WO1992016154A1 - Dispositif pour l'enlevement de matiere au moyen de la lumiere laser - Google Patents

Dispositif pour l'enlevement de matiere au moyen de la lumiere laser Download PDF

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Publication number
WO1992016154A1
WO1992016154A1 PCT/DE1992/000219 DE9200219W WO9216154A1 WO 1992016154 A1 WO1992016154 A1 WO 1992016154A1 DE 9200219 W DE9200219 W DE 9200219W WO 9216154 A1 WO9216154 A1 WO 9216154A1
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WO
WIPO (PCT)
Prior art keywords
optical fibers
laser
laser pulse
bundle
shock
Prior art date
Application number
PCT/DE1992/000219
Other languages
German (de)
English (en)
Inventor
Kristian Hohla
Johannes Agethen
Original Assignee
Technolas Lasertechnik Gmbh
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 Technolas Lasertechnik Gmbh filed Critical Technolas Lasertechnik Gmbh
Publication of WO1992016154A1 publication Critical patent/WO1992016154A1/fr

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Classifications

    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K26/00—Working by laser beam, e.g. welding, cutting or boring
    • B23K26/02—Positioning or observing the workpiece, e.g. with respect to the point of impact; Aligning, aiming or focusing the laser beam
    • B23K26/06—Shaping the laser beam, e.g. by masks or multi-focusing
    • B23K26/064—Shaping the laser beam, e.g. by masks or multi-focusing by means of optical elements, e.g. lenses, mirrors or prisms
    • B23K26/0643—Shaping the laser beam, e.g. by masks or multi-focusing by means of optical elements, e.g. lenses, mirrors or prisms comprising mirrors
    • 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
    • A61B18/26—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 for producing a shock wave, e.g. laser lithotripsy
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K26/00—Working by laser beam, e.g. welding, cutting or boring
    • B23K26/02—Positioning or observing the workpiece, e.g. with respect to the point of impact; Aligning, aiming or focusing the laser beam
    • B23K26/06—Shaping the laser beam, e.g. by masks or multi-focusing
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K26/00—Working by laser beam, e.g. welding, cutting or boring
    • B23K26/02—Positioning or observing the workpiece, e.g. with respect to the point of impact; Aligning, aiming or focusing the laser beam
    • B23K26/06—Shaping the laser beam, e.g. by masks or multi-focusing
    • B23K26/064—Shaping the laser beam, e.g. by masks or multi-focusing by means of optical elements, e.g. lenses, mirrors or prisms
    • B23K26/0648—Shaping the laser beam, e.g. by masks or multi-focusing by means of optical elements, e.g. lenses, mirrors or prisms comprising lenses
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K26/00—Working by laser beam, e.g. welding, cutting or boring
    • B23K26/02—Positioning or observing the workpiece, e.g. with respect to the point of impact; Aligning, aiming or focusing the laser beam
    • B23K26/06—Shaping the laser beam, e.g. by masks or multi-focusing
    • B23K26/064—Shaping the laser beam, e.g. by masks or multi-focusing by means of optical elements, e.g. lenses, mirrors or prisms
    • B23K26/0652—Shaping the laser beam, e.g. by masks or multi-focusing by means of optical elements, e.g. lenses, mirrors or prisms comprising prisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00106—Sensing or detecting at the treatment site ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension

Definitions

  • the invention relates to a device for removing material and, in particular, biological tissue, with a laser system that generates laser pulses and a light-guiding device that has bundled light-guiding fibers into which the laser pulses are coupled. and direct the laser pulse to the point at which material is to be removed.
  • laser systems which, due to their high light output, evaporate tissue in such a short time and thus remove it in such a way that there is practically no heat load for the surrounding non-irradiated tissue.
  • a wide variety of laser systems including so-called excimer lasers which emit light in the UV range, have been used for such laser-induced processes.
  • ablation processes described above are also referred to as photoablation and are used above all in microsurgery (angioplasty, ophthalmology, orthopedics, etc.) in order to remove tissue as gently as possible.
  • photoablation is also used to machine workpieces or the like.
  • the known devices for photoablation generally have a light guide device which guides the laser light to the point at which material, for example tissue, is to be removed.
  • the light guide device is integrated in so-called surgical handpieces or flexible catheters and must therefore have great flexibility.
  • optical fibers are generally used as the light-guiding device. Since optical fibers are destroyed by the laser light when it exceeds a certain specific power density, the optical fiber device has a plurality of fibers which are combined into a bundle. This enables high-energy laser pulses to be transported.
  • Each laser pulse only detects and removes a limited depth of tissue.
  • This tissue-specific depth which corresponds approximately to the penetration depth of the laser light, is only a few ⁇ m. So far, efforts have been made to apply the greatest possible amount of energy or power to the largest possible area in order to remove as much tissue as possible per laser pulse.
  • the speed of operation does not depend only from the energy per laser pulse and the area acted upon, but also from the repetition rate (repetition rate) of the laser pulses.
  • the repetition rate is essentially not limited by the physically possible repetition rate of the laser system, but by the thermal stress on the tissue that is too high at higher pulse rates .
  • the repetition rate in known generic devices for removing material is less than about 25 Hz.
  • excimer lasers are used, which emit total energies between 30 and 80 mJ at the fiber bundle exit (depending on the fiber bundle diameter).
  • the individual fibers in the bundle are applied simultaneously and as evenly as possible with the laser beam.
  • laser systems with other wavelengths such as neodymium-YAG lasers, holmium or dye lasers, however, much higher laser pulse energies must be used in order to achieve an ablation effect.
  • the laser originally intended as the atraumatic tool, has therefore proven to be quite damaging in the um area.
  • the invention has for its object to provide a device for removing material and in particular biological tissue with a laser system, in which the removal process is carried out gently, so that it has no or only a negligibly small damaging effect on the environment, for example owns a healthy tissue environment.
  • the invention is based on the knowledge that the cause of the traumatic damage to the surroundings of the ablated area is the ablation process per se, but rather the shock wave associated with the ablation process in the conventional procedure. Therefore, the procedure according to the invention is such that the generation of shock waves during ablation is avoided as far as possible.
  • the light is coupled into the optical fiber bundle in such a way that it is separated in time and space in such a way that the individual optical fibers or groups are deliberately acted upon in time and in serial spatial order by at least one laser pulse each.
  • the invention is based on the idea that the formation of the shock wave is a direct consequence of the high energy per laser pulse, which is necessary when the light is applied over the entire Kätheterguer cutting surface in order to achieve "usable" removal rates.
  • the invention therefore, only one laser pulse is coupled into a single optical fiber or a group of fibers, which only irradiates a small area and whose energy is so low that it does not trigger any or no traumatic shock wave.
  • the thermal load on the area affected by the light spot is low, so that the pulse repetition frequency can be increased significantly in a device according to the invention compared to the prior art (claim 7).
  • the energy of each laser pulse is dimensioned such that the depth of its effect in the tissue corresponds approximately to the spot diameter (claim 11).
  • the maximum achievable pulse repetition frequency is consequently no longer determined by the traumatic effect, but (except by the performance of the laser) only by the fact that the time interval between two laser pulses must be selected so that the shock wave of the first laser pulse is already so has greatly diluted that an overlay with the shock wave, which is generated by the laser pulse transported by the adjacent optical fiber or group, no longer causes a traumatic effect.
  • each individual pressure wave is significantly smaller, so that it has no pain or traumatic effect.
  • the basic idea according to the invention therefore consists in sequentially applying laser pulses to the individual optical fibers of the bundle, a typical pulse repetition frequency being used, for example, in the area of angioplasty for each fiber is approximately 25 laser pulses per second (but not significantly more), so that the same total deposited energy is obtained as if a conventional device were operated with 25 laser pulses per second.
  • the basic concept according to the invention thus differs not only because of the fact that the laser beam - in contrast to the prior art - is "scanned" into an optical fiber bundle, but also fundamentally from the devices in the prior art, in which a " scanning movement "of the laser beam is used:
  • the "scan movement" of the scanning beam is used to ablate an area which is substantially larger than the area which is associated with a "stationary" beam and a correspondingly widened beam spot could be processed therapeutically.
  • the optical fibers are aligned in such a way that the light exit surfaces of optical fibers, the light entry surfaces of which are adjacent, are also adjacent.
  • the optical fibers can be arranged in the bundle regularly and in particular in a linear manner (claim 3).
  • a scanning device each of which applies a laser pulse to a specific group of optical fibers
  • the "scanning pattern" of the scanning device is imaged on the light entry surfaces of the optical fibers on the light exit surfaces, so that even when several optical fibers are exposed to a laser pulse at the output the optical fibers are defined and reproducible conditions.
  • a shock or pressure wave sensor which detects the shock wave or pressure wave triggered by each individual laser pulse.
  • An evaluation unit records the respective impact or pressure wave in association with the optical fiber or group of optical fibers acted upon by the triggering laser pulse.
  • the maximum value and the amplitude of the shock wave triggered by a laser pulse with a certain pulse duration and with a certain energy depend on the material that the laser pulse hits:
