Abstract: A method is provided including introducing a delivery device through a vessel wall to a treatment site within one of a peri-adventitial space or a pericardium adjacent a coronary blood vessel and delivering a treatment agent through the delivery device. The treatment agent is delivered through the delivery device according to conditions that hydraulically dissect tissue planes within the peri-adventitial space. A kit is provided including a delivery device having a needle to be advanced through one of an epicardium of a heart and a wall of a coronary blood vessel into a peri-adventitial space and a treatment agent comprising particles having an average diameter on the order of 15 microns or more to be delivered through the delivery device into the peri-adventitial space.

Abstract: An agent delivery catheter and method, configured to deliver an agent to an inner surface of a patient's body lumen by forming an agent containment pocket along the inner surface of the patient's body lumen wall between a proximal expandable frame and a distal expandable frame, while minimizing ischemic conditions during the procedure.

Abstract: An elongated intravascular device having a frame configured for reversibly expanding in a patient's body lumen, which has a sleeve secured to the frame, and at least one sleeve-folding strut configured to fold the sleeve inwardly as the frame radially collapses in the patient's body lumen. Additional aspects of the invention are directed to methods of recovering such expanded frame type devices, and a recovery catheter configured for collapsing an expanded frame. The devices and methods of the invention facilitate the collapse of expanded frame devices, for repositioning or removal from the patient's body lumen.

Abstract: Systems, devices and methods for eluting an agent at a treatment site are disclosed. The devices include an expandable frame and at least one membrane. The membrane may carry an agent to elute at the treatment site. The membrane may allow blood flow at the treatment site during agent delivery.

Abstract: A medical device for treating a defective heart valve. The medical device comprises a distal anchoring member for disposing in a blood vessel. A proximal anchoring member for disposing in or at an entrance of the blood vessel. A telescoping assembly coupling at a first end to the distal anchoring member and at a second end to the proximal anchoring member. The telescoping assembly is deployable into the blood vessel. The telescoping assembly reduces a distance between the distal anchoring member and the proximal anchoring member, wherein the telescoping assembly comprises of at least two members capable of sliding into each other giving the telescoping assembly adjustable lengths.

Abstract: Embodiments include an infusion-occlusion system having a delivery catheter, a guide catheter adapted to receive the delivery catheter, and a guidewire with an occlusion device adapted to be received within the guide catheter. The guide catheter of the catheter kit may be provided with an occlusion device at the distal end of the guide catheter. The delivery catheter may have an accessory lumen, coaxial or co-linear lumen, a supporting mandrel, or an occlusion device at its distal end. Moreover, according to some embodiments, occlusion devices may be a single material or a composite balloon having an inner liner and an outer layer of different materials, a high compliance low pressure balloon, or a filter device that restricts particles from passing through but does not restrict fluid, such as blood. An inflation device with a large volume and low volume syringe can be used to inflate the balloon.

Abstract: The present invention relates to balloon catheters for treating a luminal system of a patient. Specifically, the invention relates to catheters having a flexible membrane positioned at a distal portion of the catheter, the flexible membrane retained in a substantially unexposed conformation prior to deployment. Preferably the flexible membrane is capable of delivering a therapeutic agent to a localized environment when deployed to an exposed conformation.

Abstract: Embodiments include an infusion-occlusion system having a delivery catheter, a guide catheter adapted to receive the delivery catheter, and a guidewire with an occlusion device adapted to be received within the guide catheter. The guide catheter of the catheter kit may be provided with an occlusion device at the distal end of the guide catheter. The delivery catheter may have an accessory lumen, coaxial or co-linear lumen, a supporting mandrel, or an occlusion device at its distal end. Moreover, according to some embodiments, occlusion devices may be a single material or a composite balloon having an inner liner and an outer layer of different materials, a high compliance low pressure balloon, or a filter device that restricts particles from passing through but does not restrict fluid, such as blood. An inflation device with a large volume and low volume syringe can be used to inflate the balloon.

Abstract: An apparatus including a tether, and an aptation device coupled to the tether at a position corresponding to a location to contact cusps of an atrioventricular valve during systole, wherein the tether and aptation device are suitable for percutaneous delivery to a patient. An apparatus including a support annulus comprising a length corresponding to a circumference of one of an interior portion of an atrium and an atrioventricular valve annulus; and an aptation device coupled to the support annulus corresponding to a location to contact cusps of an atrioventricular valve during at least one of systole when the support annulus is seated in one of an atrium and an atrioventricular valve annulus, wherein the support annulus and aptation device are suitable for percutaneous delivery to a patient. Also, a method of introducing an aptation device to contact cusps or leaflets of an atrioventricular valve.

Abstract: A catheter for use in a patient's body lumen, having a shaft section configured to minimize ultrasonic image artifacts and the direct ultrasonic image brightness of the shaft surface and its internal components, and to produce its image at a wide range of imaging angles, preferably with an intensity not substantially different than surrounding tissue of the body lumen under ultrasound visualization. The shaft section is operative for the desired use of the catheter, yet is also configured to facilitate accurately imaging the shape and location of the shaft section, and easily differentiate it from the surrounding anatomy without unduly obscuring the images of the adjacent anatomy using an ultrasound imaging system.

