Reentry catheters and methods for traversing chronic total occlusions

Abstract

A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. A method of crossing a chronic total occlusion includes the steps of advancing the reentry catheter across the occlusion via a channel formed in the subintimal space, and advancing a guidewire via a selected exit port into the native lumen distally of the occlusion. The catheter may be removed, leaving the guidewire across the occlusion to guide further interventional devices.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS[0001]This application claims priority to U.S. Provisional Patent Application No. 62 / 830,199, filed Apr. 5, 2019, and U.S. Provisional Patent Application No. 62 / 907,299, filed Sep. 27, 2019, the entire contents of both of which are incorporated herein by reference in their entireties.BACKGROUND OF THE INVENTION[0002]An interventional guide wire or other interventional device is often used in medical procedures that attempt to establish a pathway through a heavily stenosed or chronically occluded vessel. A chronically occluded vessel is referred to as containing a chronic total occlusion or CTO. During these procedures, the guide wire or device can only be of clinical benefit to establish vessel patency if it is advanced distally into the vessel true lumen.[0003]One technique for restoring patency across a CTO involves advancing a guide wire through the intimal layer of the vessel wall and into the subintimal plane or space, where it can be furt...

Images