Bendable wire lumen

Abstract

One aspect of some embodiments of the present invention relates to a redirecting microcatheter comprising an outer tubular body comprising a first proximal end and a first distal end; the first far end comprises a far end opening and at least one side opening; an inner tubular body sized and shaped to be inserted within the outer tubular body; the inner tubular body comprises a second proximal end and a second distal end; the second distal end is adjacent to the at least one side opening; at least one actuator for translating the second distal end of the inner tubular body from an unactuated position in which the second distal end of the inner tubular body faces the distal end opening to an actuated position in which the second distal end of the inner tubular body faces the distal end opening, the second distal end of the inner tubular body faces the one or more side openings in the outer tubular body.

Description

[0001] Related Applications

[0002] This application claims the benefit of priority to U.S. Provisional Patent Application No. 63 / 341,431, filed on May 13, 2022, the contents of which are incorporated herein by reference in their entirety.

[0003] Technical field and background technology

[0004] The present invention, in some embodiments thereof, relates to catheters having a dedicated guidewire lumen, and more particularly, but not exclusively, to catheters having a flexible lumen.

[0005] Other background art includes U.S. Patent No. US6217527B1, which discloses a method and apparatus for completely traversing a substantially occluded blood vessel by passing a redirectable wire, such as a guidewire, from a relatively proximal point through an occlusion within a subintimal space formed between the intimal and adventitial layers of a blood vessel wall. The wire can be advanced to a point distal to the occlusion and then deflected back into the vessel lumen, typically using a deflecting catheter that is advanced along the guidewire after positioning the guidewire within the subintimal space. The deflecting catheter can include a flapper valve assembly or a preformed actuator wire for redirecting the guidewire. After the guidewire is returned to the vessel lumen, the deflecting catheter can be withdrawn and the guidewire can be used to introduce other interventional and diagnostic catheters to perform procedures such as stent placement.

[0006] U.S. patent application publication No. US20200282187A1 discloses an occluder comprising a hollow distal portion, wherein the distal portion comprises a distal end and a side port located proximal to the distal end, wherein the side port is used to receive a guide wire and guide the guide wire laterally from the occluder.

[0007] US Patent No. US9233224B1 discloses a medical device and method for accessing arterial side branches. The device includes a catheter having a side wall, an inner cavity and a side port formed through the side wall. A perforating wire has a proximal portion located in the inner cavity and a distal portion arranged to be removable from the side port. When the catheter is deployed to a position where the side port is aligned with the side branch artery, the wire can be delivered to the side branch artery through the side port. In another embodiment, the catheter has inner and outer telescopic tubes, in which an offset outlet is formed. The telescopic tube can be used to change the degree of deflection of the perforating wire by changing the relative position of the offset outlet.

[0008] The U.S. patent application publication No. US20020055733A1 discloses a catheter assembly and method for delivering a wire to a blood vessel. The catheter assembly of the present invention has the feature of containing two wire lumens in a single catheter to prevent wire entanglement and wire crossing. A torsion member is provided to assist the rotation of the catheter. The assembly allows the wire to be delivered to a side branch vessel that is at a steep angle relative to the main vessel. The assembly can also deliver two wires to a bifurcation.

[0009] U.S. patent application publication No. US20210236774A1 discloses a catheter that allows a surgical tool to be selectively guided into multiple blood vessels of a patient. The catheter includes a catheter body having a main outlet and a side outlet. An internal balloon is provided in the catheter body. The internal balloon is inflatable and can be located at or near a distal portion of the side outlet. When deflated, the internal balloon allows the surgical tool to advance through the side outlet and leave the main outlet. When inflated, the internal balloon guides the surgical tool to be pushed out of the side outlet instead of the main outlet.

[0010] U.S. patent application publication No. US20190091438A1 discloses a catheter having an inner cavity, the catheter including a side port passing through the elongated body of the catheter at a predetermined position. The side port can be positioned at an anatomical location of interest, and a fluid, such as a drug, is injected along the inner cavity of the catheter, and the fluid flows out of the side port to treat the anatomical location. Multiple alternative embodiments may include a translatable inner sheath that can cover some of the side ports and may also include a hole that can be aligned with at least one of the side ports. The side port can be opened and closed by an actuator such as a push / pull wire or an electrically responsive shape memory material. A selective filter can be used to cover the side port so that only fluids with a specific viscosity and / or molecular size can pass through the filter and the side port.

