Abstract: A deflectable stylet for a catheter includes an elongate deflectable member with a bend-enhancing region defined at a distal part of the deflectable member. An actuator has a distal end. 1 fast with a distal end of the deflectable member, relative displacement between the actuator and the deflectable member causing deflection of the distal part of the deflectable member at the bend-enhancing region. A control member is displaceably arranged relative to the deflectable member, the control member interacting with the bend-enhancing region of the deflectable member for controlling the extent of deflection of the distal part of the deflectable member.

Abstract: Medical devices and related methods are disclosed for delivering an implant into the body of a patient. The devices include a damping assembly having an internal chamber with a varying inner diameter, and a piston slideably disposed therein. The piston is operably connected with a catheter portion such that movement of the piston is associated with concurrent movement of the catheter for implant delivery. The varying inner diameter of the damping assembly results in a decrease in damping force during implant delivery, thus providing a substantially constant velocity of implant delivery.

Abstract: The invention relates to a medicament container for a liquid medicament, the medicament container comprising a bag with an outlet, the bag being compressible or shrinkable by subjection of at least a part of the medicament container to an energy source.

Abstract: Some embodiments relate to a catheter system having a changeable or adjustable working length. The catheter system can comprise a proximal end, a distal end, and a first axial lumen configured to receive a guidewire formed through at least a portion of the catheter body. A first opening can be formed through a portion of the catheter body and be in communication with the first lumen. The sheath can be rotatable, axially movable, or otherwise changeable from at least a first position to a second position, wherein the sheath can substantially cover the first opening in the catheter body in the first position, and can substantially expose the first opening in the catheter body in the second position.

Abstract: A steerable guide wire including one or more electroactive polymer layers, wherein each EAP layer is disposed between a layer of a first electrode and a layer of a plurality of second electrodes.

Abstract: A surgical instrument having a long shaft comprises, in the shaft, a sealing element produced by primary shaping at the installation location. The sealing element is produced such that any actuating mechanisms are installed and held in place in the shaft and then a curable plastic material is injected into the shaft such that the material encloses the actuating element along a length that is greater than the inside diameter and smaller than its length.

Abstract: Disclosed herein are various deflectable catheter systems that utilize materials having negative coefficients of thermal expansion to cause the catheter to deflect. A representative embodiment of the present invention includes a catheter having a heat-sensitive control member located outside the distal end of the catheter, but which is in mechanical communication with the distal end of the catheter such that heat may be applied to the control member to cause the distal portion to deflect. The applied heat, however, does not introduce any significant heat into the distal end of the catheter. The system may also include a processor to estimate an amount by which the catheter has been deflected based in part on temperature information of the control member, or even resistance measurements for the control member. The system may also include calibration systems and methods.

Abstract: The invention generally relates to method and apparatus for crossing an obstruction in a tubular member, and more particularly to a medical device method for crossing of a chronic occlusion in a subintimal or interstitial space of an artery.

Abstract: System and components for inducing pleurodesis. A tube device is provided that is generally inert in a first state. The device includes a second state that is configured to provide one or both of mechanical and chemical stimulation to induce pleurodesis. Different sheath and tube configurations are provided for the actuatable features of the device.

Abstract: A noncircular inner lumen guiding catheter with assisted variable support has an inner wall defining a noncircular cross-sectional shaped lumen for use in delivery of multiple microcatheters or other devices for treatment of neurovascular defects, such as for treatment of aneurysms. The noncircular inner lumen guiding catheter with assisted variable support includes torque transmittal guidance walls that are flexible linearly but not circumferentially, and that are neither collapsible nor kinkable. The noncircular shaped cross-section of the inner lumen may extend along the entire length of the catheter or a portion thereof, including distal or proximal.

Abstract: Apparatus and methods for an endovascular catheter that can be inserted within tortuous body anatomies and then selectively stiffened and fixed in place. In a particular embodiment, this stiffness is reversible. The stiffness or a comparable mechanical characteristic of the catheter assembly may be adjusted to a relatively low value during insertion (so that it easily navigates a guide wire or the like), and then subsequently adjusted to a relatively high value in situ to keep the catheter assembly substantially fixed in place (i.e., during delivery of an interventional device).

