Abstract: A catheter insertable into a cavity of a patient for monitoring pressure including a first lumen for drainage from the cavity and an expandable balloon. The balloon has a liquid containing chamber to monitor pressure within the cavity of the patient as pressure on the outer wall of the balloon deforms the balloon and compresses the liquid within the balloon. An exit port provides passage of air from an interior of the balloon to outside the catheter. A membrane has plurality of pores dimensioned to enable passage of air but prevent passage of the liquid therethrough. A pressure sensor communicates with the liquid containing chamber for measuring pressure based on compression of liquid caused by deformation of the expanded balloon.

Abstract: Briefly, in accordance with one embodiment, a multi-lumen shaft may be used to with an endoscopic instrument.

Abstract: Devices, agents, and associated methods for selective modulation of renal nerves by localized delivery of neural ablative substances are disclosed herein. One aspect of the present technology is directed to a method for delivering a neuromodulatory agent (e.g., capsaicin) via a catheter to a kidney of the patient. The neuromodulatory agent selectively neuromodulates afferent renal nerves in a patient compared efferent renal nerves of the patient. The method can also include removing the catheter from the patient after delivering the neuromodulatory agent to conclude the procedure.

Abstract: A method and system for instilling a medium into portions of a luminal network is provided. The method includes generating a model of a luminal network based on images of the luminal network, determining a location of a treatment target in the luminal network, navigating a bronchoscope through the bronchial tree to a target, guiding a catheter through the bronchoscope, dispensing medium to the target from a distal end of the catheter, and removing a quantity of medium from the luminal network.

Abstract: In one embodiment of the present invention, a system for treating an occlusion within a patient's vasculature with ultrasonic energy comprises a catheter configured to be passed through the patient's vasculature such that a portion of the catheter is positioned at an intravascular treatment site. The system further comprises an ultrasound radiating member, an ultrasound signal generator configured to supply a drive signal to the ultrasound radiating member, an infusion pump configured to pump a therapeutic compound into the fluid delivery lumen so as to cause the therapeutic compound to be delivered to the treatment site and a controller configured to control the ultrasound signal generator and the infusion pump.

Abstract: Tube systems may include a tube with an inflatable balloon that is affixed to, and circumferentially surrounding an exterior portion of the tube. The inflatable balloon may be positioned between the first open end and the second open end of the tube. The tube may be flexible and hollow and may have a first open end and a second open end. The tube may include a suction line, a suction line port, and a spacer that extends from an exterior surface of the tube and is positioned proximate to the suction line port. The spacer may be configured to prevent occlusion of the suction line port.

Abstract: A system for reconstituting circulation in a cadaver includes at least a pump, a fluid driven by the pump, and operative fluid connections between the pump and the cadaver. The system may be used to occlude one or more arterioles within the cadaver. The system may include a first circuit that creates a first fluid path with vessels of the cadaver, with first circuit having a first fluid conduit, a heater unit, a first pump, and a resistance device. The system may also include a second circuit that creates a second fluid path with vessels of the cadaver that are different from the vessels of the first circuit, with the second circuit having a second fluid conduit and a second pump. Alternately, the system may include a first circuit that creates a first fluid path with vessels of the cadaver and a second flow path that creates a second fluid path with the reservoir, where the first circuit includes a first conduit, a second connector, a pump, a reservoir, and a connector.

Abstract: In one embodiment of the present invention, a system for treating an occlusion within a patient's vasculature with ultrasonic energy comprises a catheter configured to be passed through the patient's vasculature such that a portion of the catheter is positioned at an intravascular treatment site. The system further comprises an ultrasound radiating member, an ultrasound signal generator configured to supply a drive signal to the ultrasound radiating member, an infusion pump configured to pump a therapeutic compound into the fluid delivery lumen so as to cause the therapeutic compound to be delivered to the treatment site and a controller configured to control the ultrasound signal generator and the infusion pump.

Abstract: Assist device (10) for sclerosing treatment of varicose veins, aimed at being partially inserted into a blood vessel (20), including a tubular element (11), which has at least three ways (13, 14, 15), at least two of which (13, 14) are connected to at least one related inflatable balloon element (12, 12?, 16) by at least one through hole (30, 31), and at least one remaining way (15) of said three ways (13, 14, 15) has at least one hole (32) for the passage of a sclerosing substance (17), aimed at reaching a wall (18) of said blood vessel (20), in which at least one (16) of said at least two balloon elements (12, 12?, 16) has an elongated shape extending toward at least another balloon element (12, 12?) and a volume comprised in the range of 30% to 99% of the space inside said blood vessel.

