An apparatus and method for creating
drug-filled pockets within
muscle tissue, such as myocardium of the heart for increasing
angiogenesis. More particularly, the apparatus has an excising
assembly with a
dilator tip for penetrating and advancing through the surface and body of a
muscle or organ, such as the heart. Preferably, the
dilator tip has a low level
laser optical fiber emission to ease the passage of the excising
assembly and provide
thermal damage which also stimulates
angiogenesis. More preferably, the
dilator tip also disperses a pharmacologically active substance as the apparatus is passed through the tissue and / or creates pockets. The excising
assembly is connected to a hand-held control device from which the operator pushes a switch to activate a
punching mechanism within the excising assembly. The
punching mechanism cuts a discrete piece of
muscle tissue and traps it within the excising assembly leaving a pocket in the remaining
muscle tissue. The excising assembly may also optionally release a bolus of the pharmacologically active substance into the pocket so created. Most preferably, there is a timing mechanism to measure the contraction of the heart, and the timing mechanism is synchronized with the operator's switch on the hand-held device to ensure that the
punching occurs at maximum contraction of
systole. A measurement guide determines how much excised tissue is trapped in the reservoir of the excising assembly. At a threshold level of filling, the surgeon will remove the excising assembly from the hand-held control device and open the punching mechanism for release of tissue. More preferably, the threshold level of filling will automatically turn off the switch to the punching mechanism to indicate to the surgeon the need to empty the excising assembly of tissue.