Abstract: A guide catheter includes a tubular section formed of a shape memory polymer that can transform dynamically between first and second states or conditions, or among three states or conditions, to provide a wide range of properties of the guide catheter as desired during delivery of the guide catheter through the vasculature to a target site, and removal of the guide catheter from the target site and vasculature. The states or conditions of the shape memory polymer be dynamically changed to vary properties of the tubular section such as stiffness, flexibility, shape, or biodegradability, which can be controlled by exposure of the shape memory polymer to temperature changes, electric fields, magnetic fields, wavelengths of light, and chemical solutions.

Abstract: Systems capable of providing force and displacement outputs sufficient to actuate remote mechanisms to enhance catheter capabilities include both low-force and remote actuation arrangements. The remote actuation and low-force actuation systems may be used for catheter distal end deflection, sensor deployment, feedback controlled movement, fluid delivery rate and directional control applications as well as catheter retention mechanism deployment. Remote actuation mechanism may employ phase change based, magnetic based or hydraulic based. Low-force remote actuation structures include a coaxially-extending pull wire, a reaction member, and a remote mechanism responsive to the pull force.

Abstract: A system for the metering and delivery of small discrete volumes of liquid is comprised of a small or minimal number of inexpensive components. One such component is a movable member, such as a miniature precision reciprocating displacement pump head, which is driven by an actuator that comprises a shape memory alloy material. The operating mechanism of the system is of little or minimal complexity. The system facilitates the precise metering and delivery of the small discrete volumes of liquid. Potential applications for the system include subcutaneous, long-term, automated drug delivery, for example, the delivery of insulin to a person with diabetes. In such an application, the small, simple and inexpensive nature of the invention would allow for its use as both a portable and a disposable system.

Abstract: Catheter assembly including an elongate shaft comprising a thermoplastic polymer such as a thermoplastic shape memory polymer having a pre-selected glass transition temperature (Tg) and a means for heating the thermoplastic polymer, wherein the thermoplastic polymer is in a rubbery state at temperatures above the glass transition temperature and is in a glassy state at temperatures below the glass transition temperature. The elongate shaft may be selectively heated and cooled to provide sufficient flexibility and retention during a medical procedure.

Abstract: An ophthalmic injection device has a dispensing chamber housing, a needle fluidly coupled to a dispensing chamber, a power source for providing current to the dispensing chamber housing, a controller for controlling the power source, and a housing at least partially enclosing the dispensing chamber housing, the power source, and the controller. The dispensing chamber housing is made of a shape memory alloy and has an inner surface defining a dispensing chamber for receiving a quantity of a substance. The controller directs a first current to the dispensing chamber housing to heat the substance contained in the dispensing chamber and a second current to the dispensing chamber housing to alter the shape of the dispensing chamber housing to deliver the substance.

Abstract: An adapter for an endovascular device and a catheter steering device are provided. The adapter for an endovascular device includes a body, a conductive metal ring and a conductive wire. The body includes a first open end, a second open end, a central lumen having a substantially cylindrical surface extending from the first open end to the second open end, and a channel extending from the central lumen to an external opening. The conductive metal ring is attached to the surface of the central lumen, and the conductive wire is coupled to the conductive metal ring and extends through the channel and the external opening. The steering device for a catheter that has a plurality of lumens with spaced distal openings includes a stylet for disposition within one of the plurality of lumens, and a steering member for disposition within a different one of the plurality of lumens.

Abstract: Embodiments of the present disclosure include methods and systems for a catheter assembly including a catheter shaft, a balloon positioned on the catheter shaft, where the balloon has a first balloon waist, a first lead extending longitudinally through the catheter shaft, and a first sealing member adjacent the first balloon waist and coupled to the first lead, where the first lead can provide electrical current to reversibly transition the first sealing member from a nonactivated state to an activated state in response to a temperature change in the first sealing member, and where at least a portion of the balloon rotates relative the catheter shaft in the nonactivated state and the first sealing member engages the first balloon waist to form a fluid tight seal and to prevent rotation of the balloon relative the catheter shaft in the activated state.

Abstract: Controllable catheter (10) having an elongated shaft (13) which is subdivided into multiple shaft segments, at least two of which are designed as tilt segments (12) and are each connected to at least one adjustment device, so that they can be tilted about a desired tilt angle with respect to the longitudinal axis of the shaft (13), wherein each of the at least one adjustment device is individually controllable and allows individual tilting of a corresponding tilt segment about a desired tilt angle.