Abstract: A catheter may include a distal side and a proximal side comprising a shaft having an outer tubular member, and an insertion member. The catheter may have at least a part of the insertion member in an axial direction disposed in the outer tubular member. At least one outer tubular member or insertion member is a multilayer tube having a first layer and a second layer laminated with the first layer. In a cross-section perpendicular to an axial direction of the multilayer tube, a ratio of cross-sectional areas of the second layer to the first layer is 0.7 or less.

Abstract: A device for secluding a body vessel may include a distal balloon, a proximal balloon, an aspiration port positioned adjacent to the distal balloon, an injection port positioned adjacent to the proximal balloon, and a lumen assembly. The lumen assembly may comprise a central lumen, a distal balloon lumen operably coupled to the distal balloon, a proximal balloon lumen operably coupled to the proximal balloon, an aspiration port lumen operably coupled to the aspiration port, and an injection port lumen operably coupled to the injection port. The distal balloon and the proximal balloon may define a treatment chamber therebetween, and the aspiration port and the injection port may be positioned within the treatment chamber on the lumen assembly.

Abstract: Disclosed is an inter- and intra-catheter flow device for the management of vascular bleeding disorders that provide a liquid flow-pass between proximal and distal balloons for bridging the circulation between the upper and lower segments of a hemorrhaging artery or blood vessel, while blocking the blood flow to the hemorrhaging middle segment(s) of the artery or blood vessel between the two or more balloons. When only one balloon is inflated, these devices can create a pressure gradient between proximal or distal and middle segments of the artery or blood vessel. These devices are useful for controlling proximal artery blood pressure, preventing distal ischemia-reperfusion injury, identifying the bleeding location, controlling the bleeding, repairing and remodeling vascular structures, extending resuscitative endovascular balloon occlusion of the aorta (REBOA) use duration, and performing fluid resuscitation.

Abstract: The disclosure provides for an adjustable catheter system with isovolumetric suction and restoration of fluid for the removal of a thrombus and a method of use thereof. The catheter system includes an inner catheter and an outer sheath surrounding at least a portion of the inner catheter. The inner catheter may include at least three lumina extending from the proximal end to the distal end of the inner catheter, at least one infusion fenestration along the infusion segment, and a distal encapsulation balloon at the distal end. The outer sheath may include at least three lumina extending from the proximal end to the distal end of the outer sheath and a proximal encapsulation balloon at the distal end. The catheter system may further include an agitator for mechanical morcellation of the thrombus.

Abstract: This disclosure provides apparatus and methods for detecting pressure changes within a cavity of a patient. A pressure-sensing catheter comprises an elongate member and a monitor lumen. The pressure-sensing catheter may have a hollow pressure-compliant member in fluid communication with the monitor lumen and thereby define a fluid column. A connector apparatus can be in fluid communication with the monitor lumen, and can comprise a first complementary connector and a second complementary connector. One of the first complementary connector and the second complementary connector can have a pressurizing device that can displace a volume of fluid located within a bore of the other complementary connector into the fluid column, wherein the ratio of the volume of displaced fluid to the volume of the fluid column ranges from about 1:2 to about 1:4. The pressure catheter can comprise a radio-opaque band circumscribing the exterior of the elongate member.

Abstract: An apparatus comprises a shaft, an expandable dilator, and at least one ventilation pathway. The shaft defines a longitudinal axis and comprises a distal and proximal ends with at least one shaft lumen. The expandable dilator comprises body with its own proximal and distal ends. The body is configured to transition between a contracted state and an expanded state. The body is configured to dilate a Eustachian tube of a patient in the expanded state. The at least one ventilation pathway is configured to provide ventilation from the distal end of the body to the proximal end of the body when the body is in the expanded state. In some examples, the ventilation pathway comprises a set of transversely oriented vent openings formed through the shaft. In some other examples, the ventilation pathway comprises a space defined between one or more radially outwardly protruding features of the expandable dilator.

