A medical instrument for localized drug delivery to tissue, comprising: a catheter shaft assembly having a proximal end, a distal end, a longitudinal axis between the proximal and distal ends, at least one injection lumen, at least one inflation lumen, and a guidewire lumen; a hub coupled to the proximal end of the catheter shaft assembly, the hub comprising at least one injection port coupled to the at least one injection lumen, at least one inflation port coupled to the at least one inflation lumen, and a guidewire port coupled to the guidewire lumen; an inflatable body at the distal end of the catheter shaft assembly, the inflatable body being inflatable from an involuted contracted configuration; a tissue penetrating member coupled to the inflatable body in an orientation transverse to the longitudinal axis of the catheter shaft assembly and further coupled to an injection lumen of the catheter shaft assembly, wherein said tissue penetrating member is coupled to the inflatable body with a tip end of said tissue penetrating member pointing outwardly of the inflatable body and enclosed within walls of the inflatable body when in the involuted contracted configuration; and at least one protective element coupled to said inflatable body in proximity to said tissue penetrating member, wherein at least the tip end of said tissue penetrating member is bordered by said at least one protective element when said inflatable body is in said involuted contracted configuration, wherein said protective element is radio-opaque and is configured to provide an indication of an inflation status of said inflatable body when viewed via x-ray. a catheter shaft assembly having a proximal end, a distal end, a longitudinal axis between the proximal and distal ends, at least one injection lumen, at least one inflation lumen, and a guidewire lumen; a hub coupled to the proximal end of the catheter shaft assembly, the hub comprising at least one injection port coupled to the at least one injection lumen, at least one inflation port coupled to the at least one inflation lumen, and a guidewire port coupled to the guidewire lumen; an inflatable body at the distal end of the catheter shaft assembly, the inflatable body being inflatable from an involuted contracted configuration; a tissue penetrating member coupled to the inflatable body in an orientation transverse to the longitudinal axis of the catheter shaft assembly and further coupled to an injection lumen of the catheter shaft assembly, wherein said tissue penetrating member is coupled to the inflatable body with a tip end of said tissue penetrating member pointing outwardly of the inflatable body and enclosed within walls of the inflatable body when in the involuted contracted configuration; and at least one protective element coupled to said inflatable body in proximity to said tissue penetrating member, wherein at least the tip end of said tissue penetrating member is bordered by said at least one protective element when said inflatable body is in said involuted contracted configuration, wherein said protective element is radio-opaque and is configured to provide an indication of an inflation status of said inflatable body when viewed via x-ray.