Abstract: An improved catheter is provided. The catheter may include a deflectable member located at a distal end of a catheter body. The deflectable member may comprise an ultrasound transducer array. The deflectable member may be interconnected to the catheter body by a live hinge. The catheter may include a lumen extending from a proximal end of the catheter body to the distal end. The lumen may be used to deliver an interventional device to a point distal to the distal end of the catheter body. The deflectable member may be selectively deflectable in a pivot-like manner through an arc of at least 90 degrees. In embodiments where the deflectable member includes an ultrasound transducer array, the ultrasound transducer array may be operable to image both when aligned with the catheter body and when pivoted relative to the catheter body.

Abstract: An ophthalmic injection device has a dispensing chamber housing, a plunger, an actuator for driving the plunger, a temperature control device, and a temperature release mechanism. The dispensing chamber housing has an inner surface and an outer surface. The inner surface partially defines a dispensing chamber for holding a quantity of a substance. The plunger is engaged with the inner surface of the dispensing chamber housing, is capable of sliding in the dispensing chamber housing, and is fluidly sealed to the inner surface of the dispensing chamber housing. The temperature control device at least partially surrounds the dispensing chamber housing and is capable of altering the temperature of the substance in the dispensing chamber. The temperature release mechanism is in a locked position when the substance is outside the proper temperature range and an unlocked position when the substance is in the proper temperature range.

Abstract: Disclosed herein are various deflectable catheter systems that utilize materials having negative coefficients of thermal expansion to cause the catheter to deflect. A representative embodiment of the present invention includes a catheter having a heat-sensitive control member located outside the distal end of the catheter, but which is in mechanical communication with the distal end of the catheter such that heat may be applied to the control member to cause the distal portion to deflect. The applied heat, however, does not introduce any significant heat into the distal end of the catheter. The system may also include a processor to estimate an amount by which the catheter has been deflected based in part on temperature information of the control member, or even resistance measurements for the control member. The system may also include calibration systems and methods.

Abstract: A catheter kit including a drainage catheter hub having a rotatable lever handle adapted to secure a suture thread to maintain the anchor configuration of the distal end of the catheter to secure the position of the catheter within the patient's body. The rotatable lever handle has a released position for allowing movement of the suture and a secured position for preventing movement of the suture. A rotatable lever handle adapted to secure the proximal portion of the suture that may otherwise remain loose during the procedure. The rotatable lever handle and associated rotatable barrel can be depressed relative to hub body in a locked configuration to prevent inadvertent rotational movement of the rotatable lever handle and a release slot or release button that can be actuated by the practitioner with a release tool to allow for rotational movement of the rotatable lever handle.

Abstract: A medical device, comprising: an elongate tubular knitted catheter comprising at least one biocompatible, electrically non-conductive filament arranged in longitudinally adjacent substantially parallel rows each stitched to an adjacent row.

Abstract: A system and method are provided for attracting a magnetically responsive substance inserted in a subject's body towards a target area within the body to treat the area. The system generally comprises a medical device having a proximal end, a distal end, and at least one magnetic element disposed at the distal end of the medical device for orienting the distal end in a desired direction to place an aperture against the opposite wall of the vessel. The system further includes a voltage that may be applied to a coil that is disposed on the side of the medical device and proximally spaced from the magnetic element. A voltage is applied to the coil to attract the magnetically responsive substances inserted into the body around the coil. A high frequency alternating current voltage is applied to an adjacent transducer to ultrasonically disperse the collected magnetically responsive substances into the surrounding target tissue.

Abstract: A shape memory alloy (SMA) actuator includes a groove formed in a surface of a shape memory alloy (SMA) substrate establishing a trace pattern for a layer of conductive material formed over an electrically insulative layer. The trace pattern includes a first end, a second end, and a heating element disposed between the first and second ends. The SMA substrate is trained to deform at a transition temperature achieved when electricity is conducted through the conductive material via first and second interconnect pads terminating the first and second ends of the trace pattern.

Abstract: A shape memory material activated device of the present invention uses a shape memory material activator to create a path through a shell wall of the device. The path through the shell wall may release a substance contained in the shell or allow a substance to enter the shell. The path may be created by fracturing, puncturing, exploding, imploding, peeling, tearing, stretching, separating, debonding, abrading or otherwise opening the shell and, may be permanent or reversible. The substance may be released in one location while the device is stationary or along a path while it is traveling, self-powered by the shape memory material activator. In addition, the substance may be delivered to an object upon contact with its surface. The self powering abilities allow these devices to be used as substance delivery devices as well as actuators, transporters, and energy conversion systems with modular characteristics and growth potential.

