Endovenous closure of varicose veins with mid infrared laser

Abstract

This invention is an improved method and device for treating varicose veins 200 or the greater saphenous vein 202 . The method comprises the use of infrared laser radiation in the region of 1.2 to 1.8 um in a manner from inside the vessel 200 or 202 such that the endothelial cells of the vessel wall 704 are damaged and collagen fibers in the vessel wall 704 are heated to the point where they permanently contract, the vessel 200 or 202 is occluded and ultimately resorbed. The device includes a laser 102 delivered via a fiber optic catheter 300 that may have frosted or diffusing fiber tips 308 . A motorized pull back device 104 is used, and a thermal sensor 600 may be used to help control the power required to maintain the proper treatment temperature.

We claim:  
     
         1 . An endovenous method of treating a varicose vein using a laser having a wavelength between about 1.2 and about 1.8 um to heat and shrink collagen in a varicosed vessel wall in the absence of blood.  
     
     
         2 . The method of  claim 1  in which the laser energy is delivered with a fiber optic laser delivery device.  
     
     
         3 . The method of  claim 1  further comprising the following steps: 
 Inserting a fiber optic laser delivery device into the varicose vein;  
 Using a pullback device to retract the fiber optic laser delivery device through the varicose vein at a rate of between about 0.1 mm/sec and about 10.0 mm/sec while simultaneously delivering laser energy therefrom.  
 
     
     
         4 . The method of  claim 3  in which the fiber optic laser delivery device is retracted at a rate of between about 1.0 mm/sec and about 5.0 mm/sec.  
     
     
         5 . The method of  claim 3  in which the pullback device begins retraction of the fiber optic laser delivery device just prior to initiating delivery of the laser energy, thereby preventing the tip of the fiber, optic laser delivery device from sticking to the vessel wall.  
     
     
         6 . The method of  claim 1  in which blood is removed from the varicosed vein prior to treatment with laser energy.  
     
     
         7 . The method of  claim 2  in which the fiber optic laser delivery device is introduced to the varicose vein through an introducer catheter.  
     
     
         8 . The method of  claim 2  in which the energy delivered through the fiber optic laser delivery device is evenly distributed by using a diffuse radiating-tip mounted to the distal end of the fiber optic laser delivery device.  
     
     
         9 . The method of  claim 2  in which an non-contact thermal sensor is used to maintain a desired temperature.  
     
     
         10 . The method of  claim 9  in which the thermal sensor is used to maintain a desired coagulation temperature.  
     
     
         11 . The method of  claim 9  in which the thermal sensor is used to maintain a desired collagen shrinkage temperature.  
     
     
         12 . The method of  claim 9  further comprising the step of using the fiber optic laser delivery device as a sensing element.  
     
     
         13 . The method of  claim 9  further comprising the step of modulating the laser power based on the sensed temperature to maintain the desired temperature.  
     
     
         14 . A system for endovenous treatment of varicose veins comprising the following: 
 A laser having a wavelength between about 1.2 and about 1.8 um;    A fiber optic laser delivery device having a proximal end and a distal end, for delivery of laser energy from the distal end of the fiber optic laser delivery device to the inside wall of a varicose vein; and    A pullback device which retracts the fiber optic laser delivery device through the varicose vein at a rate of between about 0.1 mm/sec and about 10.0 nm/sec while simultaneously delivering laser energy therefrom, wherein collagen in the varicosed vessel wall can be heated and shrunk in the absence of blood.    
     
     
         15 . The system of  claim 14  in which the pullback device retracts the fiber optic laser delivery device through the varicose vein at a rate of between about 1.0 mm/sec and about 5.0 mm/sec.  
     
     
         16 . The system of  claim 14  further comprising anesthesia administered to tissue surrounding the varicose vein, wherein the anesthesia causes swelling of the tissue surrounding the varicose vein which causes compression of the varicose vein in order to remove blood prior to treatment.  
     
     
         17 . The system of  claim 14  further comprising an introducer catheter, wherein the fiber optic laser delivery device can be introduced to the varicose vein.  
     
     
         18 . The system of  claim 17  in which the introducer catheter comprises an elongated lumen portion having a proximal end and a distal end, wherein the fiber optic laser delivery device is introduced to the introducer catheter through the proximal end and is introduced to the varicose vein through the distal end.  
     
     
         19 . The system of  claim 18  further comprising a diffusing tip at the distal end of the introducer catheter for providing even distribution of energy radiating during treatment.  
     
     
         20 . The system of  claim 18  further comprising a diffusing tip at the distal end of the fiber optic laser delivery device for providing even distribution of energy radiating during treatment.  
     
     
         21 . The system of  claim 14  further comprising an non-contact thermal sensor.  
     
     
         22 . The system of  claim 21  further comprising a controller coupled to the thermal sensor for controlling the temperature in a region near the distal end of the fiber optic laser delivery device.  
     
     
         23 . The system of  claim 22  in which the controller modulates a power input to the laser for controlling the temperature in a region near the distal end of the fiber optic laser delivery device.  
     
     
         24 . The system of  claim 21  wherein the fiber optic laser delivery device is also the thermal sensor.