Abstract: An apparatus including a tether, and an aptation device coupled to the tether at a position corresponding to a location to contact cusps of an atrioventricular valve during systole, wherein the tether and aptation device are suitable for percutaneous delivery to a patient. An apparatus including a support annulus comprising a length corresponding to a circumference of one of an interior portion of an atrium and an atrioventricular valve annulus; and an aptation device coupled to the support annulus corresponding to a location to contact cusps of an atrioventricular valve during at least one of systole when the support annulus is seated in one of an atrium and an atrioventricular valve annulus, wherein the support annulus and aptation device are suitable for percutaneous delivery to a patient. Also, a method of introducing an aptation device to contact cusps or leaflets of an atrioventricular valve.

Abstract: An apparatus including a tether, and an aptation device coupled to the tether at a position corresponding to a location to contact cusps of an atrioventricular valve during systole, wherein the tether and aptation device are suitable for percutaneous delivery to a patient. An apparatus including a support annulus comprising a length corresponding to a circumference of one of an interior portion of an atrium and an atrioventricular valve annulus; and an aptation device coupled to the support annulus corresponding to a location to contact cusps of an atrioventricular valve during at least one of systole when the support annulus is seated in one of an atrium and an atrioventricular valve annulus, wherein the support annulus and aptation device are suitable for percutaneous delivery to a patient. Also, a method of introducing an aptation device to contact cusps or leaflets of an atrioventricular valve.

Abstract: Methods and apparatus for localization, diagnosis, contact or activity detection of bio-electric tissue providing improved sensitivity to the distance between a sensing electrode and bio-electric tissue and providing the means to measure the impedance of the tissue between a sensing electrode and bio-electric tissue. In accordance with the method, a controlled effective input impedance is provided to the monitor, which input impedance can be set to cause a significant portion of the bio-electric tissue signal to be dropped across the tissue between a sensing electrode and the bio-electric tissue when the two are separated by a predetermined or arbitrary distance. Various illustrative embodiments and forms of construction are disclosed.

Abstract: A medical device that can be used for treating a defective heart valve. One aspect of the invention pertains to a longitudinally adjustable medical device that comprises a distal portion, a proximal portion, and a cord member. The distal portion comprises a distal anchoring member, a distal telescope, and a distal backbone. The proximal portion comprises a proximal anchoring member, a proximal telescope, and a proximal backbone. The distal backbone and the proximal backbone are configured to provide a structural support to the device while providing flexibility to the device. The cord member is disposed within the device and used to facilitate longitudinal adjustment for the device.

Abstract: A guiding catheter system employs a flexible shaft having a preformed bend at a distal end. An ultrasound transducer is mounted proximal to the pre-formed bend. The ultrasound transducer has a field of view directed to a distal tip of the guiding catheter. The guiding catheter includes an open lumen adapted for the introduction of payloads through the catheter system. The guiding catheter system can be used to direct a smaller guiding catheter or guide wire into a destination vessel from a heart chamber. In one application, the guiding catheter system is used to introduce a guiding catheter into the coronary sinus ostium from the right atrium.

Abstract: The invention is generally directed to an accessing system for a patient's coronary sinus which includes a tubular support member with a distal extremity extending into the right atrium of the patient's heart. A guide member is disposed within a first lumen of the tubular support member and advanced out an angled distal tip, through the patient's coronary sinus ostium and into the coronary sinus. A stabilizing member, similar to a conventional intravascular guidewire, is disposed within a second lumen of the tubular support member and extends into the right ventricle of the patient and is seated in the apex thereof. To advance the guide member into the CS ostium, the position of the distal extremity of the tubular support member is adjusted within the atrial chamber by moving longitudinally along or rotating about (or both) the stabilizing member and the guide member is advanced into the CS ostium. These steps may be repeated in a predetermined pattern in order to pass into the coronary sinus ostium.

Abstract: An improved medical imaging system preferably includes an imaging device having a housing, an imaging transducer, and a position marker coupled near the imaging transducer. The system further includes a motor capable of driving the imaging transducer in a generally longitudinal direction relative to the housing. Data obtained from tracking the position marker may be cross-correlated with data obtained from the imaging transducer. In one aspect, the position marker may be a sensor capable of communicating with a medical positioning system.

Abstract: Optical windows for intracorporeal devices, intracorporeal devices comprising a window and a method for forming a window for an intracorporeal device are provided. The method comprises placing within a mold an assembly comprising a mandrel located within a pair of parts separated by a collar of window material, heating the window preform effective to cause the window material to soften, and applying force to urge together the pair of parts to deform the window material so as to form a window. The intracorporeal devices, such as imaging devices, include guidewires, catheters, endoscopes. In addition, the method is suitable for joining plastic parts to other parts, such as metal and ceramic parts.

Abstract: Systems, methods and apparatus for acquiring an image from within a body lumen are provided. Systems embodying features of the invention include an intracorporeal imaging component for acquiring imaging information, an image information recording component, and an image information playback component. Methods for acquiring image information from within a body lumen include steps of acquiring imaging information, storing image information, and playing back imaging information. Imaging information may be played back as acquired, or non-sequentially, or composite images may be formed by combining, filtering, enhancing, or subtracting images and the composite images displayed. Devices embodying features of the invention include optical imaging components such as an optical IGW, an optical imaging recording component, and an optical image playback component. The systems, methods and devices are suitable for use with angiopoplasty, stent delivery, and other intracorporeal clinical procedures.

Abstract: A catheter device having an elongated tubular member with a proximal end and a distal end, and a needle disposed near the distal end. In one embodiment, the needle has a rigid, penetrating tip coupled to a flexible portion by an overlapping joint. The flexible portion enables the needle to bend to a penetrating angle relative to the distal end of the elongated tubular member and penetrate a body tissue without kinking.