Device and method for dilation of a tubular anatomical structure
Described is a method and device for dilating a tubular anatomical structure. The device and method can be useful for extracting a blood clot in an artery of a mammal by concentrically irradiating an inner wall of the occluded artery using an ultraviolet (UV) laser beam delivered by an optical fiber. Dilation results from photophysical production and release of nitric oxide from the cells lining the arterial wall when UV laser light is projected as a ring beam onto the inner arterial wall.
1. A dilation system for dilating a tubular anatomical structure using UV laser light, said dilation system comprising an optical fiber and a thrombectomy balloon catheter, the optical fiber having a distal end configuration selected from the group consisting of an external cone an inverted cone, and a flat distal end comprising concentric circular grooves etched into the flat distal end, wherein the laser light is refractively emitted from the distal end of the optical fiber as a conical ring beams at an emission angle β greater than 15° and up to about 140°; wherein the optical fiber comprises a material selected from the group consisting of ALON, sapphire, and a customized polymeric material.
2. The dilation system of claim 1 , wherein the distal end of the optical fiber is a separate tip coupled to and in optical communication with the optical fiber.
3. The dilation system of claim 1 , wherein the optical fiber is disposed within a guidewire.
4. The dilation system of claim 1 , wherein the optical fiber is silica and comprises a separate tip comprising ALON.
5. The dilation system of claim 1 , wherein the optical fiber is silica and comprises a separate tip comprising sapphire.
6. The dilation system of claim 1 , wherein the optical fiber is sapphire.
7. A method for dilating a tubular anatomical structure in a body of a patient, said method comprising:
providing a dilation system of claim 1 ;
emitting UV laser light from the distal end of the optical fiber as an annular beam onto smooth muscle cells of an inner wall of the tubular anatomical structure to stimulate production and release of nitric oxide (NO·) from stores of nitrites (NO 2 − ) in the smooth muscle cells, whereby the nitric oxide causes relaxation of the smooth muscle and dilation of the tubular anatomical structure.
8. The method of claim 7 , wherein the anatomical structure in a body of a patient is selected from an anatomical canal, an anatomical tube or tubule, a blood vessel, a bronchiole, a ureter, small intestine and a vas.
9. The method of claim 7 , wherein the distal end of the optical fiber is not centered within the tubular anatomical structure.
10. The method of claim 7 , wherein the distal end of the optical fiber is centered within the tubular anatomical structure.
11. The method for dilating a tubular anatomical structure in a body of a patient of claim 9 , wherein the method is applied in an endovascular thrombectomy procedure employing a thrombectomy device wherein the method further comprises the steps of:
positioning the UV optical fiber within about 1-10 vessel diameters of a clot within an artery;
emitting a pulse of UV light energy as a laser beam onto smooth muscle cells on an inner wall of the artery to stimulate production of NO· from stores of nitrites (NO 2 − ) in the smooth muscle cells, whereby dilation of the artery results; and
removing the clot.
12. The method of claim 11 , wherein the balloon catheter is transparent to UV light.
13. The method of claim 11 , wherein the distal end of the optical fiber is not centered within the tubular anatomical structure.
14. The method of claim 11 , wherein the distal end of the optical fiber is centered within the tubular anatomical structure.
15. The method of claim 11 , wherein the UV light is directed onto the arterial wall within about 1 and about 4 vessel diameters from the clot.
16. The method of claim 11 , wherein the UV light is pulsed at high frequency of 5-25 kHz, or as a quasi-continuous 100 MHz beam with about 10 picosecond pulse widths, or as a continuous square wave for at least 2 seconds and up to 10 seconds.
17. The method of claim 11 , wherein the UV light is emitted at a wavelength of about 180-400 nm.
18. The method of claim 11 , wherein the UV light is emitted using a frequency-tripled Nd:YAG laser which emits light at 355 nm.
19. The method of claim 11 , wherein the incident intensity of the UV light is between about 2 and about 20 watts per square centimeter.
20. The method of claim 11 , wherein the thrombectomy device is selected from an aspiration catheter and a stentriever.
21. The method of claim 11 , wherein the optical fiber is disposed within a guidewire.