| abstract |
A transvascular system ( 10 ) for delivering a drug to a tissue region from a blood vessel, such as a coronary vein, includes a catheter ( 12 ) having a distal portion ( 26 ) with puncturing ( 14 ), orientation ( 16 ), drug delivery ( 62 ), and imaging elements ( 18 ). The puncturing element ( 14 ) is deployable for penetrating the vessel wall to access the tissue region. The orientation element ( 16 ), e.g. a “cage” including a plurality of struts ( 38 ) ( 40 ) and/or a radiopaque marker, has a predetermined relationship with the puncturing element ( 14 ), the imaging element ( 18 ) detecting the location of the orientation element ( 16 ) with respect to the tissue region to orient the puncturing element. The catheter ( 12 ) is percutaneously introducing into the vessel, the puncturing element ( 14 ) is oriented towards the tissue region, the puncturing element ( 14 ) is deployed to access the tissue region, and the drug is delivered to the tissue region. An ablation device ( 230 ) may also be deployed to create a cavity or fluid reservoir in the tissue region for receiving the drug therein, or an indwelling catheter ( 214 ) may be advanced into and left in the tissue region. |