Paul J. Zalesky

Engineering considerations for integrating laser angioplasty with ultrasound diagnostics in a single device

The application of direct laser energy for the ablation of atherosclerotic plaque has been investigated extensively. It has been recognized that the need for an onboard guidance capability which can direct the laser energy is essential for controlled plaque removal. Intravascular ultrasound represents one approach for identifying diseased tissue and directing laser therapy. The design of a catheter with combined laser and ultrasound capabilities is discussed. The design considers the optical and acoustical requirements. In addition, vascular anatomical constraints and their impact on the mechanical aspects of the device configuration are considered. The optical considerations dictate safe and predictable high energy laser transmission. The acoustic requirements consider material properties and ultrasonic beam resolution. The vascular anatomy imposes constraints on maximum catheter size and it requires a means for conventional delivery of the device to the targeted lesion.