Abstract: A device for the minimally invasive insertion into a lumen of a hollow organ comprises a hose-shaped wall (3) with a multiplicity of piezoelectric fibers (4) embedded therein.

Abstract: A method and device for treating a Chronic Total Occlusion provides a controllable stiffness catheter with a shaft having a stiffness sheath and an access lumen. The device has a stiffness device in a stiff state below a given temperature and in a soft state above the temperature, a temperature-changing device in thermal contact with the stiffness device, the temperature-changing device changing a temperature of the stiffness device below and above the temperature, and a power controller electrically connected to the stiffness device and selectively supplying power to the temperature-changing device to change a stiffness of the stiffness device between the stiff and soft states. A guidewire is moved to a treatment site and the catheter moves along the guidewire up to CTO in its soft state. The catheter stiffens without straightening and, in the stiff state, the catheter or the guidewire is projecting through the CTO.

Abstract: A multiple catheter system is described. In one embodiment a medical catheter system includes a first catheter having an entrance orifice, an exit orifice, a channel connecting the entrance orifice and the exit orifice, and a wall surrounding the channel. In this embodiment the hardness of the wall surrounding the channel decreases in in hardness, increases in hardness and then decreases in hardness again, when considered from an initial reference point at the entrance orifice and traveling towards the exit orifice. Another medical catheter system includes a first catheter having an entrance orifice, an exit orifice, a channel linking the entrance orifice and the exit orifice, and a first wall surrounding the channel wherein the first wall has a bendable curve memory portion.

Abstract: An elongate device for introduction into a body lumen comprises a body extending in a longitudinal direction (L), and having at least two skeletal members (21, 21a, 21b, 24, 27a, 27b), which are substantially aligned in the longitudinal direction (L), and at least one electroactive polymer material (22), which changes volume upon electrical activation, arranged to control a distance between two longitudinally spaced-apart portions of said skeletal members (21, 21a, 21b, 24, 27a, 27b). The body presents an asymmetric bending stiffness, and/or the electroactive polymer material is asymmetrically arranged about a central axis of the device, such that the body is arranged to bend transversely of the longitudinal direction (L) upon activation of the electroactive polymer material. The electroactive polymer material (22) is form fit onto at least one of the skeletal members (21, 21a, 21b).

Abstract: A device (1) which includes an elongate body (2) with a movable mass (3) arranged for sliding movement within the body (2), the element (4) being arranged to decelerate toward an end of the body (2) in order to impart forward movement thereto, via momentum transfer, and being arranged to accelerate away from said end in order to further drive the body (2) forward, again using momentum transfer.

Abstract: Micro-streerable catheters for use in delivering therapeutic treatment in the body, such as ablation and cauterization, and which exhibit precise movement are disclosed. Embodiments include electrical micro-catheters that comprise of electroactive polymers. A preferred embodiment includes a programmable catheter.

Abstract: Methods for easy, atraumatic access to areas of the vasculature that are otherwise difficult to access, using steerable guide catheters constructed with components that are selected to provide optimal navigability, torque transfer, and push ability for a variety of typical percutaneous access routes. The catheter wall thickness in the deflecting segment of the guide catheter is about 1 French (? mm) or less, and includes a slotted deflection tube, and this construction allows a very tight turning radius which in turn enables guide catheter access to regions of the vasculature that are otherwise inaccessible.

Abstract: An apparatus for delivery through a vessel including an extensor segment and first and second anchor segments positioned on either side of the extensor segment, wherein each segment has associated with it an individually-addressable electro-active polymer.

Abstract: A drainage catheter is adapted to drain fluid from the body cavity through a body conduit and includes an elongate tube and a retention member disposed at the distal end of the elongate tube. The retention member is adapted for movement between a low-profile state facilitating insertion of the catheter and a high-profile state facilitating retention of the catheter in its operative position. A woven mesh forms at least a portion of one of the tube and the retention member. The woven mesh can be formed of filaments heat-settable so that the catheter automatically moves to the high-profile state. Insertion of the catheter can be facilitated using a stylet which can be removed after insertion to permit the catheter to automatically return to its high-profile state.

