DE10239950B3 - Application catheter for laser light used for tumor treatment with axial adjustment of light conductor for allowing treatment of adjacent areas of tumor for single catheter insertion - Google Patents

Abstract

Catheter (1) has light conductor (2) for laser light output over part of its length at its distal end (3). Catheter sleeve (4) encloses light conductor and is transparent in light output range and made of flexible or rigid material, with connection for cooling fluid circulated through sleeve interior during operation. Light conductor is coupled to axially adjustable slider (5) to adjust axial position of light conductor.

Description

The invention relates to an application catheter for laser light for treating tumors with a light guide for the laser light, the light emitting in its distal end portion over a portion of its length is, and with a liquid-tight or liquid donating sheath catheter for this light guide, which at least in the light-emitting region of the light guide translucent is, wherein the sheath catheter made of flexible or rigid material and at least one Connection for one while him of use flowing through coolant has and the light guide with its light-emitting end inside a defined position relative to the distal end of the tunneled catheter has, wherein the optical fiber axially adjustable within the tunneled catheter is and the duct catheter at least over at the distal end such a length translucent is that the light emitting end portion of the light guide also in axially recessed Position within the translucent area of the tunneled catheter is arranged.

Such a laser application catheter is for example off DE 197 02 898 A1 or off US Pat. No. 6,283,958 B1 known. After insertion of this catheter into a tumor located inside the human body, for example in the liver, this tumor can be treated with laser light from inside and coagulated. If the tumor is larger and significantly larger than the light-emitting length of the light guide, the application catheter must be introduced several times into this tumor and this treated at different locations. The duration of surgery is correspondingly long, and the entire treatment is correspondingly difficult.

From the practice is an initially defined laser application catheter known, in which the axial adjustability of the light guide offers the possibility when in a supplied and ingested location fixed application catheter larger tumors to treat without delocalization, by first a first tumor area and after the axial displacement of the light guide, an adjacent area This tumor can be treated. This adjustment of the light guide However, in the known device by the surgeon by feel or with Help be carried out by himself applied marks. Unfavorable is doing that the light guide in the different adjustment positions is held insufficient, so unintentionally moved again and perhaps shifted back to an already treated part of the tumor could be so that it could come to too strong Gewebeverbrennungen there. Becomes the light guide, however, in an opposite direction too far adjusted, can Parts of the tumor tissue remain untreated or possibly even accidentally healthy tissue or non-translucent insertion aids be exposed to laser light and destroyed.

Out EP 0 801 928 A1 is a laser device, so an application catheter for laser light, known for transmyocardial revascularization. The housing held by the user is connected to the distal head via a neck member, comparable to the sheath catheter. An optical fiber bundle, that is to say a light guide whose proximal end is connected to the laser light source, extends through the housing and through the neck element or through the enveloping catheter to the distal end element.

In the housing, the fiber bundle with connected to a moveable selector, which is located outside from the case extends and is connected to a control means which with the thumb can be operated by the user. Thus causes this operation of the control by the surgeon movement of the distal End of the fiber bundle over the distal head element of the neck element addition. The light guide is that is, with an axially adjustable in the proximal region of the tunneled catheter Slider connected and the slider is to the adjustment of the light guide adjustable in the axial direction relative to the tunneled catheter.

From a vacuum source goes one Vacuum line connected to the barbed inlet in the housing which is with an air passage around the fiber bundle around communicates so that one Suction on the distal head element of the device is made possible which fulfills two important functions. On the one hand, the suction force pulls the epicardial tissue firmly against the contact area of the distal header so that a relatively small opening in muscle fibers can be formed to enable that this distal end of the fiber bundle penetrates the myocardium and intervenes in this.

While the fiber bundle through the user the epicard opening is advanced through and into the myocardium, become laser pulses generated from its distal end to a channel through the myocardium train.

