# US 2018/0021552 A1 · Methods and devices for treatment of stenosis of arteriovenous fistula shunts

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- Number: US 2018/0021552 A1
- Document ID: US20180021552A1
- Status: Published application
- Kind: A1
- Application number: 15/723,067
- Filed: 2017-10-02
- Published: 2018-01-25
- Earliest claimed: 2013-10-16
- Assignees: Ra Medical Systems, Inc.
- Applicants: Ra Medical Systems, Inc.
- Inventors: James B. LAUDENSLAGER; Dean S. IRWIN
- Web page: https://patentgrep.com/patent/US20180021552A1

## CPC

- A61M 25/09: Guide wires
- A61B 18/245: {for removing obstructions in blood vessels or calculi}
- A61B 50/30: Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments (for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40)
- A61B 2018/00285: {Balloons}
- A61B 2018/0041: {Removal of thrombosis}
- A61B 2018/00577: {Ablation}
- A61B 2018/206: {the laser light passing along a liquid-filled conduit}
- A61B 2018/2222: {Fibre material or composition}
- A61B 2018/2238: {with means for selectively laterally deflecting the tip of the fibre}
- A61B 2050/314: {Flexible bags or pouches}
- A61B 2090/3966: {Radiopaque markers visible in an X-ray image}
- A61M 25/002: {Packages specially adapted therefor (combined with means for introducing catheters, e.g. dispensers, A61M25/0113); catheter kit packages (for surgical articles A61B50/30)}
- A61M 2025/0177: {having external means for receiving guide wires, wires or stiffening members, e.g. loops, clamps or lateral tubes}
- A61M 2025/105: {having a balloon suitable for drug delivery, e.g. by using holes for delivery, drug coating or membranes}
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Devices and methods are discussed directed to the use of a low profile laser ablation catheter for use in laser ablation removal of arterial plaque blockages to restore blood flow in the treatment of arteriovenous fistulas. Also discussed are devices and methods directed to packaging, long term storage and sterilization of liquid core ablation catheters.

## Claims

### Claim 1

A method of treating an arteriovenous fistula of a patient, comprising:
emitting pulsed ultraviolet laser ablation energy from a XeCl excimer laser at a nominal output wavelength of about 308 nm and a repetition rate of less than about 100 Hz into an input end of an ablation catheter;
transmitting the pulsed ultraviolet laser ablation energy through the ablation catheter;
axially advancing and guiding a distal end of the ablation catheter through a blockage that is disposed within or adjacent the arteriovenous fistula while emitting the pulsed ultraviolet laser ablation energy from an active emitting surface of the distal end of the ablation catheter while ablating and debulking the blockage, and
treating the blockage with a drug eluting balloon catheter after the distal end of the ablation catheter has traversed the blockage to improve long term patency of a lumen through the blockage.

### Claim 2 (depends on 1)

The method of claim 1 wherein axially advancing and guiding the distal end of the ablation catheter comprises axially advancing and guiding the ablation catheter which further comprises a radiopaque marker band disposed on the distal end of the ablation catheter and further comprising imaging the distal end of the ablation catheter using fluoroscopy.

### Claim 3 (depends on 1)

The method of claim 1 further comprising emitting red light from a red diode laser and the distal end of the ablation catheter and visualizing a position of the distal end of the ablation catheter using diffusion of the red light through the skin of the patient.

### Claim 4 (depends on 1)

The method of claim 1 wherein guiding the distal end of the ablation catheter comprises advancing the distal end of the ablation catheter from a distal end of a support catheter comprising a deflectable distal section.

### Claim 5 (depends on 1)

The method of claim 1 wherein axially advancing and guiding the distal end of the ablation catheter comprises axially advancing and guiding an ablation catheter comprising a liquid filled ultraviolet light transmitting catheter including a biocompatible liquid core, the liquid core being sealed at both ends with ultraviolet light transmitting windows which are crimped to a catheter body to seal in the liquid core.