Abstract: The present invention describes a system for controlling a thin flexible thermoplastic catheter. The system includes a plurality of shape memory alloy filaments attached to the distal end of the catheter, each filament having a phase and a temperature; a means for receiving a strain value for at least one of the filaments; a means for determining the phase change that will results in the strain value, whereby the phase change is dependent on the temperature and the temperature is dependent on a voltage; and a means for setting the voltage in each filament thereby resulting in movement of the catheter. In addition, a three-degrees of freedom force sensor measures the magnitude and direction of the force exerted on the tip of the catheter. The catheter can be autonomously guided or it can be interfaced to a haptic device. The catheter can also be fitted with microtools.

Abstract: A catheter assembly comprises a catheter which comprises an inner shaft and an outer shaft, and at least one heat transmitting mechanism. At least one portion of at least one of the inner shaft and the outer shaft of the catheter has a predetermined longitudinal stiffness and a predetermined temperature. The predetermined longitudinal stiffness is changed when the predetermined temperature is changed. The at least one heat transmitting mechanism extends distally from the proximal end of the catheter, along the length of the catheter, to a position adjacent to the at least one portion. At least a portion of the at least one heat transmitting mechanism is constructed and arranged to conductively change the predetermined temperature of the at least one portion of the at least one of the inner shaft and the outer shaft.

Abstract: The present invention provides, in part, a dexterous endoscope apparatus, referred to herein as a MicroFlex Scope (MFS). The MFS is an novel, small diameter, e.g., less about 1 mm to about 4 mm, about 1 mm to about 3 mm, etc., dexterous endoscope that allows for access, direct visualization, tissue sampling, treatment, etc. of body lumens. In one embodiment, the distal end of the MFS of the invention is an ultra-flexible tip that comprises a plurality of thin, curved shape memory alloy (SMA) actuator elements attached to at least one structural skeleton, e.g., a coil spring skeleton or hinge structure. The SMA actuator elements in each structural skeleton segment are indirectly heated by a heater element and produce force in response to their temperature relative to specific thresholds. In certain embodiments, the heater element may include an integrated heater/sensor element adapted to heat the actuator element and to sense the temperature and bend state of the actuator element.

Abstract: A guiding catheter system for delivering an elongated therapeutic or diagnostic device into a patient's left ventricle which includes a first guiding catheter with a shaped distal extremity configured to be aligned with or parallel to a longitudinal axis or long dimension of the patient's left ventricle and a second guiding catheter slidably and rotatably disposed within an inner lumen of the first guiding catheter which has a shaped distal shaft section and an inner lumen configured to slidably receive an elongated therapeutic or diagnostic device such as a tissue ablation device, e.g. an optical fiber connected to a laser source, an ultrasonic energy emitting device or a radio frequency energy emitting device. The shaped distal section of the first guiding catheter is shaped or is shapable within the patient's heart chamber.

Abstract: A shape memory alloy (SMA) actuator includes a groove formed in a surface of a shape memory alloy (SMA) substrate establishing a trace pattern for a layer of conductive material formed over an electrically insulative layer. The trace pattern includes a first end, a second end, and a heating element disposed between the first and second ends. The SMA substrate is trained to deform at a transition temperature achieved when electricity is conducted through the conductive material via first and second interconnect pads terminating the first and second ends of the trace pattern.

Abstract: A steerable coil working channel system for accessing stenosis, partial occlusions, or complete occlusions within a body lumen. The working channel system generally includes an coiled elongate member such as a hollow guidewire that can be advanced through tortuous regions in the vasculature. A deflectable distal tip is coupled to a distal end of the elongate body to facilitate directionality and positioning of the distal end of the working channel at the target site and steering the elongate body through the tortuous regions in the vasculature.

Abstract: A photothermal actuator comprises an optical fiber bundle, a light inputting apparatus, and a thermal receiving element. The optical fiber bundle is inserted in a tube of a catheter etc. The light inputting apparatus inputs light into the optical fiber bundle. The thermal receiving element is provided on a part of an outer surface of the optical fiber bundle. The thermal receiving element is heated by the light so that the thermal receiving element and a part of the optical fiber bundle are stretched, whereby the optical fiber bundle and the tube are bent.

Abstract: A thrombolysis catheter apparatus is disclosed comprising: (a) an elongated thrombolysis catheter portion comprising a plurality of independently controllable electroactive polymer actuators, which provide a curvature to the thrombolysis catheter based upon received control signals; (b) a control unit coupled to the plurality of actuators and sending the control signals to the plurality of actuators; and (c) an occlusion removal device. Also disclosed is a method of treating an arterial occlusion by advancing the thrombolysis catheter portion through the arterial vasculature of a patient to a position proximate the occlusion, while controlling the shape of the thrombolysis catheter portion using the control unit. The occlusion is then removed using the occlusion removal device.