On the other hand, if the advancement of the fiber bundle continues, the air evacuation provided helps to remove particles caused by the laser and also to draw blood into the channel to ensure that the revascularization begins properly. When the fiber bundle is retracted after the formation of a channel, the distal end member can be moved away, and the opening in the epicardium closes naturally. However, a flow through the neck member corresponding to the tunneling catheter with a cooling fluid is in EP 0 801 928 A1 not revealed.

It is therefore the task, a To create application catheter of the type defined in, at which retains the advantage that by a veschiebbaren Light guide the treatment of larger tumors is feasible, without to delocalize the application catheter, with which but at the same time unwanted or uncontrolled or inaccurate displacements of the Light guide and its light emitting area can be avoided can.

To solve this problem is the Initially defined application catheter characterized in that that the light guide with a in the proximal region of the tunneled catheter axially adjustable slide is connected, and that the slide relative to the adjustment of the light guide in the axial direction to the duct catheter is adjustable. This will allow the user or operator to locate preferred positions of the light guide within the tunneled catheter while facilitates a treatment. Thus, a tumor can be treated easily which are much larger than the light-emitting area of the light guide is without displacing the application catheter to have to, by the slide can be moved axially in a targeted manner, whereby the associated light guide adjusted accordingly becomes.

For example, a first laser irradiation inside a tumor with a light guide in a forward Position take place, in which its light-emitting area of the distal end of the duct catheter preferably is close, but still with coolant is charged. After laser irradiation can then the Slide and thus the light guide within the tunneled catheter, whose positioning in the tumor remains unchanged to a certain Way retired which can be re-lasered. Such additive velvet necrosis has an elongated shape and can, for example twice as long as the light-emitting area of the light guide his. In this case, such a withdrawal movement be repeated several times on the slide, however, in the majority of cases be a one-off or retreat if necessary twice.

It is particularly useful if the Slide and thus the light guide within the tunneled catheter adjustable between two axially spaced end positions and in particular at least in these end positions relative to the tunneled catheter solvable is determinable. This makes it easier for the surgeon to find more preferable Positions of the light guide within the tunneled catheter during a Treatment.

A further advantageous embodiment The invention can provide that the slider and thus the light guide in at least one intermediate position between its end positions usable and in particular solvable is definable and that the distance between the distal end position and at least the adjacent intermediate position and / or the other End position of the length of the light-emitting area approximately corresponds, so that by axial Adjustment of the light guide Laser light applications without gaps Continuing to perform successively are.

The distances of the respective preferred positions of the light guide can ie the length of the light emitting area such that an adjustment the slider and the light guide by such a length to one seamless Exposing the interior of the tumor with laser light leads and the individual treatment steps continue and complete. is However, the light-emitting area longer than such individual steps or shorten the User the individual withdrawal steps Of the light guide, he can also multiply certain areas of a tumor treat, for example, the border area once and the neighboring, closer to the interior of the tumor Area then after a partial retraction movement again and so on.

The sheath catheter may be proximal End a guide for the Have slider relative to which the slide in the axial direction adjustable, in particular removable and can be inserted. For example could in the inserted position of the slide, in which also the light guide farthest into the duct catheter is inserted and with its light-emitting area the distal end of the duct catheter the next is, a first treatment step and after retraction the slide another treatment step can be performed. Not excluded is a reverse procedure.

It is particularly advantageous if the slide two attacks and the sliding guide corresponding against attacks for limiting the two end positions of the slider and thus of the light guide Has. Thus, the user easily finds the preferred one Positions of the slide and thus also of the light guide.

The stop for the furthest to the distal End of the application catheter shifted light guide can on the sliding sleeve on the outside opposite the Leadership superior Projection or collar, in particular a handle, and the counter stop the Front side of the guide his. This preserves this stopper of the slider a dual function, because he does not only as a stop, but also as a handle for the Opera teur is available at which he can grasp the slider and move it back and forth. The counter-attack is thus at one of the guide sleeve in each Trap towering Spool piece.

