WO1991010473A1 - Actionnement d'un laser commande par ordinateur a l'aide de la debitmetrie doppler - Google Patents

Actionnement d'un laser commande par ordinateur a l'aide de la debitmetrie doppler Download PDF

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Publication number
WO1991010473A1
WO1991010473A1 PCT/US1991/000248 US9100248W WO9110473A1 WO 1991010473 A1 WO1991010473 A1 WO 1991010473A1 US 9100248 W US9100248 W US 9100248W WO 9110473 A1 WO9110473 A1 WO 9110473A1
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WO
WIPO (PCT)
Prior art keywords
laser
internal tissue
catheter
tissue
unwanted internal
Prior art date
Application number
PCT/US1991/000248
Other languages
English (en)
Inventor
Israel Barken
Original Assignee
Israel Barken
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Israel Barken filed Critical Israel Barken
Publication of WO1991010473A1 publication Critical patent/WO1991010473A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/026—Measuring blood flow
    • A61B5/0261—Measuring blood flow using optical means, e.g. infrared light

Definitions

  • the present invention relates generally to an apparatus and method for laser doppler flowmetry. More particularly, the present invention provides an apparatus and method for computer control of laser firing employing laser doppler flowmetry as the information feedback source for information relating to the tissue to be irradiated.
  • the development of the laser Doppler flowmetry technique has facilitated clinical monitoring of tissue microcirculation.
  • the procedure is typically carried out endoscopically using a special probe.
  • Quantitative measurements of the microculatory blood flow are typically difficult to perform in humans with available methods for blood flow evaluation.
  • the laser Doppler flowmetry is a se iguantitative method and is well suited for measuring variations in the flux values of, for example, healthy versus pathological, comparisons within an organ or other tissue.
  • Laser Doppler flowmetry measures the difference in blood cell flux in the tissue.
  • the use of laser Doppler for blood flow measurements was first employed in studying blood flow in retinal vessels in rabbits. Riva, et al , Laser Doppler measurements of blood flow in capillary tubes and retinal vessels , Invest. Opthalmol. (1972) 11:936.
  • Laser Doppler flowmetry has been widely used for microcirculatory studies. See, e. g. , Kvernebo, K. , e. g. , Experiences with laser Doppler blood flow measurements in healthy human gastric mucosa, Int. J. Microcirc. Clin. Exp. (1984) 3:450; al-Khaja, N.
  • the principle underlying the laser Doppler flowmetry technique is based upon the fact that the frequency of light changes when scattered from a moving object, e. g. , an erythrocyte.
  • the change in the reflected light spectrum depends upon the product of the number of moving erythrocytes in the illuminated tissue volume and their mean velocity. It will be understood, by those skilled in the art, that laser Doppler flowmetry is well suited for measuring variations in the flux values of, for example, healthy versus pathological comparisons within designated tissue.
  • an apparatus and method employing laser Doppler flowmetry to identify the presence of microcirculation in tissue and transmit that information to a laser firing computer control.
  • the firing of the laser is controlled by the tissue information garnered from laser Doppler flowmetry to delineate which tissue areas-volumes have been sufficiently exposed to laser irradiation.
  • the apparatus comprises a catheter having laser fibers which transmit the laser energy to the end of the catheter.
  • a flexible probe which may be constructed as part of the catheter or as a separate probe, contains the laser Doppler apparatus, as is known in the art.
  • a receiver is coupled to the laser Doppler probe to display the Doppler signals relating to tissue information.
  • a laser source is connected to the laser fibers and to a computer which controls firing of the laser.
  • the laser Doppler receiver transmits the flux information to the computer.
  • the computer is, in turn, programmed to activate the laser and regulate the laser firing, both in energy level and in duration of firing, to sufficiently irradiate the tissue until the base line Doppler reading is achieved. This level is indicative of the complete abolition of microcirculation in the tissue.
  • Figure 1 is a diagrammatic view of the present invention.
  • Figure 2 is a diagrammatic partial cross-sectional view of a catheter probe in accordance with the present invention.
  • the present invention is illustrated with reference to Figures 1 and 2.
  • the apparatus 10 of the present invention consists generally of a laser doppler device 12 and a laser doppler receiver 14 of conventional availability for use in laser Doppler flowmetry.
  • the apparatus 10 further consists of a laser device 16 and laser power supply 18, also of conventional availability for use in laser surgery.
  • the laser Doppler receiver 14 and the laser power supply 18 are coupled to a control computer 20.
  • Control computer 20 is pre-programmed with a control program which receives tissue microcirculation information from the laser doppler 12 and calculates the required duration and energy of the laser irradiation necessary to abolish microcirculation in the tissue. Manual override of the control computer is permitted.
  • Both the laser device 16 and the laser doppler 12 may be operably connected to a single catheter containing the laser fibers and the laser Doppler transmitter/receiver as illustrated with reference to Figure 2. It is possible, within the scope and contemplation of the present invention, to employ a separate laser probe and laser doppler probe (not shown) both of which are under control of the physician. In accordance with a preferred embodiment of the present invention, however, as illustrated with reference to Figure 2, there is shown a combined laser and laser Doppler catheter 22.
  • the laser and laser Doppler catheter 22 consists of a laser device 16, an laser Doppler device 12 and a catheter 22.
  • Catheter 22 comprises an elongated flexible catheter tube constructed of any suitably biologically and chemically inert material as is well known in the art.
  • the catheter tube has a generally circular, transverse cross section, which defines a lumen.
  • the lumen may be use to accommodate a guide wire, introduce fluids, extract fluids or may be closed.
  • the diameter of the catheter tube may vary according to the desired application, i. e. , the size of the body tubing system into which it will be introduced.
  • at least one of a plurality of optical fibers 15 are disposed about the inner circumference of the lumen.
  • the plurality of optical fibers 15 may be disposed about the outer circumference of the catheter tube 22 or within the wall of the catheter tube 22 itself.
  • the optical fibers 15 may be adhered to the catheter tube by any suitable means, i. e. , gluing embedding in the material of the catheter tube wall.
  • Each of the plurality of optical fibers 15 are made of a material such as is well known in the optical fiber art and are of sufficient size to transmit sufficient laser irradiation to destroy the internal unwanted tissue or structure without detrimentally increasing thermal conductivity of the optical fiber itself.
  • Each of the plurality of optical fibers 15 may protrude from the distal end of the catheter tube 22 and, at the proximal end of the catheter tube 22, are individually connected to and controlled by the laser device 16 and computer system 20.
  • At least one laser Doppler transmitter/receiver or separate transmitter and receiver apparatus 16 is mounted at the distal end of the catheter tube 22 and electrically connected to the laser Doppler device 12 by suitable electrical conductors which are preferably affixed to or embedded in the catheter tube wall.
  • each of the plurality of optical fibers 15 may be configured to direct the laser irradiation at an pre-determined angle from the longitudinal axis of the catheter tube 15.
  • each of the plurality of optical fibers 15 are configured to fire the laser irradiation at an angle of approximately 90° relative to the longitudinal axis of the optical fiber carrying the laser.
  • each of the plurality of optical fibers 15 is under the control of the computer system 20 and responds to the feedback received from the laser Doppler 12 or to control from the physician 5.
  • the plurality of optical fibers 15 are provided about the entire inner or outer circumference of the catheter 22 and each of the plurality of optical fibers 15 direct the laser firing generally perpendicular to the longitudinal axis of each optical fiber, the laser and laser Doppler catheter apparatus 10, of the present invention, is able to selectively irradiate virtually any sector of the 360" cross-sectional area about the catheter tube 22. It will be understood by those skilled in the art, therefore, that each of the plurality of optical fibers 15 fires only to a predetermined sector of the surrounding tissue.
  • the described laser and laser Doppler catheter apparatus 10 is primarily adapted for use with any natural tubing system, e. g. , transrectally, intravessically, intratracheally, intraesophageally, or intrathecally, it utility is not limited to body system subserved by a natural passageway.
  • the laser and laser Doppler catheter 10 may be introduced through an introductory balloon catheter as more fully described in the Barken Patent Application, which is hereby incorporated by reference.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Hematology (AREA)
  • Cardiology (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Physiology (AREA)
  • Optics & Photonics (AREA)
  • Electromagnetism (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Otolaryngology (AREA)
  • Laser Surgery Devices (AREA)

