| 摘要 |
A system for delivering medicaments to tissue includes a tissue-removal and medicament-delivery device. The device includes a delivery member and an optical fiber formed together into a unitary structure by cladding. The optical fiber has an inlet for receiving laser energy from a laser energy source and an outlet for emitting laser energy. The delivery member has an inlet for receiving medicament from a medicament source and an outlet for injecting medicament. A handpiece is adapted to receive the ablating and injecting device in a controlled and movable relationship. In use, a distal end of the handpiece is placed against tissue to be ablated. The ablating an d injecting device is advanced beyond the distal end of the handpiece and into the tissue while emitting laser energy from the optical fiber. The emitted laser energy ablates the tissue as the optical fiber advances. The ablating and injecting device is then retracted from the tissue, thereby resulting in a channel formed in the tissue. While the device retracts, medicament is injected from the delivery member into the channel, thereby providing a plug within the channel. Alternatively, medicament may be injected into the tissu e surrounding the channel by delivering the medicament into the tissue surrounding the channel opening or delivering it directly into the channel wall. The medicament may include growth factor combined with a cellular matr ix which enhances angiogenesis in the tissue or may include a gene that encodes for said growth factor, or any other therapeutic agent or gene therapy agent that promotes angiogenesis or any therapeutic agent for the treatment of cardiovascular disease. The medicament delivery system is particularly usefu l in cardiac applications for performing transmyocardial revascularization (TM R) in ischemic myocardium and promoting endothelial cell growth within the myocardium.
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