Abstract: A device for secluding a body vessel may include a distal balloon, a proximal balloon, an aspiration port positioned adjacent to the distal balloon, an injection port positioned adjacent to the proximal balloon, and a lumen assembly. The lumen assembly may comprise a central lumen, a distal balloon lumen operably coupled to the distal balloon, a proximal balloon lumen operably coupled to the proximal balloon, an aspiration port lumen operably coupled to the aspiration port, and an injection port lumen operably coupled to the injection port. The distal balloon and the proximal balloon may define a treatment chamber therebetween, and the aspiration port and the injection port may be positioned within the treatment chamber on the lumen assembly.

Abstract: Disclosed are medical devices that incorporate siRNA. In addition to one or more siRNA constructs, devices include nanostructures fabricated on a surface to form a nanotopography. A random or non-random pattern of structures may be fabricated such as a complex pattern including structures of differing sizes and/or shapes. Microneedles may be incorporated on devices. The pattern including nanostructures may be formed on the surface of the microneedles.

Abstract: In one embodiment of the present invention, a system for treating an occlusion within a patient's vasculature with ultrasonic energy comprises a catheter configured to be passed through the patient's vasculature such that a portion of the catheter is positioned at an intravascular treatment site. The system further comprises an ultrasound radiating member, an ultrasound signal generator configured to supply a drive signal to the ultrasound radiating member, an infusion pump configured to pump a therapeutic compound into the fluid delivery lumen so as to cause the therapeutic compound to be delivered to the treatment site and a controller configured to control the ultrasound signal generator and the infusion pump.

Abstract: A balloon structure includes a proximal balloon portion having a first internal volume, a distal balloon portion having a second internal volume, and a central balloon portion disposed between and joined with the proximal and distal balloon portions. The central balloon portion has a third internal volume isolated from the first and second internal volumes. A first lumen is associated with the third internal volume to direct pressure to the third internal volume for inflation of the central balloon portion. At least one second lumen is associated with the first and second internal volumes to direct pressure to the first and second internal volumes for inflation of the proximal balloon portion and the distal balloon portion. Whereby, upon inflation, the central balloon portion dilates, or delivers other treatments to tissue in the passage, with the proximal and distal balloon portions limiting movement of the balloon structure in the passage.

Abstract: The present invention relates to a vascular closure device for sealing a puncture site in a vascular wall comprising a sheath (10) having a distal end and at least one proximal end, wherein the sheath (10) comprises a tubular body (100). The vascular closure device (1) is characterized in that at least one distal balloon member (11) is firmly arranged at the distal end of the tubular body (100) of the sheath (10) and at least one expandable anchor member (12) is firmly arranged proximal to the distal balloon member (11) on the tubular body of the sheath (10), wherein at least the distal side of the distal balloon member (11) is a pressure area for applying pressure on the outside of the vascular wall. Furthermore a method of positioning of a vascular closure device (1) is described.

Abstract: To obtain an oxygen clathrate hydrate containing the dissolved oxygen that is maintained in a state of being dissolved in a solution even when being heated to 100° C.

Abstract: Assist device (10) for sclerosing treatment of varicose veins, aimed at being partially inserted into a blood vessel (20), including a tubular element (11), which has at least three ways (13, 14, 15), at least two of which (13, 14) are connected to at least one related inflatable balloon element (12, 12?, 16) by at least one through hole (30, 31), and at least one remaining way (15) of said three ways (13, 14, 15) has at least one hole (32) for the passage of a sclerosing substance (17), aimed at reaching a wall (18) of said blood vessel (20), in which at least one (16) of said at least two balloon elements (12, 12?, 16) has an elongated shape extending toward at least another balloon element (12, 12?) and a volume comprised in the range of 30% to 99% of the space inside said blood vessel.

Abstract: An apparatus for performing phlebotomy through a peripheral intravenous line. The apparatus includes an introducer and a catheter configured to advance the catheter through a peripheral intravenous line. A y-adapter with a port of larger diameter is configured to receive the catheter and place in fluid communication with the peripheral intravenous line. When advanced the catheter is configured to transport a bodily fluid (i.e. blood) to a volume outside of the body.

Abstract: Methods and devices are disclosed herein that allow for infusion and aspiration through a single device. The device can be used to treat a stroke by delivering the device to the site of a blood clot and simultaneously or sequentially infusing a thrombolytic or other drug into the clot and aspirating the dissolving clot from the patient. The methods and devices can advantageously permit more efficient thrombolytic infusion and clot aspiration. Modular systems are also disclosed, as are methods of treating subdural hematoma or other conditions.