Abstract

Appareil et procédé de commande par ordinateur (20) des paramètres d'émission d'un laser (16) par débitmétrie Doppler (12, 14) à laser en tant que source de retour des informations qui concernent le tissu devant être soumis au rayonnement.
PCT/US1991/000248 1990-01-12 1991-01-11 Actionnement d'un laser commande par ordinateur a l'aide de la debitmetrie doppler WO1991010473A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US46414890A 1990-01-12 1990-01-12
US464,148 1990-01-12

Publications (1)

Publication Number Publication Date
WO1991010473A1 true WO1991010473A1 (fr) 1991-07-25

Family

ID=23842757

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1991/000248 WO1991010473A1 (fr) 1990-01-12 1991-01-11 Actionnement d'un laser commande par ordinateur a l'aide de la debitmetrie doppler

Country Status (1)

Country Link
WO (1) WO1991010473A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4325724A1 (de) * 1993-07-30 1995-02-02 Paul Dr Debbage Vorrichtung und Verfahren zur Untersuchung eines Objektes und zur Einwirkung auf das Objekt
WO2019130465A1 (fr) * 2017-12-27 2019-07-04 オリンパス株式会社 Dispositif de traitement chirurgical

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4062237A (en) * 1976-05-07 1977-12-13 Fox Martin D Crossed beam ultrasonic flowmeter
US4576177A (en) * 1983-02-18 1986-03-18 Webster Wilton W Jr Catheter for removing arteriosclerotic plaque
US4681104A (en) * 1984-02-23 1987-07-21 Shiley Inc. Apparatus for focusing an intravascular laser catheter
US4770653A (en) * 1987-06-25 1988-09-13 Medilase, Inc. Laser angioplasty

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4062237A (en) * 1976-05-07 1977-12-13 Fox Martin D Crossed beam ultrasonic flowmeter
US4576177A (en) * 1983-02-18 1986-03-18 Webster Wilton W Jr Catheter for removing arteriosclerotic plaque
US4681104A (en) * 1984-02-23 1987-07-21 Shiley Inc. Apparatus for focusing an intravascular laser catheter
US4770653A (en) * 1987-06-25 1988-09-13 Medilase, Inc. Laser angioplasty

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4325724A1 (de) * 1993-07-30 1995-02-02 Paul Dr Debbage Vorrichtung und Verfahren zur Untersuchung eines Objektes und zur Einwirkung auf das Objekt
WO2019130465A1 (fr) * 2017-12-27 2019-07-04 オリンパス株式会社 Dispositif de traitement chirurgical

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