Systems and methods for endoluminal valve creation

A system for visualizing a delivery of fluid to a space within a blood vessel wall, the system comprising:

• an elongated shaft, comprising:
• a distal portion configured to be intravascularly positioned adjacent to the blood vessel wall, wherein the distal portion has a sloped surface, a tissue engagement surface extending distally in a longitudinal direction from the sloped surface, and a trough extending distally from the sloped surface in the longitudinal direction, wherein the trough comprises a bottom portion and sidewalls extending between the bottom portion to the tissue engagement surface so that the bottom portion is open to the blood vessel wall;
• a tool lumen extending through the elongated shaft and terminating at an exit port proximal to the tissue engagement surface;
• and
• a visualization lumen extending through the elongated shaft and into the distal portion, wherein the visualization lumen is configured to guide a visualization device to the distal portion to visualize tissue in the blood vessel wall adjacent to the tissue engagement surface, and wherein the visualization lumen and the trough are configured to guide the visualization device to visualize tissue in the blood vessel wall adjacent to the tissue engagement surface;
• and
• a fluid delivery tool configured to advance through the tool lumen and distally from the exit port to access the space in the blood vessel wall, wherein the fluid delivery tool includes a fluid lumen to deliver the fluid to the space within the blood vessel wall.

A device for delivering a fluid to a space within a blood vessel wall, the device comprising:

• a catheter shaft having a distal portion configured to be intravascularly positioned adjacent to the space within the blood vessel wall, wherein the distal portion comprises:
• a sloped surface at an angle with respect to a longitudinal axis of the distal portion;
• a tissue engagement surface extending distally from the sloped surface along the longitudinal axis of the distal portion;
• a trough formed in the tissue engagement surface, wherein the trough is open to the blood vessel wall and positioned to define at least a portion of a periphery of the space when the distal portion is pressed against the blood vessel wall;
• and
• a first port positioned along at least a portion of the sloped surface;
• a first lumen extending through the catheter shaft and terminating at the first port of the distal portion, wherein the first lumen and the first port are positioned to direct a fluid delivery tool into the space when the distal portion is pressed against the blood vessel wall;
• and
• a second lumen extending through the catheter shaft and terminating at a second port open to the trough, wherein the second lumen is positioned to direct an imaging device adjacent to the space when the distal portion is pressed against the blood vessel wall to image the space within the blood vessel wall, and wherein the trough is configured to guide the imaging device while imaging the space within the blood vessel wall.