Systems and methods for delivering drugs to selected locations within the body

A method of providing access to a selected tissue region within a patient's body from a blood vessel using a transvascular catheter having a deployable puncturing element, and an orientation element on a distal portion thereof, the method comprising:

• percutaneously introducing the distal portion of the transvascular catheter into a blood vessel;
• directing the distal portion endovascularly to a vessel location adjacent to the selected tissue region;
• orienting the puncturing element towards the selected tissue region using the orientation element;
• deploying the puncturing element to access the selected tissue region;
• advancing a floppy catheter into the selected tissue region via the transvascular catheter;
• and
• removing the transvascular catheter from the body, leaving the floppy catheter in the selected tissue region.

A method for delivering a substance to a selected tissue region within a patient's body with a catheter having a deployable puncturing element, a drug delivery element, an orientation element, and an imaging clement carried by a distal portion of the catheter, the method comprising:

• percutaneously introducing the distal portion of the catheter into a blood vessel;
• directing the distal portion endovascularly to a vessel location adjacent to the selected tissue region;
• rotating the catheter about its longitudinal axis while imaging the orientation element with the imaging element to orient the puncturing element towards the selected tissue region;
• deploying the puncturing element to access the selected tissue region;
• and
• delivering a substance with the drug delivery element to the selected tissue region.

A method for delivering a substance within a patient's heart with a catheter having a puncturing element, a drug delivery element, and an orientation element on a distal portion thereof, the method comprising:

• percutaneously introducing the distal portion of the catheter into a blood vessel;
• directing the distal portion endovascularly into a coronary vein or a coronary artery adjacent to a selected tissue region located beyond a wall of the coronary vein or coronary artery;
• orienting the puncturing element towards the selected tissue region using the orientation element:
• deploying the puncturing element from the catheter through the wall of the coronary vein or coronary artery to access the selected tissue region;
• and
• delivering a substance with the drug delivery element to the selected tissue region.