Abstract: Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver treatment in the pericardial space are disclosed. A steerable instrument is advanced transvenously into the right atrium of the heart, and a distal segment is deflected into the right atrial appendage. A fixation catheter is advanced employing the steerable instrument to affix a distal fixation mechanism to the atrial wall. A distal segment of an elongated medical device, e.g., a therapeutic catheter or an electrical medical lead, is advanced through the fixation catheter lumen, through the atrial wall, and into the pericardial space. The steerable guide catheter is removed, and the elongated medical device is coupled to an implantable medical device subcutaneously implanted in the thoracic region. The fixation catheter may be left in place.

Abstract: A medical system for electrical stimulation includes a first column of electrodes, a second column of electrodes, an expandable member disposed between first and second columns, and an expansion mechanism adapted to transmit an externally applied pressure to the expandable member. The pressure expands the expandable member in order to force the first column of electrodes apart from the second column of electrodes. The first and second columns, disposed side-by-side, may be inserted through a percutaneous needle and into a epidural space, alongside a spinal cord; after insertion, the first column may be forced apart from the second column by applying the pressure to the expandable member.

Abstract: A method of delivering therapy to a target site. The method includes (a) obtaining a base image of the target site, (b) injecting a dose of a mix of a therapeutic agent and a contrast agent into a first injection location at the target site via a needle passing through a catheter, (c) collecting sequential fluoroscopic images of a contrast agent dispersion cloud at the first injection location, (d) determining a contrast agent dispersion area from the sequential fluoroscopic images, (e) determining a therapeutic agent dispersion area from the contrast agent dispersion area, (f) marking the therapeutic agent dispersion area on the base image of the target site, and (g) repeating (b) through (f) until the target site is substantially covered with overlapping therapeutic agent dispersion areas corresponding to a plurality of injections at a plurality of injection locations at the target site.

Abstract: Catheter systems including one or more flow restrictors are disclosed. The catheter systems may include two or more delivery branches. The delivery branches may be connected to a supply catheter section using a branching catheter connector that may include one or more flow restrictors. The flow restrictors may include a restrictor body located within a lumen with a channel located between the restrictor body and interior surface of the lumen, the channel restricting flow through the lumen past the flow restrictor. The channel may be defined by a groove formed in the restrictor body and/or the interior surface of the lumen. Methods of providing pressure relief by flowing fluid past a flow restrictor are also disclosed.

Abstract: Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver treatment in the pericardial space are disclosed. A steerable instrument is advanced transvenously into the right atrium of the heart, and a distal segment is deflected into the right atrial appendage. A fixation catheter is advanced employing the steerable instrument to affix a distal fixation mechanism to the atrial wall. A distal segment of an elongated medical device, e.g., a therapeutic catheter or an electrical medical lead, is advanced through the fixation catheter lumen, through the atrial wall, and into the pericardial space. The steerable guide catheter is removed, and the elongated medical device is coupled to an implantable medical device subcutaneously implanted in the thoracic region. The fixation catheter may be left in place.

Abstract: This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

Abstract: This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

Abstract: This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

Abstract: This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

Abstract: A catheter system and method for intracranial infusion of therapeutic substances to a patient. An anchor formed of generally flexible, elastomeric material is used to mount the catheter to the outer surface of the skull of the patient. The anchor has a through hole for receiving the catheter, a channel, extending substantially from the through hole, into which a portion of the catheter may be inserted to retain the portion substantially parallel to the surface of the skull, and at least one flange for engaging the outer surface of the skull. An anchor clip may be provided to engage the anchor adjacent the through hole to further stabilize the catheter.

Abstract: A multilumen catheter having tubings extending into lumens within the catheter. The lumens may be used for blood, drugs or other medicants. The lumens may also be used for sensors. The junction element, external to the patient, connects the tubings to the lumens. The tubings, also external to the patient, connect to infusion members, to which one or more infusion systems may be connected to deliver blood, drugs and other medicants to the patient. A sensor having a sensing element may extend through the sensor lumen and be positioned internal to the patient for physiological parameter sensing. An external portion of the sensor may be connected to associated electronics to provide automatic monitoring of the physiological parameters and automatic delivery and control of the infusants.