The trained as a sleeve guide can on the inside at the proximal end of a constriction, in particular a firmly inserted inner ring or the like and the slider at its distal End have a cross-sectional enlargement, for example in the form of a collar or collar, have, which strikes on the inner side of the constriction during retraction of the slider. This can be prevented at the same time that the slide is unintentionally pulled out of serving for his leadership sleeve.

At least for the end positions of the light guide can Latching provided with the Hüllkatheter his. This will be for the user finding and maintaining these end positions relieved, leaving these end positions as preferred positions for laser light applications can be used.

The snap-in connections for detachable fixing the end positions of the light guide can be within the guide sleeve between be provided this and the slide, since the light guide with the slide is firmly connected.

For example, the slider at its distal end an annular groove and in a radially something compliant ring, such as an O-ring, and the guide inside have at least two annular grooves into which the ring in particular engages or locks in the two end positions.

In addition or instead of the slider detent openings or Rastnuten and the leadership one matching catch body or latching ring and in particular may be a sealing ring between Slider and guide be provided. Also in this way, the preferred positions of the Slider inside the guide and thus the optical fiber within the tunneled catheter noticeably reached and while the treatment can also be sufficiently defined.

Between the end positions of the light guide can at least one intermediate position for the light guide in particular solvable be provided latchable, being within the leadership between the ring grooves for the end positions at least one further annular groove for an intermediate position can be provided. By choosing the distances of the individual annular grooves can So the different preferred positions of the light guide be given, so that a user can also make several sliding or retreating movements to apply the laser light in different positions without change the location of the duct catheter can perform.

To couple the slider with the Optical fiber can be connected to the over the proximal end of the slider or an inner longitudinal cavity of the Slider protruding portion of the light guide a stop projection attached at a defined distance to the distal end of the light guide, for Example glued, clamped or crimped, be that at axial Plant on the slide with this and the light guide in common is axially adjustable. The specified distance of the stop projection to distal end of the optical fiber or the photoconductive fiber chosen so that the position of the end of the light-conducting fiber or the Light guide in the tunneled catheter as far as possible in front in the distal end of the Hüllka theter is arranged, in a closed embodiment of the tunneled catheter but from this end so far remains that a sufficient or unrestrained coolant flow guaranteed especially stays around the distal end. If necessary, can be also provided with such a stop projection provided light guide on a gland catheter do not use a slider for has an axial adjustment of the light guide, because then the light guide in any case and without much effort for the user the optimal - fixed - position within the duct catheter gets without the user having to search this position for a long time.

The distance to the distal end the light guide attached to this stop projection can with the sliding sleeve in the axial direction positively and / or non-positively connected - for example via a or several threads - verschraubar or be releasably coupled by means of bayonet lock. Thus can the optical fiber or the conductive fiber with her Stop projection inserted after positioning the tunneled catheter in this and connected to the slider, after which the application catheter for the Use is ready while the axial adjustment of the light guide for one after another to be performed Treatments within the same tumor without changing the location of the application catheter is feasible.

A particularly favorable embodiment of the invention can thereby insist that with the light-conducting fiber before the stopper projection connected to the proximal end of the slider a stop cap with a conically projecting in the axial direction Stop is and that the slide one to this projecting conical stop has matching nut cone. This will at the same time, that the stop cap with the conical stop and the passage opening for the photoconductive Fiber seals, and in addition prevents the light-conducting fiber or the Light guide from the desired Position slips.

As a stopper projection or stopper cap, a Luer connection may be provided, which adjacent to its projecting cone has a lock, for example a threaded portion, which fits to a corresponding locking portion or thread at the front end of the slider. Thus, a commercial part can be used with its advantages to connect the photoconductive fiber or the light guide to the slider, while creating a seal and a releasable coupling and to be a defined position of the light emitting tip within the Hüllkatheters work without the user having to search for this optimal location.

The slider itself can be inside his leadership be sealed, in particular the locking or O-ring simultaneously a sealing ring can be. This ensures that the coolant is not at the proximal end of the tunneled catheter can escape in the area of the slide.

