Abstract: A lead delivery system for implanting a lead in a patient's internal jugular vein (IJV) through a subclavian vein. The system comprises an outer catheter having a distal portion, an intermediate portion, and a proximal portion. The outer catheter defines a lumen extending through the proximal portion to a side port located on the intermediate portion. The distal portion includes a support region for leveraging against a wall of a superior vena cava (SVC) of the patient. An inner catheter is sized to slide within the lumen and out the side port. The inner catheter includes a distal curve configured to facilitate access to the internal jugular vein. A guidewire is sized to slide within a lumen of the inner catheter. The lumen and side port are configured to direct the inner catheter towards the entrance to the IJV when the outer catheter is inserted with the support region in place against the SVC. Methods of providing access to a patient's internal jugular vein through a subclavian vein.

Abstract: A lead delivery system for delivering a medical electrical lead to an internal jugular vein (IJV) through a subclavian vein. An inner catheter extends from a proximal end to a distal end. The inner catheter includes an inner catheter curve configured to direct the distal end to the IJV when positioned in the subclavian vein. The stiffness of the inner catheter decreases in an inner catheter transition region in a direction from the proximal end to the distal end. An outer catheter extends from a proximal end to a distal end and is sized to slide over the inner catheter. The outer catheter includes an outer catheter curve. The stiffness of the outer catheter decreases in an outer catheter transition region in a direction from the proximal end to the distal end. The system further comprises a guidewire having a distal end and a proximal end.

Abstract: An intravascular lead adapted to be deployed to a stimulation site within a vessel adjacent a nerve to be stimulated includes at least a first electrode adapted to deliver an electrical pulse across a vessel wall. The first electrode includes an electrically active surface having one or more surface features adapted to focus current. The first electrode is disposed on the distal portion that the electrically active surface can be directed towards the nerve to be stimulated.

Abstract: A lead delivery system for delivering a neurostimulation lead to a patient's internal jugular vein using a percutaneous stick. The system comprises a neurostimulation lead adapted to stimulate a vagus nerve from the internal jugular vein. The lead includes a proximal end, a distal end, a generally spiral shaped retaining structure interposed between the proximal and distal ends and configured to retain the lead in the internal jugular vein, an electrode coupled to the retaining structure, and a side port interposed between the retaining structure and the proximal end. The side port provides access to a lumen extending from the distal end to the side port. A guidewire is sized to fit within the side port and lumen and reduce a force exerted by the retaining structure against the internal jugular vein, thereby allowing rotation of the lead and orientation of the electrode by applying a torque to the lead.

Abstract: A medical electrical lead for transvascularly stimulating a nerve, muscle or other tissue from an adjacent vessel is described. The lead includes an expandable distal portion having one or more spirals for securing and stabilizing the lead within the vessel.

Abstract: A neuron stimulating lead having a stent-like anchor is described. A distal portion of the lead is mounted to an exterior of the lead anchor. The stent-like lead anchor is formed from a superelastic material and is adapted to transition from a collapsed configuration to an expanded configuration upon deployment in a vessel. In the expanded configuration, the lead anchor presses the distal portion of the lead against at least one vessel wall of a vessel in which the lead is deployed securing and stabilizing the distal portion of the lead within the vessel.

Abstract: A medical electrical lead for implantation in a patient's internal jugular vein at a target location and adjacent a vagus nerve. The lead comprises a proximal region having a proximal stiffness and a distal region. The distal region has a distal stiffness and a first spiral configured to retain the distal region in the internal jugular vein. A transition region is interposed between the proximal and distal regions and has a transitional stiffness. An electrode is coupled to the distal region. The proximal stiffness is less than the distal stiffness so as to reduce an amount of force transferred from the proximal region to the distal region. The transitional stiffness is less than the distal stiffness and greater than the proximal stiffness.

Abstract: A delivery catheter that includes a flexible shaft having a proximal end and a distal end, the distal end having an outer diameter less than about 13 mm; a delivery lumen having a proximal end and a distal end, the delivery lumen within the flexible shaft, the delivery lumen having at least an outlet port or at least one side hole at the distal end of the delivery lumen, the delivery lumen having a cross-sectional area at least about 5 mm2; a pressure monitoring lumen having a proximal end and a distal end, the pressure monitoring lumen within the flexible shaft; a pressure port adjacent to and connected to the distal end of the pressure monitoring lumen; a balloon inflation lumen having a proximal end and a distal end, the balloon inflation lumen within the flexible shaft; a soft tip at the distal end of the flexible shaft; a balloon at the distal end of the flexible shaft, the balloon connected to the distal end of the balloon inflation lumen, the balloon includes at least one of the following materials, po

Abstract: A new and versatile ultra-miniature pressure sensor comprises a very thin diaphragm of approximately one micron or less, e.g., 0.2 microns. In some embodiments, the diaphragm has a radius of 20 microns and the pressure sensor can detect signals at or near 0.1 Atm with 1% accuracy. The diaphragm is formed by epitaxial growth of silicon or by bonding and etching. A plurality of high sensitivity piezoresistive strain gauges measure strain of the diaphragm. Less than 0.1 microns thick, the piezoresistive strain gauges are embedded in the diaphragm by ion implantation or formed thereon by epitaxial growth. The ability to form ultra-thin piezoresistive layers on very thin diaphragms enables the miniaturization of the pressure sensor as well as any device that employs it.

Abstract: A delivery catheter that includes a flexible shaft having a proximal end and a distal end, the distal end having an outer diameter less than about 13 mm; a delivery lumen having a proximal end and a distal end, the delivery lumen within the flexible shaft, the delivery lumen having at least an outlet port or at least one side hole at the distal end of the delivery lumen, the delivery lumen having a cross-sectional area at least about 5 mm2; a pressure monitoring lumen having a proximal end and a distal end, the pressure monitoring lumen within the flexible shaft; a pressure port adjacent to and connected to the distal end of the pressure monitoring lumen; a balloon inflation lumen having a proximal end and a distal end, the balloon inflation lumen within the flexible shaft; a soft tip at the distal end of the flexible shaft; a balloon at the distal end of the flexible shaft, the balloon connected to the distal end of the balloon inflation lumen, the balloon includes at least one of the following materials, po