Abstract: A multilumen catheter having tubings extending into lumens within the catheter. The lumens may be used for blood, drugs or other medicants. The lumens may also be used for sensors. The junction element, external to the patient, connects the tubings to the lumens. The tubings, also external to the patient, connect to infusion members, to which one or more infusion systems may be connected to deliver blood, drugs and other medicants to the patient. A sensor having a sensing element may extend through the sensor lumen and be positioned internal to the patient for physiological parameter sensing. An external portion of the sensor may be connected to associated electronics to provide automatic monitoring of the physiological parameters and automatic delivery and control of the infusants.

Abstract: An external surface of a catheter body includes a pressure responsive slit formed in an indentation wherein a wall thickness of the catheter body within the indentation is less than a wall thickness of a major portion of the catheter body. Material exits a lumen of the catheter body, via the pressure responsive slit, when a pressure inside the lumen exceeds an external pressure.

Abstract: A medical system for electrical stimulation includes a first column of electrodes, a second column of electrodes, an expandable member disposed between first and second columns, and an expansion mechanism adapted to transmit an externally applied pressure to the expandable member. The pressure expands the expandable member in order to force the first column of electrodes apart from the second column of electrodes. The first and second columns, disposed side-by-side, may be inserted through a percutaneous needle and into a epidural space, alongside a spinal cord; after insertion, the first column may be forced apart from the second column by applying the pressure to the expandable member.

Abstract: An intrathecal catheter for delivering fluid to, or withdrawing fluid from, the cerebrospinal fluid compartment of a patient, includes a proximal end and a distal portion. The distal portion has an outer diameter of about 1 mm or less, a bending stiffness of about 0.002 pounds per square inch or less, and a distal end. A delivery region is located between the proximal end and the distal end, and a lumen extends from the proximal end to the delivery region. The catheter may further include a coiled structure region to prevent dislodgement of the catheter from a tissue in which the coiled structure is implanted, for example the cisterna magna. The catheter may also include tines to anchor portions of the catheter, for example to a portion of the spinal canal.

Abstract: A cardiac transvenous defibrillation lead has a continuous coil conductor within a layer of insulation. A portion of the coil conductor is exposed as a defibrillation electrode. In order to enhance fluoroscopic visualization of the exposed electrode during implant, the end of the exposed electrode is marked with a radiopaque element. The element may be in the form of an adhesive filled with radiopaque material that is used to backfill under the layer of insulation. Alternatively, a tube made of radiopaque material may be installed between the layer of insulation and the coil conductor.

Abstract: A catheter system and method for intracranial infusion of therapeutic substances to a patient. An anchor formed of generally flexible, elastomeric material is used to mount the catheter to the outer surface of the skull of the patient. The anchor has a through hole for receiving the catheter, a channel, extending substantially from the through hole, into which a portion of the catheter may be inserted to retain the portion substantially parallel to the surface of the skull, and at least one flange for engaging the outer surface of the skull. An anchor clip may be provided to engage the anchor adjacent the through hole to further stabilize the catheter.

Abstract: A catheter body includes an exit port over which a pressure responsive sleeve is formed that allows material to exit a lumen of the catheter body at a given pressure. In one embodiment, a surface of the sleeve is approximately flush with a surface of the catheter body. In another embodiment the sleeve includes a tapered edge.

Abstract: Catheter systems including one or more flow restrictors are disclosed. The catheter systems may include two or more delivery branches. The delivery branches may be connected to a supply catheter section using a branching catheter connector that may include one or more flow restrictors. The flow restrictors may include a restrictor body located within a lumen with a channel located between the restrictor body and interior surface of the lumen, the channel restricting flow through the lumen past the flow restrictor. The channel may be defined by a groove formed in the restrictor body and/or the interior surface of the lumen. Methods of providing pressure relief by flowing fluid past a flow restrictor are also disclosed.

Abstract: A medical catheter comprising a proximal end having an opening for fluid containing a therapeutic drug, a distal end, the distal end defining at least one opening, and a porous portion covering the opening defined by the distal end. In one embodiment, the medical catheter comprises a proximal end having an opening for fluid containing a therapeutic drug, at least two distal ends, the proximal end connected to the two distal ends with a connector, the distal ends each defining at least one opening, a diffuser covering the opening of each distal end, and a separate restrictor downstream of the connector and upstream of each distal end to provide substantially equal flow through each distal end. An additional restrictor can also be placed upstream of the connector. In another embodiment, a combination diffuser and restrictor covers the opening of each distal end.