Especially when combining individual or more of the features and measures described above may be elongated with a position of the laser delivery catheter Coagulation necrosis can be generated, which has a significantly greater length than the light-emitting area of the light guide has, the position the application catheter or belonging to him encasing catheter unchanged can stay because of the light guide in a defined manner within of the sheath catheter axially is adjustable. The light-emitting length of the Lichtlei age can therefore several times in complementary sections be used so that a correspondingly larger tumor can be treated can. At the same time, the application catheter can be rinsed and cooled, because he sealed in spite of the displacement in a simple manner can be. over the length of the withdrawn pusher, whether it is inside the ducted catheter, it may be that he is outside at a guided tour adjustable, the user also has a simple way information about the position of the light guide or the light-conducting Fiber inside the sheath catheter. About the Rasterierung he has additional, tactile information and can thereby fix preferred positions.

It should be noted that the application catheter and the duct catheter flexible, but can be rigid.

Below is an embodiment the invention described in more detail with reference to the drawing. It shows in partly schematized representation:

1 a longitudinal section of an application catheter with tunneled catheter and light-conducting fiber or light guide, said light-conducting fiber is only partially inserted and not yet finally mounted,

2 one of the 1 corresponding representation after final assembly, in which the photoconductive fiber is coupled by means of a Luer connector attached to it with a sliding sleeve, wherein the sliding sleeve and thus the light-conducting fiber are in a forward end position,

3 a representation according to 2 after a retraction of the light guide by an example, the length of the light emitting region of the light guide corresponding amount and

4 a representation according to 2 and 3 , wherein the light guide relative to the position according to 2 is axially moved back by two lengths of its light emitting area in a retracted end position.

A generally designated 1 usually flexible, but possibly also rigid application catheter for laser light is used to treat tumors and has a light guide 2 consisting of a photoconductive fiber, for the laser light on, in its distal end region 3 light-emitting over part of its length. To the application catheter 1 further includes a sheath catheter 4 for the light guide 2 and you recognize in the 1 to 4 clearly, as the light guide 2 inside this tunneled catheter 4 is arranged. Here is the tunneled catheter 4 at least in the light-emitting region of the light guide 2 translucent, being in known, in the FIG. not shown manner has connections and guides for him to flow through during use of cooling liquid inside the tunneled catheter 4 can circulate, as for example in the US patent 6,283,958 B1 . 7 and 8th is shown.

According to 2 has the light guide 2 with its light-emitting end 3 inside of the distal end of the tunneled catheter 4 in the position of use a sufficient cooling permitting clearance A.

Especially when comparing the 2 to 4 it becomes clear that the light guide 2 within the duct catheter 4 is axially adjustable, so that is the light-emitting end 3 different positions within the tunneled catheter 4 can take. As a result, he can with positioned sheath catheter 4 so be made effective in different positions, without the application catheter 1 to reposition. Thus, a correspondingly longer coagulation necrosis without changing the position of the application catheter 1 or his duct catheter 4 can be produced, that is, it can be treated a significantly larger tumor than with an axially non-adjustable light guide 4 the case is.

It is further contemplated that the sheath catheter 4 is translucent at its distal end at least over such a length that the light-emitting end portion 3 of the light guide 2 also in the axially recessed position according to 4 still within this translucent area of the duct catheter 2 is arranged, so his laser light can be emitted to the outside.

2 and 4 show that the light guide 2 within the duct catheter 4 adjustable between two axially spaced end positions and in the embodiment in a manner to be described, at least in these end positions relative to the tunneled catheter 4 is releasably fixed.

It is according to 3 also provided that the light guide 2 in at least one intermediate position between its end positions be is usable, this intermediate position according to 3 exactly half between the two end positions according to 2 and 4 equivalent. It can also this intermediate position according to 3 be releasably fixable in a manner to be described.

The distance between the individual positions of the light guide or its end corresponds to the length of its light-emitting end region 3 , so that by the axial adjustment from the position according to 2 in accordance with 3 and finally in the according 4 Laser light applications can be carried out consecutively without interruption. This treatment could also by a reverse adjustment, starting, for example, from the position according to 4 be performed.

