having individual blood loss seals and individually capable of receiving a laser delivery means, visualization or marking means, or other tools. The interventional catheter device has a distal end with, optionally, a guide means for directing an advancing laser delivery or other device to an angle with respect to the central axis of the catheter device, the distal end optionally comprising a radio-opaque portion for visualization via a fluoroscope or other means, the distal end of the catheter device further comprising an ultrasound transducer for visualizing the orientation and firing angles of the catheter device. The methods of use also comprise placing channel opening blockers, such as an angioplasty-type inflatable balloon or an axially compressible, radially expandable stainless steel wire mesh or other material stent in place inside the coronary artery, thereby preventing undesired bleeding from the coronary artery.

Inventors

• 👤 Douglas R. Murphy-Chutorian

Bibliographic Details