  • shock wave profiles for plaque and calcined tissue there are different shock wave profiles for plaque and calcined tissue than for normal tissue.
  • the detection of the generated shock wave in association with the respectively applied optical fiber or group of optical fibers and thus - i.e. on the basis of the features of claims 2 and 3, the location where the laser pulse strikes, a statement about the type of ablated material.
  • any pressure sensors for example intracorporeal sensors, which are arranged in a ring around the distal end of the optical fiber bundle can be used as the shock or pressure wave sensor.
  • shock or pressure wave sensor can be arranged extracorporeally, since it detects the shock or pressure wave transmitted by the bundle of optical fibers.
  • the property of a device according to the invention that the pulsed laser beam sequentially scans the area to be ablated can also be used for an optical determination of the type of material to be ablated:
  • an optical sensor is provided which detects the wavelength distribution of the fluorescent light triggered by each individual laser pulse.
  • An evaluation unit determines the material of the affected area from the wavelength distribution in association with the optical fiber or group of optical fibers acted upon by the triggering laser pulse.
  • any scanning devices for example the scanning devices described in WO 87/01819, can be used as the scanning device which generates the "scanning" movement of the pulsed laser beam over the optical fiber bundle.
  • the scanning device can have a mirror or a prism arrangement mounted on a rotating disk.
  • FIG. 3 shows a simplified illustration to explain the function of a device according to the invention with mirror deflection
  • FIG. 4 shows a cross section through a device according to the invention with a rotating prismatic disk.
  • the device shows the distal region of a device for removing tissue 4.
  • the device has a large number of optical fibers 1, which are arranged in a bundle 2 and integrated into a catheter 2 1 .
  • FIG. 2 shows that, in known devices for photoablation, the individual fibers 1 in the multifiber bundle 2 are exposed to laser light.
  • a laser beam 6 generated by a laser system (not shown) is emitted from an optical imaging or focusing lens 7 (or a lens system) onto the coupling surface 8 'of the multifiber bundle 2 while at the same time adapting the beam spot to the size and shape the coupling surface 8 'shown.
  • All individual optical fibers 1 which are guided within the multifiber bundle 2 are thus irradiated with laser light simultaneously and as uniformly as possible. Due to the 8 "at each laser pulse at the output of the multifiber bundle 2 exiting light energy, the layers of tissue 4 lying directly against the (distal) catheter head are subjected to such a high thermal load that the tissue evaporates.
  • tissue material 3 Due to the explosive expansion of tissue material 3, the ablated material is displaced to the side in front of the catheter head and, on the other hand, a shock wave 5, which spreads into the surrounding tissue area, occurs, which can lead to tissue and cell line damage.
  • FIG 3 shows a device according to the invention, in which the individual laser pulses of the laser system, which in turn is not shown, are sequentially coupled into individual optical fibers 1 contained in the multifiber bundle 2.
  • the laser beam 6 is imaged via the focusing lens 7 and a deflection unit, which has a mirror 9 rotatably mounted about a pivot axis D, in each case on individual optical fibers 1 or groups in such a way that different optical fibers or groups are acted upon one after the other become.
  • the individual optical fibers which are combined to form a multifiber bundle 2 in a catheter (not shown), are arranged linearly. Different, regular spatial arrangements of optical fibers are also conceivable (e.g. triangle, rectangle, etc.).
  • the clock frequency of the mirror adjustment does not necessarily have to match the repetition rate of the laser system, ie more than one light pulse can be transmitted per beam image on an optical fiber 1 or group.
  • a shock or pressure wave sensor 10 is also provided, which detects the shock wave or pressure wave 5 triggered by each individual laser pulse.
  • the shock or pressure wave sensor 10 is arranged extracorporeally and detects the shock or pressure wave 5 transmitted by the bundle 2 of optical fibers 1.
  • An evaluation unit (not shown) determines the respective shock or pressure wave from the output signal of the sensor 10 in association with the optical fiber 1 or group of optical fibers acted upon by the triggering laser pulse.
  • FIG. 4 shows a further embodiment of the invention, which differs from the embodiment shown in FIG. 3 by the design of the deflection unit, which in this embodiment is a disk 11 with prisms 12 'that can be rotated about an axis R , 12 ", .. is formed.
  • the laser beam 6 also passes through an optical imaging lens 7 and then passes through a prism 12 'embedded in the edge region of the disk 11 rotating about the axis R, which deflects the beam 6 onto an optical fiber 1 or group of the bundle 2.
  • the prisms (only two are shown in the cross-sectional representation, namely 12 ', 12 ") are arranged radially in the edge region of the disk 11 in such a way that the laser beam passes through the prisms (12, 12 ', ...) one after the other and is deflected differently.
  • the speed of rotation of the disk then indicates the average pulse rate of the arrangement.
  • the methods of sequential scanning can also be used to activate only parts of the catheter cross section.
  • optical fibers are specifically excluded from the radiation, which is technically easy to implement in the deflection devices shown. This is of particular interest if a suitable detection method is used which allows the tissue in front of the catheter to be recognized.
  • Another advantage of this beam deflection method is that the same energy can be applied to each individual fiber. This is very difficult with simultaneous illumination of the bundle, since each laser beam has more or less pronounced inhomogeneities. The total average power, which is thus transported by a fiber 1, can be increased not inconsiderably in this way, so that there is a considerable increase in the cutting speed.
  • the frequency of the laser pulses must be increased accordingly, the energy of the individual laser pulse is reduced accordingly.
  • Approx. 50 optical fibers 1 are arranged in a typical angioplasty catheter.
  • the laser With a pulse repetition rate of 25 Hz per fiber 1, the laser must be operated with a total repetition rate of 1,250 Hz. At the same time, the individual pulses must be mapped onto a single fiber or onto a group of fibers. The laser beam must be scanned over the entrance surface 8 'of the fiber bundle 2, so to speak.
  • the laser pulse frequency is in orders of magnitude below the limit frequency of 10 Hz estimated above.
  • the device according to the invention can thus be easily implemented in practice by arranging any scanning or scanning device on the light-entry-side (proximal) end 8 'of the optical fibers, which deflects the laser pulses in such a way that the laser pulses Entry surfaces of the individual fibers 1 "scanned".
  • the invention can be used both in the field of medical technology and for material processing of technical workpieces.