Furthermore, overlapping treatments would also be possible if certain sites within a tumor multiply, other sites but less often or only once with laser light are applied should.

For the above-defined adjustment of the light guide 2 is provided in the embodiment that the light guide 2 with one in the proximal region of the tunneled catheter 4 axially adjustable arranged slide 5 connected to the adjustment path of the light guide in the axial direction relative to the tunneled catheter 4 axially adjustable and movable. One recognizes this again clearly when comparing the 2 . 3 and 4 , the different positions of this slider 5 show, wherein the slider according to 2 pushed in as far as possible, according to 3 pulled out about half of the sliding path axially to the rear and finally according to 4 completely pulled out to the entire displacement.

The duct catheter 4 has at its proximal end a guide 6 for the slider 5 on, relative to which the slider 5 in the manner described in the axial direction adjustable, namely pulled out and inserted.

Here are the slider 5 two stops and the sliding guide 6 corresponding counter stops for limiting the two end positions of the slider 5 and thus that of the light guide 2 ,

The stop for the furthest to the distal end of the application catheter 1 or the duct catheter 4 shifted position of the light guide 2 is in the embodiment a on the sliding sleeve 5 on the outside opposite the guide 6 outstanding advantage 7 or collar, which also serves as a handle in the embodiment and thus greatly facilitates the handling of the user. The counter-attack is according to 2 the proximal end of the guide 6 to which this projection or the handle 7 can be moved. In addition or instead, but could also the distal end of the slider 5 at the end of the guide 6 come to the inside to the plant.

The trained as a sleeve guide 6 also has on the inside at its proximal end a constriction, which in the embodiment, a firmly inserted inner ring 8th is, and the slider 5 has a cross-sectional enlargement at its distal end 9 which is a collar or a collar in the embodiment. When retracting the slide, this cross-sectional enlargement 9 inside the constriction or the inner ring 8th strike, so that thereby the second stop and counter stop are formed, as in 4 is clearly shown.

In addition, locking connections are provided with the Hüllkatheter for these end positions of the light guide, said detent connections for determining the end positions of the Lichtlei age 2 within the guide sleeve 6 between this and the slider 5 are provided. The slider 5 has at its distal end one at the cross-sectional enlargement 9 circumferential annular groove and therein a radially slightly protruding and yielding ring 10 For example, an O-ring, and the guide 6 has inside groove-shaped annular grooves 11 into which the ring 10 fits and engages in the respective preferred position and locks, for example according to 2 and 4 in the two end positions.

Furthermore, between the end positions of the light guide 2 provided in the exemplary embodiment, an intermediate position for the light guide, which is also releasably latched by within the guide 6 between the annular grooves 11 for the end positions another ring groove 11 is intended for an intermediate position in 3 shown in use and in 4 is particularly clear.

In 4 is also shown that the distal end of the ducted catheter 4 can also be open, so that at the open end of the cooling liquid can flow.

So with the help of the slider 5 the light guide 2 can be adjusted axially in the manner already described, he is with the slide 5 coupled. To couple the slider 5 with the light guide 2 is in the embodiment at the over the proximal end of the slider 5 or one inside this slider 5 located, continuous inner longitudinal cavity 5a protruding portion of the light guide 2 a stop projection 12 with a defined distance to the distal end of the light guide 2 attached, for example, clamped or crimped. For axial abutment of this stop projection 12 at the proximal end of the slider 5 So it's the slider 5 with this stop jump 12 and therefore also with the light guide 2 together axially adjustable. The distance at a defined distance to the distal end of the light guide 2 at this fixed stop projection 12 is with the slider 5 in the axial direction positively and / or non-positively connected and can for example via a or screwed several threads or coupled by means of bayonet - even releasably - be coupled.