[0011] U.S. Patent No. US9610438B2 discloses a delivery catheter, including a catheter body, a side port, a first electrode and a second electrode. The catheter body may include a proximal end, a distal end and a peripheral surface. The catheter body defines a delivery lumen extending longitudinally within the catheter body. The side port is defined in the peripheral surface of the catheter body, close to the distal end and connected to the delivery lumen. The electrode may be adjacent to and spaced from the side port. A variety of techniques are also described for using the delivered catheter to identify a desired lead implantation location, such as through the electrode, and implanting a medical lead or other implantable element at the desired location through the delivery lumen and the side port. Summary of the invention

[0012] The following is a non-exclusive list of some examples including embodiments of the invention. The invention also includes embodiments that include less than all features of one embodiment and embodiments that use features from multiple examples, even if not explicitly listed below.

[0013] Example 1. A redirecting microcatheter, comprising:

[0014] a. an outer tubular body comprising a first proximal end and a first distal end; the first distal end comprising a distal opening and at least one side opening;

[0015] b. an inner tubular body sized and shaped to be inserted into said outer tubular body; said inner tubular body comprising a second proximal end and a second distal end; said second distal end being adjacent to said at least one side opening;

[0016] c. at least one actuator for translating the second distal end of the inner tubular body from an unactuated position, wherein in the unactuated position, the second distal end of the inner tubular body faces the distal opening, to an actuated position, wherein in the actuated position, the second distal end of the inner tubular body faces the one or more side openings in the outer tubular body.

[0017] Example 2. A redirecting microcatheter according to Example 1, wherein the actuator includes at least one retainer, the at least one retainer being coupled to a position adjacent to the second distal end of the inner tubular body: and at least one wire, the at least one wire being coupled to the at least one retainer.

[0018] Example 3. The redirecting microcatheter of Example 1 or Example 2, wherein the translating comprises bending the second distal end of the inner tubular body at an angle of about 1 degree to about 150 degrees.

[0019] Example 4. The redirecting microcatheter of any one of Examples 1 to 3, wherein the translating comprises bending the second distal end of the inner tubular body at an angle of approximately 90 degrees.

[0020] Example 5. The redirecting microcatheter of any one of Examples 1 to 4, wherein the at least one side opening is located at a distance of about 0.5 mm to about 10 mm from the distal opening.

[0021] Example 6. The redirecting microcatheter of any one of Examples 1 to 5, wherein the distal opening has a size of about 0.015" to about 0.1".

[0022] Example 7. The redirecting microcatheter of any one of Examples 1 to 6, wherein the at least one side opening has a size of about 0.015" to about 0.1".

[0023] Example 8. A redirecting microcatheter according to any one of Examples 1 to 7, wherein the outer tubular body is made of one or more of nylon, polyether block polyamide (Pebax), polyurethane (polyorithen), metal, polytetrafluoroethylene (PTFE) and any combination thereof.

[0024] Example 9. The redirecting microcatheter of any one of Examples 1 to 8, wherein the outer tubular body is a braided / coiled shaft.

[0025] Example 10. The redirecting microcatheter of any one of Examples 1 to 9, wherein the outer tubular body has a length of about 90 centimeters to about 180 centimeters.

[0026] Example 11. The redirecting microcatheter of any one of Examples 1 to 10, wherein the outer tubular body has a size suitable for passing through a 5F or 6F sheath.

[0027] Example 12. The redirecting microcatheter of any one of Examples 1 to 10, wherein the outer tubular body comprises a reinforced region adjacent to and / or around the one or more side openings.

[0028] Example 13. The redirecting microcatheter of Example 12, wherein the reinforced region comprises one or more metal elements configured to increase a stiffness level of the reinforced region.

[0029] Example 14. The redirecting microcatheter of any one of Examples 1 to 13, wherein the inner tubular body is made of a flexible material.