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

Abstract

Il est décrit un dispositif pour l'enlèvement de matière, notamment de tissu biologique, comportant un système à laser générant des impulsions laser, ainsi qu'un dispositif de guidage de lumière présentant des fibres optiques (1) réunies en un faisceau (2), dans lesquelles sont injectées les impulsions laser (6) et lesquelles guident l'impulsion laser (6) vers l'endroit où la matière doit être enlevée. L'invention se caractérise en ce que le faisceau (2) est divisé en au moins deux groupes de fibres optiques (1) et que chaque impulsion laser (6) n'est pas injectée dans au moins un groupe de fibres optiques (1).
PCT/DE1992/000219 1991-03-13 1992-03-13 Dispositif pour l'enlevement de matiere au moyen de la lumiere laser WO1992016154A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DEP4108146.3 1991-03-13
DE4108146A DE4108146C2 (de) 1991-03-13 1991-03-13 Vorrichtung zum Abtragen von Material mit Laserlicht

Publications (1)

Publication Number Publication Date
WO1992016154A1 true WO1992016154A1 (fr) 1992-10-01

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PCT/DE1992/000219 WO1992016154A1 (fr) 1991-03-13 1992-03-13 Dispositif pour l'enlevement de matiere au moyen de la lumiere laser

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DE (1) DE4108146C2 (fr)
WO (1) WO1992016154A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1995027446A1 (fr) * 1994-04-11 1995-10-19 Lms Laser Medical Systems Erzeugung Und Vertrieb Medizinisch Technischer Geräte Gesellschaft M.B.H. Procede de differenciation de tissus et de controle au laser et dispositif pour le traitement de tissus dentaires durs par impulsions laser
AT402256B (de) * 1992-11-17 1997-03-25 Mgaloblischwili Gurami Dr Chirurgische lasersonde

