Transillumination catheter and system

Abstract

A method of identifying vasculature comprising the steps of introducing an indicator in a peripheral vessel, and advancing a portion of the indicator into an internal vessel to identify said vessel. A catheter for identifying vasculature is also disclosed. The catheter is adapted to be introduced into a peripheral vessel and a portion thereof advanced into an internal vessel. The catheter comprises a light delivery portion at a distal end thereof and an expandable member located proximal to the light delivery portion.

What is claimed is:  
     
         1 . A method of identifying vasculature comprising the steps of introducing an indicator in a peripheral vessel, and advancing a portion of the indicator into an internal vessel to identify said vessel.  
     
     
         2 . The method of  claim 1  wherein the step of introducing an indicator comprises introducing a catheter having a light delivery portion, and further comprising the step of activating the light delivery portion to transmit light and identify the vessel.  
     
     
         3 . The method of  claim 2  further including the step of diffusing the transmitted light.  
     
     
         4 . The method of  claim 3  wherein the light has a wavelength in the range of 100 to 1100 nm.  
     
     
         5 . The method of  claim 3  wherein the light has a wavelength in the range of 400 to 700 nm.  
     
     
         6 . The method of  claim 3  wherein the light has a wavelength in the range of 600 to 700 nm.  
     
     
         7 . The method of  claim 2  further comprising the step of occluding blood flow through the internal vessel.  
     
     
         8 . The method of  claim 7  wherein said catheter comprises a balloon and said step of occluding comprises expanding the balloon.  
     
     
         9 . The method of  claim 8  further comprising the step of transecting a distal end of said internal vessel in preparation for a coronary anastomosis after expanding the balloon.  
     
     
         10 . The method of  claim 9  wherein said internal vessel is an internal thoracic artery and further comprising the step of sealingly joining a free end of said internal thoracic artery to a stenotic coronary artery after transecting the distal end of said internal thoracic artery.  
     
     
         11 . The method of  claim 1  wherein the internal vessel comprises an internal thoracic artery.  
     
     
         12 . The method of  claim 1  wherein the internal vessel comprises a right coronary artery.  
     
     
         13 . The method of  claim 1  wherein the internal vessel comprises a left main coronary artery.  
     
     
         14 . The method of  claim 1  wherein the internal vessel comprises a left anterior descending artery.  
     
     
         15 . The method of  claim 1  wherein the internal vessel comprises a left circumflex.  
     
     
         16 . The method of  claim 1  wherein the internal vessel comprises an aorta.  
     
     
         17 . The method of  claim 1  wherein the internal vessel comprises any branches off of a proximal coronary artery.  
     
     
         18 . The method of  claim 1  wherein the internal vessel comprises a bypass graft vessel.  
     
     
         19 . The method of  claim 18  wherein the bypass graft vessel comprises a gastroepiploic artery  
     
     
         20 . The method of  claim 18  wherein the bypass graft vessel comprises an inferior epigastric artery.  
     
     
         21 . The method of  claim 1  wherein the peripheral vessel comprises a brachial artery.  
     
     
         22 . The method of  claim 1  wherein the peripheral vessel comprises a radial artery.  
     
     
         23 . The method of  claim 1  wherein the peripheral vessel comprises a femoral artery.  
     
     
         24 . The method of  claim 1  wherein the peripheral vessel comprises a carotid artery.  
     
     
         25 . The method of  claim 11  further comprising the step of dissecting at least a portion of the internal thoracic artery after advancing the indicator.  
     
     
         26 . The method of  claim 11  further comprising the step of separating a sternum after advancing the indicator.  
     
     
         27 . A method of identifying a saphenous vein for a surgical procedure comprising the steps of introducing at least a portion of an indicator having a light delivery portion at a distal end thereof into the saphenous vein and transmitting light through the light delivery portion to identify the vein.  
     
     
         28 . A catheter for identifying vasculature, the catheter adapted to be introduced into a peripheral vessel and a portion thereof advanced into an internal vessel, the catheter comprising a light delivery portion at a distal end thereof, and an expandable member located proximal to said light delivery portion.  
     
     
         29 . The catheter of  claim 28  further comprising an optical fiber.  
     
     
         30 . The catheter of  claim 28  wherein said light delivery portion is adapted to transmit energy having a wavelength in the range of 100 to 1100 nm.  
     
     
         31 . The catheter of  claim 28  wherein said light delivery portion is adapted to transmit energy having a wavelength in the range of 400 to 700 nm.  
     
     
         32 . The catheter of  claim 28  wherein said light delivery portion is adapted to transmit energy having a wavelength in the range of 600 to 700 nm.  
     
     
         33 . The catheter of  claim 28  further comprising a second expandable member located distal to said first expandable member and surrounding a substantial portion of said light delivery portion.  
     
     
         34 . The catheter of  claim 28  further comprising a bend in the distal end thereof to facilitate positioning the catheter in the internal vessel.  
     
     
         35 . A method of performing a coronary artery bypass graft procedure on a patient's heart comprising the steps of: 
 forming at least one opening in the patient's chest;    locating a bypass graft vessel to provide an arterial blood supply;    illuminating said bypass graft vessel;    dissecting at least a portion of said bypass graft vessel;    transecting a distal end portion of said bypass graft vessel; and    connecting said distal end portion of the bypass graft vessel to a coronary artery with said bypass graft vessel in fluid communication with said coronary artery.    
     
     
         36 . The method of  claim 34  wherein said illuminating step comprises inserting a catheter having a light delivery portion into said bypass graft vessel.  
     
     
         37 . The method of  claim 35  wherein said light delivery portion is adapted to deliver light having a wavelength in the range of 100 to 1100 nm.  
     
     
         38 . The method of  claim 35  wherein said light delivery portion is adapted to deliver light having a wavelength in the range of 400 and 700 nm.  
     
     
         39 . The method of  claim 35  wherein said light delivery portion is adapted to deliver light having a wavelength in the range of 600 to 700 nm.  
     
     
         40 . The method of  claim 35  wherein said catheter comprises a balloon and further comprising the step of occluding said bypass graft vessel by inflating the balloon prior to said transecting step.  
     
     
         41 . A system for delivering energy to an internal vessel of a patient comprising: 
 a catheter comprising a flexible, elongated shaft having a proximal end, a distal end, and an energy transmitting diffuser located at the distal end of the shaft; and    a catheter guide having an opening which is sized and dimensioned to permit said catheter to be inserted longitudinally within said guide, said guide being configured for introduction into the peripheral vessel and advancement to said internal vessel to facilitate delivery of said catheter into said internal vessel.    
     
     
         42 . The system of claim  40  further comprising a guidewire adapted to extend through a longitudinal opening within the catheter guide.