What if we could clear atherosclerotic plaque in coronary arteries without requiring stents? Laser angioplasty offers such possibility or reducing trauma, cost and risks. Surgeons already use lasers equipped with radial emission optical fibers within arteries and veins to coagulate varicose venous segments for absorption and clear atherosclerosis in peripheral arteries, but existing fibers are too large and produce emission profiles insufficiently precise for coronary artery clearance.

The current technique of balloon angioplasty damages the artery wall; the artery is stretched and torn in displacing the plaque using the radial force of an inflating balloon. Torn arteries can stimulate clotting and produce a blockage that is worse than the original so stents ar placed to prop the artery open. Post operative clotting remains a threat because stents themselves can stimulate clotting, so anticoagulant coatings are applied to the stents and blood thinners are often prescribed: bandaids on bandaids. A small, flexible and highly efficient radial emitting laser fiber could vaporize or melt plaque without damaging the artery, obviating post-operative stents and anticoagulants. That fiber is HaloFiber™.

Optical fibers that deliver laser power to the lumen of the vessel typically emit energy about the circumference of the fiber but, owing to limitations imposed by Snell’s Law, the light emitted is in the shape of a hollow cone that is tilted forward, i.e., the emission is not at right angles to the fiber axis. Such non-orthogonal emission results in an uneven ring of illumination where the more distant targeted tissue receives reduced laser power density, less than is required to achieve the therapeutic result. Such inefficiencies prolong surgery and may overheat the treatment area. Inefficiencies lead to complications, a fundamental reason that such optical fibers are not used in treating coronary arteries.

HaloFiber™ corrects this inefficiency through use of micro-optical elements that efficiently redirect axial laser energy at right angles. HaloFiber produces a truly orthogonal emission band; a single, uniform band of light that may be precisely directed at plaque to the arterial wall. With total working tip diameter of under a millimeter and based upon a flexible, 0.4 mm optical fiber diameter, HaloFiber can reach any stricture that is accessible to balloons.