Method and apparatus for positioning a catheter relative to an anatomical junction

Abstract

An electrode catheter is introduced into a vein or other hollow anatomical structure, and is positioned at a treatment: site within the structure. The end of the catheter is positioned near a junction formed in the structure. This junction can be the sapheno-femoral junction. The position of the catheter near the junction is determined based on a signal from a device associated with the catheter within the structure. A fiber optic filament which emits light is used with the catheter or a guide wire over which the catheter is advanced. The light is visible externally from the patient. The light dims and may no longer externally visible at the sapheno-femoral junction where the catheter moves past the deep fascia and toward the deep venous system. The position of the catheter can be determined based on this external observation. The position of the catheter can also be determined based on measured parameters such as temperature or flow rate within the structure, and the measured changes in one or more of these parameters as the catheter nears the junction. The hollow anatomical structure can be compressed for this procedure. The position of the catheter can also be determined mechanically by including a hook-shaped tip on the catheter or guide wire which would physically engage the junction.

1 .- 69 . (canceled) 
     
     
         70 . An apparatus for intraluminal application of therapeutic energy to a target portion of a vein in the deep venous system of a patient, the apparatus comprising:
 an elongate flexible catheter having a working end;   an electrically driven energy application device disposed at the working end of the catheter; and   a light-emitting device disposed at the working end of the catheter and being configured to emit light that is bright enough to be visible externally of the patient when the light-emitting device is located in the deep venous system.   
     
     
         71 . The apparatus of  claim 70 , wherein the catheter has a length sufficient to reach from an access site below a patient's knee to the sapheno-femoral junction. 
     
     
         72 . The apparatus of  claim 70 , wherein the catheter further comprises a guide wire lumen. 
     
     
         73 . The apparatus of  claim 70 , wherein the energy application device comprises a resistive coil. 
     
     
         74 . The apparatus of  claim 70 , further comprising a power source electrically coupled to the electrically driven energy application device. 
     
     
         75 . The apparatus of  claim 70 , further comprising a temperature sensor disposed at the working end of the catheter. 
     
     
         76 . The apparatus of  claim 70 , wherein the light-emitting device is configured to emit light in a radial fashion to facilitate external visualization of the light-emitting device. 
     
     
         77 . The apparatus of  claim 70 , wherein the light-emitting device is an integrated part of the catheter. 
     
     
         78 . An apparatus for treating a target portion of a hollow anatomical structure of a patient, the apparatus comprising:
 an elongate flexible catheter having a distal end and a length sufficient to reach from an access site below the patient's knee to a junction located above the patient's knee;   a thermal energy-producing device coupled to the distal end of the catheter; and   a visual feedback-producing device coupled to the distal end of the catheter, the visual feedback-producing device being distinct from the thermal energy-producing device.   
     
     
         79 . The apparatus of  claim 78 , wherein the junction is the sapheno-femoral junction. 
     
     
         80 . The apparatus of  claim 78 , wherein the catheter further comprises a guide wire lumen. 
     
     
         81 . The apparatus of  claim 78 , wherein the thermal energy-producing device comprises a resistive coil. 
     
     
         82 . The apparatus of  claim 78 , further comprising a power source electrically coupled to the thermal energy-producing device. 
     
     
         83 . The apparatus of  claim 78 , further comprising a temperature sensor disposed at the working end of the catheter. 
     
     
         84 . The apparatus of  claim 78 , wherein the visual feedback-producing device is configured to emit light in a radial fashion to facilitate external visualization of the visual feedback-producing device. 
     
     
         85 . The apparatus of  claim 78 , wherein the visual feedback-producing device is configured to emit light that is bright enough to be visible externally from the patient to thereby provide visual feedback to allow an operator to monitor the progress and location of the visual feedback-producing device in the patient. 
     
     
         86 . An apparatus for intraluminal application of heat to a target portion of a hollow anatomical structure, the apparatus comprising:
 an elongate flexible catheter having a working end;   a resistive coil disposed at the working end of the catheter, the resistive coil being configured to receive electric current from a power source and produce the heat to treat the target portion; and   a light-emitting device disposed at the working end of the catheter.   
     
     
         87 . The apparatus of  claim 86 , wherein the catheter further comprises a guide wire lumen. 
     
     
         88 . The apparatus of  claim 86 , further comprising a temperature sensor disposed at the working end of the catheter. 
     
     
         89 . The apparatus of  claim 86 , wherein the visual feedback-producing device is configured to emit light in a radial fashion to facilitate external visualization of the visual feedback-producing device. 
     
     
         90 . The apparatus of  claim 86 , wherein the visual feedback-producing device is configured to emit light that is bright enough to be visible externally from the patient to thereby provide visual feedback to allow an operator to monitor the progress and location of the visual feedback-producing device in the patient.