| 摘要 |
A device for luminal recanalization of atherosclerotic blood vessels includes a guide sleeve adapted to be introduced into the blood vessel and advanced to the atherosclerotic plaque. The sleeve includes a fluid passage to conduct fluid to the distal end to inflate an exterior-mounted balloon to immobilize the sleeve and block blood flow in the vessel. A fiberoptic core is adapted to be advanced through the guide sleeve, with spacing therebetween to permit the flow of cooling fluid to the distal end of the sleeve. The distal end of the fiberoptic core is provided with a heat conductive cap which is adapted to be selectively heated by laser energy delivered through the core. The cap is advanced beyond the distal end of the sleeve to contact the plaque, and the laser energy virtually instantaneously heats the cap to cause thermal destruction of the plaque. The core may be removed to flush the plaque debris from the vessel, and to introduce an endoscopic fiberoptic core to visualize the results. In tortuous vessels, a preformed guide wire may first be inserted into the vessel, the guide sleeve advanced about the guide wire into the vessel, and the wire removed and replaced by the fiberoptic core. In a related embodiment the guide sleeve is provided with parallel channels to receive the fiberoptic core and the guide wire simultaneously, so that the sleeve may be advanced through a vessel along a guide wire with the cautery cap extended and heated reiteratively as required to remove plaque as it is encountered. |