[0030] Example 15. The redirecting microcatheter of any one of Examples 1 to 14, wherein at least a portion of the inner tubular body is made of a flexible material.

[0031] Example 16. A redirecting microcatheter according to any one of Examples 1 to 15, wherein at least a distal portion of the inner tubular body is made of a flexible material.

[0032] Example 17. The redirecting microcatheter of any one of Examples 1 to 16, wherein the flexible portion of the inner tubular body comprises a Shore hardness of about 20D to about 60D.

[0033] Example 18. The redirecting microcatheter of any one of Examples 1 to 17, wherein the inner tubular body is made of one or more of nylon, Pebax, polyurethane, metal, PTFE, and any combination thereof.

[0034] Example 19. The redirecting microcatheter of any one of Examples 1 to 18, wherein the outer tubular body is a braided / coiled shaft.

[0035] Example 20. The redirecting microcatheter of any one of Examples 1 to 19, wherein the inner tubular body has a length of about 100 mm to about 1800 mm.

[0036] Example 21. The redirecting microcatheter of any one of Examples 1 to 20, wherein the length of the inner tubular body is approximately the length of the outer tubular body.

[0037] Example 22. The redirecting microcatheter of any one of Examples 1 to 20, wherein the second distal end extends to a distance of about 0.1 centimeters to about 1.5 centimeters from the first distal end.

[0038] Example 23. A redirecting microcatheter according to any one of Examples 1 to 21, wherein the inner tubular body is configured to be withdrawn from the outer tubular body, thereby allowing other instruments to be inserted into the outer tubular body.

[0039] Example 24. A redirecting microcatheter according to any one of Examples 1 to 23, wherein the inner tubular body is configured to allow other instruments to be inserted into itself without being withdrawn from the outer tubular body.

[0040] Example 25. The redirecting microcatheter of any one of Examples 1 to 24, wherein the at least one actuator is made of one or more of stainless steel, nitinol, cobalt chromium, nylon, polyetheretherketone, and Dynema.

[0041] Example 26. The redirecting microcatheter of any one of Examples 1 to 25, wherein the at least one retainer is a ring.

[0042] Example 27. A redirecting microcatheter according to any one of Examples 1 to 26, wherein the at least one retainer is positioned on the flexible portion of the inner tubular body.

[0043] Example 28. The redirecting microcatheter of any one of Examples 1 to 27, wherein the at least one retainer is located about 1 mm to about 20 mm from the second distal end.

[0044] Example 29. The redirecting microcatheter of any one of Examples 1 to 28, wherein the at least one retainer is disposed around the inner tubular body.

[0045] Example 30. The redirecting microcatheter of any one of Examples 1 to 28, wherein the at least one retainer is a groove on the surface of the inner tubular body.

[0046] Example 31. The redirecting microcatheter of any one of Examples 1 to 29, wherein the at least one retainer is made of one or more of stainless steel, nitinol, cobalt chromium, nylon, polyetheretherketone, platinum-iridium, and gold.

[0047] Example 32. The redirecting microcatheter of any one of Examples 1 to 31, wherein the inner tubular body is sized and shaped to allow insertion of at least one guide wire therein.

[0048] Example 33. A redirecting microcatheter according to any one of Examples 1 to 32, wherein the outer tubular body includes a first lumen and the at least one actuator extends in the first lumen.

[0049] Example 34. A redirecting microcatheter according to any one of Examples 1 to 33, wherein the inner tubular body includes a second lumen, and the at least one actuator extends in the second lumen.

[0050] Example 35. A redirecting microcatheter according to any one of Examples 1 to 34, wherein the inner tubular body includes a third lumen, and the at least one guide wire is inserted into the third lumen.

[0051] Example 36. A redirecting microcatheter according to any one of Examples 1 to 35, wherein the redirecting microcatheter further comprises at least one handle located proximal to the redirecting catheter, the at least one handle being configured to receive one or more of the first proximal end of the outer tubular body, the second proximal end of the inner tubular body, and the third proximal end of the actuator.