Abstract: According to an aspect of the present disclosure, a medical device may include a deflation catheter assembly. The deflation catheter assembly may include a tubular member having an outer surface, an inner surface, and a central lumen defined by the inner surface. The deflation catheter assembly may also include a plurality of passages extending through a side of the tubular member and from the inner surface to the outer surface. The deflation catheter assembly may also include an anchoring member coupled to the tubular member. A distal portion of the tubular member may extend distal the anchoring member. The plurality of passages may be at the distal portion of the tubular member. The anchoring member may be configured to move between an unexpanded state and an expanded state. At least a portion of the anchoring member may protrude radially outwardly from the outer surface of the tubular member when the anchoring member is in the expanded state.

Abstract: Enteral safety system (ESS) may include syringe having visual indicator such as barrel with measurement marks of a color. Barrel may allow content viewing. ESS may include hub for connecting syringe to enteral set. Hub may have a visual indicator such as being same color as barrel's marks. Enteral tubing or set may have a visual indicator such as a lengthwise stripe same color as barrel's marks. Enteral tubing may allow content viewing. ESS may include an enteral tubing-feeding tube hub for connecting enteral tubing to a feeding tube. This hub may have visual indicator such as same color as barrel's marks. Feeding tube may have visual indicator such as a lengthwise stripe same color as barrel's marks. Feeding tube may allow content viewing. The syringe, syringe-enteral tubing hub, enteral tubing, enteral tubing-feeding tube hub, and feeding tubing are properly connectable by reference to visual indicators such as color matching.

Abstract: A treatment system includes a delivery device which delivers a combination of a breathing gas and frozen ice or other particles to a patient in order to induce hypothermia. The treatment system also includes a temperature system for measuring the temperature of exhaled gases and a controller which can adjust the duration or rate at which the ice particles are delivered in order to control the patient's core temperature based on the measured exhalation gas temperature.

Abstract: Heat sensors can be positioned within an anatomical vessel of a patient so as to monitor temperature changes, such as during ablation procedures in the heart. Some heat sensors can include a wire that defines an extended heat sensing region capable of detecting a change in the local temperature. Some heat sensors can be conformable to an inner surface of a wall of an anatomical vessel to maintain contact therewith or to be in close proximity thereto.

Abstract: A catheter for treatment of sinusitis capable of causing a space in a further rear (distal side) of a posterior nasal aperture to communicate with external air is provided. The catheter comprises an anterior nasal aperture balloon 33, an anterior nasal aperture balloon air supply lumen 39b for inflating the anterior nasal aperture balloon 33, a posterior nasal aperture balloon 13, a posterior nasal aperture balloon air supply lumen 19b for inflating the posterior nasal aperture balloon 13, and a drainage lumen 39a having an opening 41 between the anterior nasal aperture balloon 33 and the posterior nasal aperture balloon 13, in which an external air communication lumen 19a having an opening 21 on a distal side from the posterior nasal aperture balloon 13 is further provided.

Abstract: A delivery system for delivery of a therapeutic agent such as stem cells into a vein and across a micro circulation system into an artery comprises a multi lumen catheter for delivery of a therapeutic agent. A discharge device is located in a vein. The operation of the delivery device is controlled by a pressure stem cell solution delivery gun system. There are multiple delivery stages. These may include delivery of an elixir to open up the pressure bed, a platelet-rich plasma, stem cells, scaffolds, and finally an elixir to provide emichment and nourishment of the stem cells.

Abstract: Medical devices that incorporate siRNA are provided. In addition to one or more siRNA constructs, devices include nanostructures fabricated on a surface to form a nanotopography. A random or non-random pattern of structures may be fabricated such as a complex pattern including structures of differing sizes and/or shapes. Microneedles may be incorporated on devices. The pattern including nanostructures may be formed on the surface of the microneedles.

Abstract: A delivery device for a collapsible medical device may include a handle and a delivery assembly having a compartment for receiving the medical device. A catheter member may extend from the handle to the delivery assembly. The catheter member may have a first portion with a first compliance value and a second portion with a second compliance value different from the first compliance value. An internally threaded member may be fixedly connected to the delivery assembly. An externally threaded member may have a first portion operatively connected to the actuation member and a second portion threadedly coupled to the internally threaded member so that manipulation of the actuation member causes axial movement of the compartment relative to the catheter member.