Especially in 1 It is good to see that with the light-conducting fiber 2 in front of the proximal end of the slider 5 connected stop tab 12 a stop cap with an axially projecting conical stop 13 is and that the slider 5 one to this projecting conical stop 13 matching receiving or parent cone 14 having. In accordance with 2 connected position results in not only a defined stop position, but at the same time thereby the rear end of the slider 5 sealed liquid-tight, so that no coolant through the inner longitudinal cavity 5a of the slide can escape. The duct catheter 4 This way, at the same time at the end of the guide 6 and the slider 5 sealed, including the slider 5 within the leadership 6 characterized in that the latching or O-ring 10 at the same time an inside with the guide 6 cooperating sealing ring is.

As in the embodiment as a stop projection 12 or stopper cap a Luer connector is shown, which is adjacent to its projecting cone 13 a lock, for example a threaded portion, which leads to a corresponding locking portion 15 or thread on the front end of the slide 5 fits, and such Luer connections are known, whose attachment to the slider in the drawings is not shown in detail.

The application catheter 1 For treating tumors with laser light may be rigid or flexible and has a light guide 2 for this laser light on, at its distal end 3 light-emitting over part of its length. This light guide 2 is in a liquid-tight ( 1 to 3 ) or liquid-emitting ( 4 ) Envelope catheter 4 arranged, which at least in the light-emitting region of the light guide 2 is translucent. Furthermore, the light guide 2 within the duct catheter 4 with the help of a guided and displaceable in the Hüllkatheter slide 5 axially adjustable and the ducted catheter 4 at its distal end at least over such a length translucent that the light-emitting end portion 3 of the light guide 2 in its various axial positions, even in the most axially retracted position, remains disposed within this translucent region, that is to say it can take effect, so that a longer coagulation necrosis can be produced than the length of the light-emitting end 3 of the light guide 2 equivalent.

The above-described application catheter 1 provides for the user and for the patient with simplified handling by defined positions of the end positions of the light guide 2 within the duct catheter 4 greater safety in the treatment of a tumor. Above all, it opens up the possibility of avoiding in practice previously occurring dangerous situations.

Claims (17)