[0052] Example 37. The redirecting microcatheter of any one of Examples 1 to 36, wherein the redirecting microcatheter further comprises at least one marking configured to indicate a direction in which the one or more side openings face.

[0053] Example 38. A redirecting microcatheter according to Example 37, wherein the at least one marker is a radiopaque marker.

[0054] Example 39. A redirecting microcatheter according to Example 37, wherein the at least one marker is located at one or more of the following locations: on the surface of the outer tubular body, on the surface of the first distal end of the outer tubular body, adjacent to the one or more side openings, on the at least one actuator, and on the at least one retainer.

[0055] Example 40. A redirecting microcatheter according to any one of Examples 1 to 39, wherein the redirecting microcatheter further comprises a stabilizer configured to prevent bending of the first distal end when the at least one actuator is actuated.

[0056] Example 41. The redirecting microcatheter of Example 40, wherein the stabilizer extends from the first proximal end to the first distal end.

[0057] Example 42. The redirecting microcatheter of Example 40, wherein the stabilizer extends within the lumen of the outer tubular body.

[0058] Example 43. The redirecting microcatheter of Example 40, wherein the stabilizer extends between the outer tubular body and the inner tubular body.

[0059] Example 44. The redirecting microcatheter of Example 40, wherein the stabilizer extends within the lumen of the outer tubular body but outside of the inner tubular body.

[0060] Example 45. The redirecting microcatheter of Example 40, wherein the stabilizer is configured to extend beyond the distal opening when actuated.

[0061] Example 46. A method of actuating a redirecting microcatheter according to Example 1 using a guide wire, the method comprising the following steps:

[0062] a. retracting the guide wire from the distal opening of the redirecting microcatheter;

[0063] b. actuating the inner tubular body to translate the second distal end of the inner tubular body from an unactuated position, wherein in the unactuated position the second distal end of the inner tubular body faces the distal opening, to an actuated position, wherein in the actuated position the second distal end of the inner tubular body faces the one or more side openings in the outer tubular body;

[0064] c. Moving the guidewire distally so that the guidewire exits the at least one side opening in the redirecting microcatheter.

[0065] Example 47. A method according to Example 46, wherein the method also includes inserting the redirecting microcatheter into a patient's body.

[0066] Example 48. The method of Example 46 or Example 47, wherein the method further comprises using the guide wire to assist in guiding the redirecting microcatheter toward a desired position.

[0067] Example 49. The method of any one of Examples 46 to 48, wherein the inserting further comprises inserting the guide wire into the redirecting microcatheter.

[0068] Example 50. A method according to any one of Examples 46 to 49, wherein the redirecting microcatheter already includes the guide wire inserted therein.

[0069] Unless otherwise defined, all technical and / or scientific terms used herein have the same meaning as commonly understood by those of ordinary skill in the art to which the invention belongs. Although various methods and various materials similar or equivalent to those described herein can be used to practice or test various embodiments of the present invention, various exemplary methods and / or materials are described below. In the event of a conflict, the present patent specification, including various definitions, shall prevail. In addition, the various materials, various methods, and various examples are illustrative only and are not intended to be necessarily limiting. BRIEF DESCRIPTION OF THE DRAWINGS

[0070] Some embodiments of the present invention are described herein by way of example only and with reference to the accompanying drawings. With specific reference now to the accompanying drawings in detail, it should be emphasized that the various details shown are merely examples for illustrative discussion of various embodiments of the present invention. In this regard, by combining the description with the accompanying drawings, a person skilled in the art can clearly understand how to practice various embodiments of the present invention.