Abstract: Assist device (10) for sclerosing treatment of varicose veins, aimed at being partially inserted into a blood vessel (20), including a tubular element (11), which has at least three ways (13, 14, 15), at least two of which (13, 14) are connected to at least one related inflatable balloon element (12, 12?, 16) by at least one through hole (30, 31), and at least one remaining way (15) of said three ways (13, 14, 15) has at least one hole (32) for the passage of a sclerosing substance (17), aimed at reaching a wall (18) of said blood vessel (20), in which at least one (16) of said at least two balloon elements (12, 12?, 16) has an elongated shape extending toward at least another balloon element (12, 12?) and a volume comprised in the range of 30% to 99% of the space inside said blood vessel.

Abstract: Enhanced dual purpose systems enable dilating of at least a lesion within a blood vessel and providing an anti-proliferative medicament in a non-attached form directly into the lumen of the vessel. Likewise provided is the ability to stop blood flow to prevent wash-out of the medicament during dwell time within the body lumen, and the ability to remove the medicament after the dwell time of the device to prevent unwanted exposure of the same within the body.

Abstract: Various methods for optimizing coating of medical devices, such as balloon catheters are disclosed. One method configures catheter balloon folds based on balloon diameter and volume. Other methods include using a specifically-sized protective sheath, using a vacuum, using pressure, pulling the balloon through a coating solution, using at least one spacer or a wick between at least one fold for metering a therapeutic coating into the folds of the balloon, placing an intermediate layer between the balloon and the therapeutic coating, placing a soluble film having a therapeutic agent around the catheter balloon or inside the folds, and any combination thereof. Balloon catheters and catheter balloons having a specific folding configuration, a specifically-sized protective sheath, an intermediate layer, or a soluble film are also disclosed.

Abstract: Devices, systems and methods are provided for simultaneously stimulating the spinal anatomy at various locations, such as spinal levels, along the spinal cord. By stimulating multiple levels of the spinal column with the use of a single device, a single access path is created to an implantable pulse generator (IPG) rather than individual access paths for each lead at each spinal level to an IPG. By reducing the number of pathways, the procedure complexity, time and recovery are reduced. In addition, some embodiments provide additional specificity within each targeted level, such as selective stimulation of specific tissue, such as the dorsal root ganglion.

Abstract: Systems, methods, and devices for facilitating insertion of an endotracheal tube and/or for verifying the position of the endotracheal tube within an airway of a patient with respect to an anatomical landmark of a patient are disclosed. Systems, methods, and devices for facilitating removal of debris from the distal airways of a patient under direct visualization are also disclosed.

Abstract: A method and related system for providing therapy to a treatment site, such as stenosis or other vasculature disease, at one or more locations of a subject, such as the vasculature. The method includes: advancing an ultrasound catheter to or in proximity to the subject's treatment site; infusing microbubbles into or proximal to the treatment site; and delivering ultrasonic energy from the ultrasound catheter. The ultrasonic energy may be adapted for: imaging the treatment site, translating the microbubbles into or in the vicinity of the treatment site and/or rupturing the microbubbles.

Abstract: Disclosed are medical devices that incorporate siRNA. In addition to one or more siRNA constructs, devices include nanostructures fabricated on a surface to form a nanotopography. A random or non-random pattern of structures may be fabricated such as a complex pattern including structures of differing sizes and/or shapes. Microneedles may be incorporated on devices. The pattern including nanostructures may be formed on the surface of the microneedles.

Abstract: A tissue treatment system comprising a tissue treatment probe to be introduced in a target tissue region, wherein the probe comprises one or more perfusion ports that perfuse electrically conductive fluid to the target tissue region, one or more electrodes that deliver RF energy to the target tissue region to therapeutically treat the tissue, and at least one occlusive body that expands to occlude an anatomical vessel in or near where the probe is located in order to prevent heat generated by the delivery of the RF energy from being lost to mobile bodily fluids.

Abstract: Systems, methods, and devices for facilitating insertion of an endotracheal tube and/or for verifying the position of the endotracheal tube within an airway of a patient with respect to an anatomical landmark of a patient are disclosed. Systems, methods, and devices for facilitating removal of debris from the distal airways of a patient under direct visualization are also disclosed.

Abstract: A naso/orogastric device having backflow blocking means and comprises a naso/orogastric tube sized and shaped for being disposed within the esophagus so that at least a distal end thereof being placed in the stomach lumen of a patient, at least one elastic esophageal body, positioned along the naso/orogastric tube, having a pressure dependent volume, at least one esophageal sensor that detects fluid around at least one segment of the naso/orogastric tube, and a pressure regulator that regulates a pressure within the elastic esophageal body according to the detection.