Application catheter ( 1 ) for laser light for treating tumors with a light guide ( 2 ) for the laser light, which in its distal end region ( 3 ) over one. Part of its length is light-emitting, and with a liquid-tight or liquid-emitting sheath catheter ( 4 ) for this light guide ( 2 ), which at least in the light-emitting region of the light guide ( 2 ) translucent, wherein the sheath catheter ( 4 ) consists of flexible or rigid material and has at least one connection for a coolant flowing through it during use and the optical fiber ( 2 ) with its light-emitting end ( 3 ) inside a defined position relative to the distal end of the tunneled catheter ( 4 ), wherein the optical fiber ( 2 ) within the tunneled catheter ( 4 ) is axially adjustable and the tunneled catheter ( 4 ) at the distal end is translucent at least over such a length that the light-emitting end region ( 3 ) of the light guide ( 2 ) also in axially recessed position within the translucent region of the tunneled catheter ( 4 ), characterized in that the light guide ( 2 ) with one in the proximal region of the tunneled catheter ( 4 ) axially adjustable slide ( 5 ) is connected and that the slider to the adjustment of the light guide ( 2 ) in the axial direction relative to the tunneled catheter ( 4 ) is adjustable. Application catheter according to claim 1, characterized in that the slide ( 5 ) and thus the light guide ( 2 ) within the tunneled catheter ( 4 ) adjustable between two axially spaced end positions and in particular at least in these end positions relative to the tunneled catheter ( 4 ) is releasably fixable. Application catheter according to claim 1 or 2, characterized in that the slide ( 5 ) and thus the light guide ( 2 ) is usable in at least one intermediate position between its end positions and in particular detachably fixable and that the distance between the distal end position and at least the adjacent intermediate position and / or the other end position of the length of the light emitting end portion ( 3 ) corresponds approximately, so that laser light applications can be successively carried out consecutively without interruption by axial adjustment of the light guide. Application catheter according to one of claims 1 to 3, characterized in that the sheath catheter at the proximal end of a guide ( 6 ) for the slider ( 5 ) relative to which of the slides ( 5 ) in the axial direction adjustable, in particular can be pulled out and inserted. Application catheter according to claim 4, characterized in that the slide ( 5 ) two stops and the sliding guide ( 6 ) corresponding counter stops for limiting the two end positions of the slide ( 5 ) and thus the light guide ( 2 ) to have. An application catheter according to claim 5, characterized in that the stop for the furthest to the distal end of the application catheter ( 1 ) shifted position of the light guide ( 2 ) on the sliding sleeve ( 5 ) on the outside opposite the guide ( 6 ) protruding projection ( 7 ) or collar, in particular a handle, and the counter-stop the front side of the guide ( 6 ) are. Application catheter according to one of claims 4 to 6, characterized in that the guide formed as a sleeve ( 6 ) inside the proximal end of a constriction, in particular a firmly inserted inner ring ( 8th ) or the like and the slider ( 5 ) at its distal end a cross-sectional enlargement ( 9 ), for example in the form of a collar or collar, which has on retraction of the slider inside of the constriction ( 8th ) strikes. Application catheter according to one of Claims 1 to 7, characterized that at least for the end positions of the light guide latching connections with the tunneled catheter are provided. Application catheter according to claim 8, characterized in that the latching connections for the determination of the end positions of the light guide ( 2 ) within the guide sleeve ( 6 ) between this and the slider ( 5 ) are provided. Application catheter according to one of claims 1 to 9, characterized in that the slide ( 5 ) at its distal end an annular groove and therein a radially somewhat yielding ring ( 10 ), such as an O-ring, and the guide ( 6 ) inside at least two annular grooves ( 11 ) into which the ring ( 10 ) engages in particular in the two end positions. Application catheter according to one of claims 8 to 10, characterized in that the slide ( 5 ) Locking openings or locking grooves and the guide have a mating latching body or locking ring and that in particular an effective between the guide and slide sealing ring is provided. Application catheter according to one of claims 8 to 11, characterized in that between the end positions of the light guide ( 2 ) at least one intermediate position for the light guide is provided in particular detachably latchable, wherein within the guide ( 6 ) between the annular grooves ( 11 ) for the end positions at least one further annular groove ( 11 ) is provided for an intermediate position. Application catheter according to one of the preceding claims, characterized in that for coupling the slide ( 5 ) with the light guide ( 2 ) at the over the proximal end of the slide ( 5 ) or an inner longitudinal cavity ( 5a ) of the slider ( 5 ) projecting portion of the light guide ( 2 ) a stop projection ( 12 ) at a defined distance from the distal end of the light guide ( 2 ), for example, glued, clamped or crimped, which in axial contact with the slide ( 5 ) with this and the light guide ( 2 ) is axially adjustable together. An application catheter according to claim 13, characterized in that the defined distance to the distal end of the light guide ( 2 ) on this fixed stop projection ( 12 ) with the slider ( 5 ) in the axial direction positively and / or non-positively connected, for example - via one or more threads - screwed or detachably coupled by means of bayonet lock. Application catheter according to claim 13 or 14, characterized in that the light-conducting fiber ( 2 ) in front of the proximal end of the slider ( 5 ) associated stop projection ( 12 ) a stop cap with an axially projecting conical stop ( 13 ) and that the slider ( 5 ) one to this projecting conical stop ( 13 ) matching parent cone ( 14 ) having. Application catheter according to one of claims 13 to 15, characterized in that as abutment projection ( 12 ) or stopper cap a Luer connection is provided, which adjacent to its projecting cone ( 13 ) has a locking, for example a threaded portion, which leads to a corresponding locking portion ( 15 ) or thread at the front end of the slide ( 5 ) fits. Application catheter according to one of claims 1 to 16, characterized in that the slide ( 5 ) within his leadership ( 6 ), wherein in particular the latching or O-ring ( 10 ) is a sealing ring at the same time.