[0071] In the drawings:

[0072] Figure 1a to Figure 1b is a schematic diagram of an exemplary redirecting microcatheter according to some embodiments of the present invention;

[0073] Figure 1c to Figure 1e is a schematic diagram of an exemplary redirecting microcatheter including a reinforcement region according to some embodiments of the present invention;

[0074] Figure 2a to Figure 2b is a schematic diagram of an exemplary redirecting microcatheter with a guide wire according to some embodiments of the present invention;

[0075] Figure 3a to Figure 3b is an exemplary multi-lumen redirecting catheter according to some embodiments of the present invention;

[0076] Figure 4a to Figure 4b is an exemplary multi-lumen redirecting catheter according to some embodiments of the present invention;

[0077] Figure 5 is a flow chart of an exemplary method according to some embodiments of the present invention;

[0078] Figure 6a to Figure 6bis a schematic diagram of an exemplary optional stabilizer according to some embodiments of the present invention;

[0079] Figure 7 is a flow chart of an exemplary method of using an exemplary stabilizer according to some embodiments of the present invention. DETAILED DESCRIPTION

[0080] The present invention, in some embodiments thereof, relates to catheters having a dedicated guidewire lumen, and more particularly, but not exclusively, to catheters having a flexible lumen.

[0081] Overview

[0082] One aspect of some embodiments of the present invention is a redirecting catheter configured to allow one or more instruments to exit the catheter from one or more side openings. In some embodiments, there are two or more side openings, and the user can choose which side opening to use. In some embodiments, the redirecting catheter includes an inner tube located inside the redirecting catheter, the inner tube being configured to face the one or more side openings without the redirecting catheter changing direction. In some embodiments, the one or more side openings are large enough to allow one or more of a guide wire, a balloon catheter, a stent catheter, multiple interventional instruments, and multiple drug release devices to pass through. In some embodiments, the inner tube can be oriented at an angle of about 1 degree to about 150 degrees relative to the longitudinal axis of the redirecting catheter, preferably at an angle of about 90 degrees. In some embodiments, the redirecting catheter is reinforced at the area where the inner tube redirects. In some embodiments, the reinforcement is achieved by adding a metal insert to the outer tube. In some embodiments, multiple reinforcements are added over the entire area including the side openings. In some embodiments, the multiple reinforcements are added at selected locations near or adjacent to the side openings. In some embodiments, the multiple reinforcements prevent unnecessary bending of the outer tube at the side openings. In some embodiments, the redirecting catheter includes a stabilizer. In some embodiments, the stabilizer is configured to avoid unnecessary bending of the distal end of the outer tube when the inner tube is bent to allow the guide wire to be redirected through the side opening. In some embodiments, the stabilizer is a wire extending from the proximal end of the outer tube to the distal end of the outer tube, located within the inner cavity of the outer tube. In some embodiments, the stabilizer is configured to move forward and backward. In some embodiments, forward movement of the stabilizer allows the distal end of the stabilizer to exit through the distal opening in the outer tube. In some embodiments, the stabilizer is sufficiently rigid to prevent the distal end of the outer tube from bending when the inner tube is bent.

[0083] Before explaining at least one embodiment of the present invention in detail, it should be understood that the application of the present invention is not necessarily limited to the details and / or methods of the construction and component arrangement set forth in the following description and / or shown in the drawings and / or embodiments. The present invention can have other embodiments or can be practiced or implemented in various ways.

[0084] Reference now Figures 1a to 1b , shows a schematic diagram of an exemplary redirecting microcatheter 100 according to some embodiments of the present invention. In some embodiments, the redirecting microcatheter 100 includes an outer tubular body 102, and the outer tubular body 102 includes a proximal end 104 and a distal end 106. In some embodiments, the proximal end is connected to an actuation handle (not shown). In some embodiments, the outer tubular body 102 includes a distal opening 108, which is located at the distal end 106 of the outer tubular body 102; and at least one side opening 110 (hereinafter referred to as "side opening 110" - although mentioned in the singular, it should be understood that the scope of the present invention also includes multiple side openings), the side opening 110 is adjacent to the distal end 106 of the outer tubular body 102 and is located proximal to the distal end 106 of the outer tubular body 102. In some embodiments, the outer tubular body 102 includes one side opening 110. In some embodiments, the outer tubular body 102 includes two side openings 110. In some embodiments, the outer tubular body 102 includes three or more side openings 110. In some embodiments, optionally, the distal opening 108 and / or one or more side openings 110 are large enough to allow passage of one or more guide wires (0.035 mm guide wire or 0.018 mm guide wire or 0.014 mm guide wire), an inner tubular body (see below), a balloon catheter, a stent catheter, and a microcatheter.