Abstract: Curves and dynamic shapes are imparted in distal segments of medical instruments e.g., catheters, through use of a temperature-activated actuator coupled to distal segment of the instrument body. The actuator comprises includes members extending side-by-side in substantially a common plane and configured to move in opposite directions when independently activated. A first heating device is coupled to a first actuator member and configured to deliver thermal energy to the first actuator member to activate the first actuator member and cause the first actuator member to move the distal segment in a first direction. A second heating device is coupled to a second actuator member and configured to deliver thermal energy to the second actuator member to activate the second actuator member and cause the second actuator member to move the distal segment in a second direction opposed to the first direction.

Abstract: An apparatus having a steerable distal end portion for insertion in a body lumen comprises a superlastic shape memory member which adopts a memorized shape in an unloaded austenitic state, and stationary heating means for heating at least a portion of the superlastic shape memory member to a temperature above the temperature inside the body lumen. Heating the superlastic shape memory member inside the body lumen causes it to increase in stiffness and tend toward the memorized shape, and subsequent discontinuation of heating causes the superlastic shape memory member to decrease in stiffness, allowing the distal end portion to be deformed from the memorized shape, thereby resulting in movement of the distal end portion which assists in steering it through the body lumen. Preferably, the elongate shape memory member is tubular, having a lumen extending therethrough, and the heating means comprises electrical heating means.

Abstract: A catheter includes a steering mechanism for manipulating the distal end of the catheter to obtain a plurality of deflection profiles. The steering mechanism comprises two steering tendons. The first steering tendon is attached to the distal-end region and the second steering tendon is attached to the distal-end region at a location proximal the attachment point of the first steering tendon. The steering tendons may be located approximately angularly aligned, thus causing the deflection profiles to be unidirectional. Alternatively, the steering tendons may be angularly separated from each other, thus causing the deflection profiles to be bidirectional. The steering tendons are attached so that moving the first steering tendon in a proximal direction causes the distal-end region to deflect in a tight loop, whereas moving the second steering tendon in a proximal direction causes the distal-end region to deflect in a U-shape.

Abstract: A catheter includes a steering mechanism for manipulating the distal end of the catheter to obtain a plurality of deflection profiles, and a torque transfer system at the distal portion to enhance torque transfer from the handle to the distal tip. The steering mechanism includes two steering tendons. The steering tendons are attached to the distal-end region of the catheter. The steering tendons may be located approximately angularly aligned, thus causing the deflection profiles to be unidirectional. Alternatively, the steering tendons may be located angularly separated from each other, thus causing the deflection profiles to be bidirectional. In other aspects, the torque transfer system includes a flat ribbon within the relatively flexible distal-end region to enhance torque transfer through the distal-end region of the catheter.

Abstract: A tubular medical device comprises a tubular body, a lumen, a compression-resisting member inserted in the lumen so that it cannot move in the direction of the axis of the tubular body, with its distal end located at a predetermined distance from the distal end of the tubular body toward the proximal end, a pull wire whose distal end is secured near the distal end of the tubular body at a position deviated from the axis of the tubular body and which is led in the tubular body to the proximal end of the tubular body, and a pulling mechanism for pulling the pull wire toward the proximal end of the tubular body which is attached to the proximal end of the tubular body and has a manipulation dial. The compression-resisting member consists of a main body and a secured portion. The compression-resisting member main body, and has a property of resisting compression in the axial direction of the tubular body. The secured portion retains the main part in place in the lumen.

Abstract: A method for treating myocardium using at least one mechanical or electromagnetic energy functional device for forming a network of branched, interconnecting passages in a boundary between endocardium and myocardium, thereby enhancing blood flow into the treated zone, and a device for selectively treating ischemic myocardium tissue comprising a tube having proximal end and distal end, and at least one hollow lumen and defining an axis, at least two mechanical or electromagnetic energy functional devices disposed within the tube, the at least two mechanical or electromagnetic energy functional devices each having a distal end disposed adjacent the distal end of the central tube, and a deflecting member adjacent the distal portion of the central tube for deflecting the distal end of each of the at least two mechanical or electromagnetic energy functional devices away from the axis, for enabling treatment of selective areas of ischemic or hibernating myocardium tissue.