Abstract: A torque mechanism for interventional catheters provides direct control over rotary positioning of the distal end of a catheter by rotating a proximal handle of the catheter. The torque mechanism comprises a stiff tube within and running the length of a flexible catheter body tube. The stiff tube is bonded at its distal end to the catheter body tubing and at its proximal end to a rotary handle. Catheter body tubing is bonded at its proximal end to a catheter hub. The catheter hub and rotary handle rotate independently, thus torque and position are transmitted by the torque tube while the catheter tube acts as a torsional spring.

Abstract: Methods and systems for treating patients suffering from or at risk of cardiac arrhythmias rely on the injection of amiodarone and other class III anti-arrhythmic drugs into the perivascular space surrounding a cardiac blood vessel. Injection may be achieved using intravascular catheters which advance needles radially outward from a blood vessel lumen or by transmyocardial injection from an epicardial surface of the heart.

Abstract: Methods and systems for regenerating damaged tissue rely on direct injection of selected therapeutic cells into a tissue at or near the site of tissue damage. Direct injection is accomplished using an intravascular catheter having a deployable needle, and injection is usually targeted into the adventitial and peri-adventitial tissues surrounding the blood vessel from which the needle is deployed.

Abstract: A needle injection catheter comprises a catheter body having an axially disposed needle near its distal end. The needle passes through a deflection path formed in a distal nose of the catheter. A deflection path typically comprises a 90° turn so that the axially disposed needle can be deflected laterally for advancement into surrounding tissue. Usually, a hydraulic or other driver will be provided in the distal end of the catheter in order to advance the needle and cause deflection.

Abstract: Methods and systems for inhibiting neointimal hyperplasia and treating vulnerable plaque comprise direct needle injection of estrogen into a perivascular space or adventitial tissue.

Abstract: Methods and kits for delivering pharmaceutical agents to the adventitia and other regions outside the external elastic lamina (EEL) surrounding a blood vessel utilize a catheter having a needle. The needle is positioned in up to 5 mm beyond the EEL and delivers an amount of pharmaceutical agent sufficient to circumferentially permeate around the blood vessel and, in many cases, extend longitudinally and radially along the blood vessel. Confirmation that a delivery aperture of the needle lies beyond the EEL may be required before delivering the pharmaceutical agent.

Abstract: Methods, systems, and apparatus for delivering drugs and other substances to extraluminal tissue surrounding a body lumen are described. Catheters are used to inject the drug or other substance intraluminally into tissue surrounding a stent or other luminal scaffold. The drug or other substance is injected in an amount sufficient to cause diffusion back through the tissue to the stent. An absorptive structure, reservoir, or the like, on the stent then absorbs excess drug as it passes from the luminal tissue. In this way, the stent is first loaded with drug. After time, as the stent becomes fully loaded and the tissue becomes depleted, drug will be begin to flow back from the stent into the surrounding luminal tissue.

Abstract: An aspiration baffle comprises an outer tube and an inner core wire. Microholes are provided in the outer tubular member to permit passage of gas but inhibit the passage of liquids. The aspiration baffle is used in a catheter having a balloon or other inflatable structure to assist in priming of the structure. After evacuating the inflatable structure by applying a vacuum, the aspiration baffle can collect and trap residual gas which remains during the priming of the inflatable structure.

Abstract: Tubular catheters having two or more axially adjacent segments are reinforced by encapsulation in a polymeric layer which provides enhanced tensile strength. Exemplary polymers include parylene, silicone, PTFE, PVDF and the like. The layers are preferably vapor coated to thicknesses of 100 &mgr;m or below. Specific rapid exchange and needle injection embodiments are illustrated.

Abstract: Methods and kits for delivering pharmaceutical agents to the adventitia surrounding a blood vessel utilize a catheter having a microneedle. The microneedle is positioned in the perivascular space and delivers an amount of pharmaceutical agent sufficient to circumferentially permeate around the blood vessel and, in many cases, extend longitudinally along the blood vessel and in some cases to the adventitia surrounding other blood vessels.

Abstract: Electroporation of cells in target tissues is performed using microneedles having integral electrode structures. In a first embodiment, a pair of electrode structures are disposed on opposite sides of a substance delivery opening on a needle or other tissue-penetrating shaft. In a second embodiment, a first electrode structure is disposed on the needle and a second electrode structure is disposed on an attached base. The electrode structures are spaced closely together and relatively low voltages are applied to achieve electroporation-enhanced substance delivery.