[0085] In some embodiments, the size (or diameter) of the distal opening 108 is about 0.015" to about 0.1". For example, 0.015", 0.02", 0.036", 0.04", 0.055", 0.084", 0.09".

[0086] In some embodiments, the size (or diameter) of the side opening 110 is about 0.015" to about 0.1". For example, 0.015", 0.02", 0.036", 0.04", 0.055", 0.084", 0.09".

[0087] In some embodiments, the side opening 110 is located about 0.5 mm to about 10 mm from the distal opening 108. Alternatively, about 0.3 mm to about 20 mm. Alternatively, about 0.1 mm to about 50 mm.

[0088] In some embodiments, the outer tubular body 102 is made of one or more of nylon, Pebax, polyurethane, metal, PTFE, and any combination thereof. In some embodiments, the outer tubular body is a braided shaft / coiled shaft.

[0089] In some embodiments, the length of the outer tubular body 102 is about 90 cm to about 180 cm. Optionally, it is about 80 cm to about 200 cm. Optionally, it is about 50 cm to about 250 cm. In some embodiments, the outer tubular body 102 comprises a size suitable for passing through a 5F or 6F sheath.

[0090] In some embodiments, the redirecting microcatheter 100 includes an inner tubular body 112, and the inner tubular body 112 includes a proximal end 114 and a distal end 116. In some embodiments, the proximal end 114 of the inner tubular body 112 is connected to an actuation handle (not shown). In some embodiments, the distal end 116 of the inner tubular body 112 extends distally until near the location of the side opening 110. In some embodiments, the inner tubular body 112 is made of a flexible material. In some embodiments, at least a portion of the inner tubular body 112 is made of a flexible material. In some embodiments, at least a distal portion of the inner tubular body 112 is made of a flexible material.

[0091] In some embodiments, the flexible portion of the inner tubular body 112 comprises a hardness of about 20A Shore to about 60A Shore; optionally about 10A Shore to about 75A Shore; optionally about 0A Shore to about 100A Shore; for example, 70A Shore, 50A Shore, 25A Shore. In some embodiments, the flexible portion of the inner tubular body 112 comprises a hardness of about 20D Shore to about 60D Shore; optionally about 10D Shore to about 75D Shore; optionally about 0D Shore to about 100D Shore; for example, 55D Shore, 40D Shore, 25D Shore.

[0092] In some embodiments, the inner tubular body 112 is made of one or more of nylon, Pebax, polyurethane, metal, PTFE, and any combination thereof. In some embodiments, the outer tubular body is a braided shaft / coiled shaft.

[0093] In some embodiments, the length of the inner tubular body 112 is about 100 mm to about 1800 mm. Optionally, it is about 50 mm to about 2000 mm. Optionally, it is about 25 mm to about 2500 mm. In some embodiments, the length of the inner tubular body 112 is about the length of the outer tubular body 102.

[0094] In some embodiments, the distal end 116 of the inner tubular body 112 extends from the proximal end of the device to a distance of about 0.1 centimeters to about 1.5 centimeters from the distal end 106 of the outer tubular body 102 .

[0095] In some embodiments, inner tubular body 112 is configured to be withdrawn from redirecting microcatheter 100 to allow other instruments to be inserted into redirecting microcatheter 100. In some embodiments, inner tubular body 112 is configured to allow other instruments to be inserted into itself without withdrawing inner tubular body 112.

[0096] In some embodiments, the redirecting microcatheter 100 includes an actuator 118. In some embodiments, the actuator 118 is a wire. In some embodiments, the actuator 118 is a push-pull wire. In some embodiments, the actuator 118 is made of one or more of stainless steel, nitinol, cobalt chromium, nylon, polyetheretherketone, and Dynema.

[0097] In some embodiments, the actuator 118 includes a proximal end 120 and a distal end 122. In some embodiments, the proximal end 120 of the actuator 118 extends into the interior of the actuation handle (not shown) to an actuation mechanism, which will be further explained below. In some embodiments, the distal end 122 of the actuator 118 is connected to a bracket 124 (see below) located near the distal end 116 of the inner tubular body 112.

