Devices and methods to perform elevation of the Schneiderian membrane in a safe, easy and minimally invasive manner are described. The devices include a cannula and a balloon. A liquid can be introduced through the cannula inside the maxillary sinus below the Schneiderian membrane to elevate the Schneiderian membrane. The balloon can be inflated through the cannula so the balloon will be expanded inside the maxillary sinus below the Schneiderian membrane while being surrounded by the liquid which was previously introduce inside the maxillary sinus. The expansion of the balloon is safely further elevating the Schneiderian membrane in a controlled amount and location.

A launching catheter for targeting a second vessel from a first vessel includes a catheter including a proximal portion and a distal portion including a needle aperture and a flat rectangular radiopaque marker. The flat rectangular radiopaque marker disappears under fluoroscopy upon rotation to provide information about rotational alignment of the launching catheter. The launching catheter includes a needle configured to extend through the needle aperture. A method of aligning the catheter includes rotating the catheter in a first blood vessel until the marker has a thickness (e.g., minimal thickness) under fluoroscopy. The thickness indicates rotational alignment of the catheter.

A catheter system can include a tubular body, and at least one of a targeting system coupled to the tubular body, an expandable member, or a fluid injection port. A method of identifying a bifurcation can include inserting a catheter system into a first vessel, positioning the catheter system at a first location, expanding an expandable member to occlude the first vessel, delivering contrast material so the contrast material pooling proximate to the expandable member, and reviewing a shape of the contrast material in the first vessel under fluoroscopy.

Disclosed herein are medical instrument and medical method for localized drug delivery. The medical instrument can comprise a catheter shaft assembly, a hub coupled to the proximal end of the catheter shaft assembly, an inflatable component at the distal end of the catheter shaft assembly, a tissue penetrating member coupled to the inflatable component in an orientation transverse to the longitudinal axis of the catheter shaft assembly, and at least one protective element coupled to the inflatable component in proximity to the tissue penetrating member. The protective element can be configured to prevent any damage of the inflatable body during a placement of the medical instrument and an actuation of the inflatable component.

A device may comprise a shaft comprising a hollow body, an anchor disposed adjacent an end of the shaft, wherein the anchor is configured to engage a surface to releasably secure the shaft to the surface, and a needle at least partially disposed within the shaft and is configured to be advanced toward the surface and outside of the shaft.

Systems, devices, and methods for maintaining patency in a bronchus of a patient are presented. A catheter is positioned within the bronchus. A target region of one or more of a bronchial wall, submucosa, media, and adventitia is punctured with an injection needle disposed on a distal end of the catheter. Such puncturing is achieved by expanding a balloon disposed on the distal end of the catheter. The balloon may be comprised of at least two materials of different elastic modulus, which allows for a flexible but relatively non-distensible, unfolding component of the balloon as well as an elastomeric, inflatable component of the balloon. Through the injection needle, an amount of one or more crosslinking agents is delivered to the target region. The delivered amount is effective to provide structural support for the bronchial wall, substituting for the bronchial cartilage thereby treating bronchomalacia.

Methods and system are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

An injectate delivery device for expanding tissue is provided. The injectate delivery device comprises: at least one fluid delivery tube comprising a proximal end, a distal end and a lumen therebetween; at least one fluid delivery element in fluid communication with the at least one fluid delivery tube lumen; a radially expanding element comprising the at least one fluid delivery element; a supply of vacuum constructed and arranged to cause tissue to tend toward the at least one fluid delivery element; and at least one control constructed and arranged to perform a function. The at least one control can be constructed and arranged to expand the radially expandable element and activate the supply of vacuum. Systems and method of injectate delivery are also provided.

The invention features is an embodiment of methods and devices that comprise a multilumen portal vein access device, comprising at least a lumen for passage of a needle or needle-tipped guide wire that is used for piercing the liver from a hepatic vein position to a branch of the portal vein through the substance of the liver, and at least one other lumen that is use for passage of a guide wire, said other lumen and guide wire serving the function of preserving the position of the portal vein access device within the hepatic vein, thereby facilitating multiple attempts at puncturing the portal vein without the need to select the hepatic vein with separate maneuvers between needle advancement attempts.

Methods and system are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.