Biasing laser catheter: monorail design

Abstract

In some embodiments, without limitation, the invention comprises a catheter having an elongated housing with a channel disposed therein. A laser delivery member is movable and at least partially disposed within the channel. A ramp is disposed within the housing at an angle to its central axis and proximate to its distal end. The ramp is adapted to move the distal end of the laser delivery member outwardly from the central axis of the housing. A guidewire biases the distal end of the laser delivery member generally inwardly toward the central axis of the housing. In some embodiments, without limitation, the offset of the central axis of the tip of the laser delivery member from the central axis of the housing is determined by adjusting the extent to which the laser delivery member travels on the ramp, and disposition of the laser delivery member on the guidewire maintains the offset tip substantially parallel to the central axis of the housing. Thus, in accordance with the invention, the distal end of the laser delivery member may be biased in a desired direction or offset, permitting ablation of an area larger than the area of the distal end of the catheter.

1 . A catheter comprising:
 an elongated housing having a central axis between a first proximal end and a first distal end, the housing having a channel disposed between the first proximal end and the first distal end;   a laser delivery member having a second proximal end, a second distal end, and at least one optical fiber, the laser delivery member being at least partially disposed within the channel and movable therein;   a cavity disposed proximate the first distal end of the elongated housing and in communication with the channel;   to a ramp disposed at an angle to the central axis and proximate the first distal end of the elongated housing, the ramp being in communication with the channel and adapted to move the second distal end of the laser delivery member outwardly from the central axis of the elongated member;   a guidewire in mechanical communication with both the laser delivery member and the elongated housing, the guidewire being adapted to bias the second distal end of the laser delivery member generally inwardly toward the central axis; and   a slot disposed proximal to the cavity, the slot in mechanical communication with the channel and the cavity, and configured to permit a portion of the guidewire to move from within the channel outwardly from the central axis of the elongated housing when the second distal end of the laser delivery member moves outwardly from the central axis of the elongated member when engaged with the ramp.   
     
     
         2 . The catheter according to  claim 1 , wherein the guidewire is at least partially eccentrically disposed within the laser delivery member. 
     
     
         3 . The catheter according to  claim 1 , wherein laser delivery member further comprises a plurality of fiber optics bundled together within an outer sheath. 
     
     
         4 . The catheter according to  claim 1 , further comprising a trigger in mechanical communication with the laser delivery member and the elongated housing and being configured to actuate the laser delivery member relative to the elongated housing. 
     
     
         5 . The catheter according to  claim 4 , wherein the trigger actuates the laser delivery member relative to the elongated housing in response to trigger actuation. 
     
     
         6 . The catheter according to  claim 1 , further comprising a trigger in mechanical communication with the laser delivery member and the elongated housing and being configured to actuate the laser delivery member from a first position relative to the elongated housing to a second position relative to the elongated housing. 
     
     
         7 . The catheter according to  claim 6 , wherein the distal end of the laser delivery member is at least partially disposed within the cavity in the first position and at least partially disposed external to the cavity in the second position. 
     
     
         8 . A catheter comprising:
 an elongated housing having a central axis, a distal end, a proximal end and a housing channel disposed between the distal end and the proximal end;   a light guide having a distal end and a proximal end;   a guidewire at least partially disposed within the housing channel and in mechanical communication with the light guide and the elongated housing; and   a monorail having a central axis substantially parallel with the central axis of the elongated housing, the monorail tip comprising:
 a monorail proximal end coupled with the distal end of the elongated housing; 
 a monorail distal end; 
 a monorail channel in mechanical communication with the housing channel and extending from the monorail proximal end to the monorail distal end, the channel; 
 a window in mechanical communication with the monorail channel; 
 a ramp disposed between the window and the monorail distal end at an angle to the central axis of the monorail tip, the ramp being in mechanical communication with the monorail channel and adapted to guide the distal end of the light guide outwardly from the central axis of the monorail tip as the distal end of the light guide is moved toward the monorail distal end; and 
 a slot disposed between the monorail distal end and the window, the slot being in mechanical communication with the monorail channel and the window, and configured to permit a portion of the guidewire to move from within the monorail channel outwardly from the central axis of the monorail tip when the distal end of the light guide moves outwardly from the central axis of the monorail when engaged with the ramp. 
   
     
     
         9 . The catheter according to  claim 8 , wherein monorail channel further comprises:
 a distal monorail channel proximate to the monorail distal end, and sized to allow the guidewire to pass therethrough; and   a proximal monorail channel proximate to the monorail proximal end, and sized to all the guidewire and the light guide to pass therethrough.   
     
     
         10 . The catheter according to  claim 8 , wherein the guidewire is eccentrically disposed within at least a portion of the light guide. 
     
     
         11 . The catheter according to  claim 8 , wherein the slot width is greater than the width of the guidewire and less than the width of the light guide. 
     
     
         12 . The catheter according to  claim 8 , further comprising a marker band disposed between the monorail distal end and the window. 
     
     
         13 . The catheter according to  claim 8 , wherein the light guide comprises one or more optical fibers. 
     