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6022309A (en) * 1996-04-24 2000-02-08 The Regents Of The University Of California Opto-acoustic thrombolysis
US6013072A (en) * 1997-07-09 2000-01-11 Intraluminal Therapeutics, Inc. Systems and methods for steering a catheter through body tissue
DE29924063U1 (de) * 1999-11-09 2001-09-27 Storz Karl Gmbh & Co Kg Lichtapplikator für die selektive Photokoagulation
EP1309284B1 (fr) 2000-02-23 2006-05-17 Carl Zeiss Meditec AG Piece a main destinee au rayonnement de lumiere sur une surface cutanee lors d'un traitement cutane medical ou cosmetique
DE10021278B4 (de) * 2000-02-23 2004-09-30 Asclepion-Meditec Ag Handstück zur Abstrahlung von Licht auf eine Hautfläche bei einer medizinischen oder kosmetischen Hautbehandlung

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US4566453A (en) * 1982-12-23 1986-01-28 Tohoku Ricoh Co., Ltd. Vascular anastomosis apparatus
US4576160A (en) * 1982-07-15 1986-03-18 Tokyo Kogaku Kikai Kabushiki Kaisha Phototherapeutic apparatus with spot size regulating means
US4587972A (en) * 1984-07-16 1986-05-13 Morantte Jr Bernardo D Device for diagnostic and therapeutic intravascular intervention
US4653495A (en) * 1984-01-13 1987-03-31 Kabushiki Kaisha Toshiba Laser medical apparatus
WO1988008279A1 (fr) * 1987-04-25 1988-11-03 Kristian Hohla Dispositif de traitement de tissus au laser
US4791926A (en) * 1987-11-10 1988-12-20 Baxter Travenol Laboratories, Inc. Method of controlling laser energy removal of plaque to prevent vessel wall damage
US4848336A (en) * 1981-12-11 1989-07-18 Fox Kenneth R Apparatus for laser treatment of body lumens
US4913142A (en) * 1985-03-22 1990-04-03 Massachusetts Institute Of Technology Catheter for laser angiosurgery
DE3836337A1 (de) * 1988-10-25 1990-04-26 Meessen Stephan Dr B Verfahren und vorrichtung zum erfassen von intrakorporal erzeugten laserinduzierten stosswellen
DE4038520A1 (de) * 1990-12-03 1991-06-20 Steiger Erwin Laser-ballonkatheter

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US4967745A (en) * 1987-04-10 1990-11-06 Massachusetts Institute Of Technology Multi-fiber plug for a laser catheter
US4838631A (en) * 1986-12-22 1989-06-13 General Electric Company Laser beam directing system

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4848336A (en) * 1981-12-11 1989-07-18 Fox Kenneth R Apparatus for laser treatment of body lumens
US4576160A (en) * 1982-07-15 1986-03-18 Tokyo Kogaku Kikai Kabushiki Kaisha Phototherapeutic apparatus with spot size regulating means
US4566453A (en) * 1982-12-23 1986-01-28 Tohoku Ricoh Co., Ltd. Vascular anastomosis apparatus
US4653495A (en) * 1984-01-13 1987-03-31 Kabushiki Kaisha Toshiba Laser medical apparatus
US4587972A (en) * 1984-07-16 1986-05-13 Morantte Jr Bernardo D Device for diagnostic and therapeutic intravascular intervention
US4913142A (en) * 1985-03-22 1990-04-03 Massachusetts Institute Of Technology Catheter for laser angiosurgery
WO1988008279A1 (fr) * 1987-04-25 1988-11-03 Kristian Hohla Dispositif de traitement de tissus au laser
US4791926A (en) * 1987-11-10 1988-12-20 Baxter Travenol Laboratories, Inc. Method of controlling laser energy removal of plaque to prevent vessel wall damage
DE3836337A1 (de) * 1988-10-25 1990-04-26 Meessen Stephan Dr B Verfahren und vorrichtung zum erfassen von intrakorporal erzeugten laserinduzierten stosswellen
DE4038520A1 (de) * 1990-12-03 1991-06-20 Steiger Erwin Laser-ballonkatheter

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AT402256B (de) * 1992-11-17 1997-03-25 Mgaloblischwili Gurami Dr Chirurgische lasersonde
WO1995027446A1 (fr) * 1994-04-11 1995-10-19 Lms Laser Medical Systems Erzeugung Und Vertrieb Medizinisch Technischer Geräte Gesellschaft M.B.H. Procede de differenciation de tissus et de controle au laser et dispositif pour le traitement de tissus dentaires durs par impulsions laser

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Publication number Publication date
DE4108146A1 (de) 1992-09-17
DE4108146C2 (de) 1995-04-20

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