Abstract: A working cannula is advanced through the urethra into the bladder. Gas is infused through the cannula into the bladder, pressurizing the bladder. A fenestrating shunt catheter is then advanced through the urethra into the bladder and against the wall of the bladder, fenestrating it. A distal segment of the shunt catheter is then advanced through the wall into the peritoneal space, while a more proximal segment of the shunt catheter remains in the bladder. Shunt holes are formed in both the distal segment and more proximal segment so that gas from the pressurized bladder flows through the shunt holes into the peritoneal space, insufflating the peritoneal space.

Abstract: A drug delivery system that can be deployed from a catheter and retained within the bladder for delivery of treatment drug solutions over a period of time. The delivery system includes an inflatable or expandable delivery element that can be collapsed within the catheter tip for navigation into the bladder before being inflated or expanded within the bladder. The inflated or expanded delivery element can engage the bladder walls or sized to be too large to be passed from the bladder such that the delivery element is retained within the bladder after inflation or expansion to administer a treatment drug solution over an extended period of time.

Abstract: Devices, systems, and methods for delivery of therapeutics, in particular thrombolytic agents, in particular plasmin, are provided. The devices, systems, and methods also provide for occlusion of a vessel or graft distal and/or proximal to a treatment zone. Also provided are devices, systems, and methods that trap emboli.

Abstract: Catheters for occluding, visualizing, irrigating, evacuating, and delivering agents to a treatment area are disclosed. The catheters comprise a catheter body comprising five lumens, first and second occlusion balloons coupled to the catheter body, an optional space-occupying balloon coupled to the catheter body and disposed between the first and second occlusion balloons, and an optional visualization means that enables visualization between the first and second occlusion balloons. Methods for using these catheters are also disclosed. A method comprises inflating the first and second occlusion balloons, inflating the space-occupying balloon, allowing fluid to exit via an evacuation lumen, optionally irrigating or aspirating to facilitate fluid exit via said lumen, and delivering an agent to a treatment area via the agent lumen.

Abstract: Clot disruption and dissolution are achieved using a catheter having the ability to infuse a thrombolytic agent, aspirate clot and fluid, and allow passage of a guidewire. Optionally, the catheter may also include a mechanical agitator for further disrupt clot in the presence of the thrombolytic agent. A flow resistor in the catheter provides for infusion and/or aspiration to be concentrated primarily at a clot treatment area in a blood vessel while also providing optional infusion and/or aspiration distal to the treatment area. In some embodiments, infusion, aspiration and guidewire passage occur through a common lumen. The thrombolytic agent, such as tPA, streptokinase, or urokinase, is directly released into the clot at the point where the agitator is engaging the clot. In this way, the thrombolytic activity of the agent is enhanced and the dissolution of the clot is improved.

Abstract: A method of treating early papillomavirus infection of an orifice of a human or animal body including any canal associated with an orifice, comprising applying a viral inactivation agent to the orifice and/or canal in an amount effective to inactivate a portion of the virus infecting the orifice or canal. Apparatus is also disclosed.

Abstract: Apparatus and method for repairing an abnormality in the wall of a body lumen, the method comprising isolating the abnormality in the wall of the body lumen from flow in the body lumen; positioning flowable forming material adjacent to the abnormality in the wall of the body lumen; and transforming the flowable forming material into a substantially stationary state so as to repair the abnormality in the wall of the body lumen, and the apparatus comprising a supply of flowable forming material; zone isolation apparatus for isolating the abnormality in the wall of the body lumen from flow in the body lumen; and positioning apparatus for positioning the flowable forming material adjacent to the abnormality in the wall of the body lumen so as to repair the abnormality in the wall of the body lumen.

Abstract: Balloon catheters, and methods of treatment therewith, are provided including an inflatable first balloon at least partially enclosed by an expandable second balloon that has holes. The annular space between the first balloon and the second balloon is configured to promote delivery of the fluid evenly through holes in the second balloon to avoid problems of underloading and/or overloading. Preferably, the annular space is in communication with the holes, and the annular space is configured to receive and then to release and distribute the fluid via the holes in a substantially uniform manner such that even amounts of fluid are released in the distal and proximal holes. The first balloon may have various configurations including being tapered relative to the second balloon. The second balloon may also be tapered accordingly. The device may also include raised portions disposed in the annular space and configured to define channels having various configurations.