     
         14 . The catheter according to  claim 8 , further comprising a trigger coupled proximate with the elongated housing and the light guide, the trigger being configured to actuate the light guide from a first position relative to the elongated housing to a second position relative to the elongated housing. 
     
     
         15 . The catheter according to  claim 8 , wherein the trigger is configured to actuate the light guide from the second position to the first position. 
     
     
         16 . A catheter comprising:
 an elongated housing having a central axis, a distal end, a proximal end and a housing channel disposed between the distal end and the proximal end;   a fiber optic bundle having a distal end and a proximal end;   a monorail having a monorail distal end, a monorail proximal end, a central axis substantially parallel with the central axis of the elongated housing, and a monorail channel in mechanical communication with the housing channel extending from the monorail proximal end to the monorail distal end, the proximal end of the monorail being mechanically coupled with the distal end of the housing channel;   a guidewire at least partially disposed within the housing channel and at least partially disposed within the monorail channel, a portion of the guidewire exiting the monorail through the monorail channel at the distal end of the of the monorail, and the guidewire being in mechanical communication with the fiber optic bundle; and   biasing means coupled with the monorail for biasing a portion of the fiber optic bundle proximal to the distal end of monorail at a position external to the monorail and substantially parallel with the central axis of the monorail.   
     
     
         17 . The catheter according to  claim 16 , further comprising means for allowing the guidewire to extend from the distal end of the fiber optic bundle and exit the monorail through the monorail channel at the distal end of the monorail channel. 
     
     
         18 . The catheter according to  claim 16 , further comprising actuating means for actuating the distal end of the fiber optic bundle from a position within the monorail channel to a position external to the monorail in coordination with the biasing means. 
     
     
         19 . The catheter according to  claim 18 , wherein at least a portion of the actuating means is coupled with the elongated housing at the proximal end of the elongated housing. 
     
     
         20 . The catheter according to  claim 18 , wherein the actuating means moves the fiber optic bundle about 1 cm to about 2 cm. 
     
     
         21 . The catheter according to  claim 16 , wherein the biasing means includes a window within the monorail with a ramp configured therein at an angle relative to the central axis of the monorail. 
     
     
         22 . The catheter according to  claim 16 , wherein the biasing means includes a slot within the monorail in mechanical communication with the monorail channel, the slot being configured to allow the guidewire to pass therethrough as a portion of the fiber optic bundle is biased with the biasing means. 
     
     
         23 . The catheter according to  claim 16 , wherein the guidewire is eccentrically disposed within the fiber optic bundle. 
     
     
         24 . The catheter according to  claim 16  further comprising a marker band disposed proximal to the distal end of the monorail. 
     
     
         25 . A catheter comprising:
 an elongated housing having a central axis, a housing distal end, a housing proximal end and a housing channel disposed between the distal end and the proximal end;   a light guide having a distal end and a proximal end, being disposed within the housing channel; and   a guidewire at least partially disposed within the housing channel and in mechanical communication with the light guide and the elongated housing,   the elongated housing further comprising:
 a window in mechanical communication with a portion of the housing channel; 
 a ramp disposed within the window at an angle to the central axis of the elongated housing, the ramp being in mechanical communication with the housing channel and adapted to guide the distal end of the light guide outwardly from the central axis of the housing as the distal end of the light guide is moved toward the housing distal end; and 
 a slot disposed between the housing distal end and the window, the slot being in mechanical communication with the housing channel and the window, and configured to permit a portion of the guidewire to move from within the housing channel outwardly from the central axis of the housing when the distal end of the light guide moves outwardly from the central axis of the housing when engaged with the ramp. 
   
     
     
         26 . A guidewire introducer comprising:
 a funnel section including a proximal end with a proximal opening having a first diameter and a distal end with a distal opening having a second diameter, a funnel channel extending between the proximal opening and the distal opening, the first diameter being greater than the second diameter; and   an elongated tubular section having an interior channel, a distal end, and a proximal end, the proximal end of the elongated tubular section being coupled with the distal end of the funnel section.   
     
     
         27 . The guidewire introduce according to  claim 26 , wherein the funnel section includes a perforation extending from the proximal opening to the distal opening. 
     
     
         28 . The guidewire introduce according to  claim 26 , the funnel section being configured to decouple from the elongated tubular section. 
     
     
         29 . The guidewire introduce according to  claim 26 , the diameter of the interior channel being configured to accept a guidewire. 
     
     
         30 . The guidewire introduce according to  claim 26 , further comprising a tab coupled with the funnel section. 
     
     
         31 . A catheter comprising:
 an elongated housing having a central axis, a distal end, a proximal end and a housing channel disposed between the distal end and the proximal end;   a light guide having a distal end and a proximal end; and   an actuating mechanism configured to actuate the light guide from a first position to a second position relative to the housing, the light guide being in a substantially fixed position relative to the housing when in the second position.   
     
     
         32 . The catheter according to  claim 31 , further comprising a monorail tip. 
     
     
         33 . The catheter according to  claim 31 , wherein the actuating mechanism includes an elongated arm and a catch block, wherein the elongated arm and catch block are coupled when the actuating mechanism is in a second position.