Methods and apparatus for transvascular muscular revascularization and

Abstract

Apparatus and methods for effecting controlled injury to a selected body region to induce muscular revascularization and to provide delivery of drugs and therapeutic agents. A transvascular or muscular revascularization device is provided comprising a stimulator with extended penetrating members and a depth regulator for controlling the extent of penetration through tissue membrane, an outer sheath for retention of the stimulator and selective deployment of the penetrating members of the stimulator, and energy transfer means in communication with the stimulator for effecting a controlled injury to a selected region with directed energy through the penetrating members of the stimulator. A method is further provided for effecting a controlled injury and drug delivery to selected blood vessels or muscle that includes selecting an elongated vascular probe and sheath assembly wherein the vascular probe is formed with a plurality of perforating members to penetrate a membrane wall and a sheath to retain the perforating members of the vascular probe in a retracted position. Upon introduction of the assembly into a selected region, the perforating members of the probe are deployed beyond the outer surface of the sheath to penetrate the selected region which provides localized drug delivery or a controlled injury. A controlled injury may be effected in a localized region such as the myocardium through a coronary vein to provide an angiogenic response that promotes revascularization of the selected muscle region.