[0098] In some embodiments, the redirecting microcatheter 100 includes a stent 124. In some embodiments, the stent 124 is connected to the inner tubular body 112 at a location adjacent to the distal end 116 of the inner tubular body 112. In some embodiments, the stent 124 is connected to at least a portion of the flexible portion of the inner tubular body 112. In some embodiments, the stent 124 is located about 1 mm to about 20 mm from the distal end 116 of the inner tubular body 112. Optionally, about 0.5 mm to about 40 mm. Optionally, about 0.1 mm to about 60 mm.

[0099] In some embodiments, the support 124 is a ring or a band. In some embodiments, the support 124 is arranged around the inner tubular body 112. In some embodiments, the support 124 is a groove on the surface of the inner tubular body 112, and the distal end 122 of the actuator is located in the groove.

[0100] In some embodiments, the stent 124 is made of one or more of stainless steel, nitinol, cobalt chromium, nylon, polyetheretherketone, platinum-iridium, and gold.

[0101] In some embodiments, actuation of the actuator 118 causes a portion of the distal end 116 of the inner tubular body 112 to translate from a first position to a second position. In some embodiments, the first position is a static position in which the portion of the distal end 116 of the inner tubular body 112 is not actuated and the distal end 116 of the inner tubular body 112 is aligned with the longitudinal axis 126 of the redirecting microcatheter 100, such as Figure 1a In some embodiments, the second position is an actuated position in which the portion of the distal end 116 of the inner tubular body 112 is actuated and translated from the longitudinal axis 126 to face and / or point (see arrow 128) toward the side opening 110, such as Figure 1b As shown. The exemplary use of a push-pull wire will be used as an exemplary actuator for the following explanation. It should be understood that this is done to allow those skilled in the art to understand the present invention and should not limit the present invention in any way. In some embodiments, the push-pull wire actuates the inner tubular body 112 to move from a first position to a second position (or from the non-actuated position to the actuated position). In some embodiments, the push-pull wire actuates the inner tubular body 112 to move from the second position to the first position (or from the actuated position to the non-actuated position). In some embodiments, the natural state of the inner tubular body 112 is in the static position (non-actuated position), and during actuation, the inner tubular body 112 will "want" to return to the static position. Therefore, in some embodiments, the actuation of the inner tubular body 112 includes actively translating the portion of the distal end 116 of the inner tubular body 112 from a static position to an actuated position by pulling the push-pull wire and maintaining the push-pull wire tension until actuation is no longer required. Then, in some embodiments, releasing and / or reducing the tension in the push-pull wire allows the inner tubular body 112 to return to the natural resting position.

[0102] In some embodiments, the translation during the actuation is about 1 degree to about 90 degrees relative to the longitudinal axis 126 of the redirecting microcatheter 100. Alternatively, about 1 degree to about 150 degrees. Alternatively, about 1 degree to about 170 degrees.

[0103] Reference now Figure 1c to Figure 1e, shows a schematic diagram of an exemplary redirecting microcatheter 100 including a reinforced region according to some embodiments of the present invention. In some embodiments, the redirecting microcatheter 100 includes a reinforced region 130 in the region surrounding the side opening 110. In some embodiments, the reinforced region includes one or more metal elements that impart a level of stiffness to the reinforced region that is higher than the level of stiffness of regions without these metal elements. For example, the outer tubular body 102 can be made of a bendable material (e.g., PEBAX), and the reinforced region can include a metal braid embedded in the outer tubular body 102 and extending to the region surrounding the side opening 110, such as Figure 1e . In some embodiments, these metal elements include any suitable form, for example, it can be a metal braid, a metal stent, a metal rod, a metal ring, etc. In some embodiments, these metal elements are located on multiple portions of the outer tubular body 102, which means that not all areas around the side opening 110 are reinforced. For example, the reinforced area can be opposite to the side opening 110, located at two locations near the side opening 110, etc. In some embodiments, the reinforced area 130 does not obstruct the side opening 110. In some embodiments, a potential advantage of having a reinforced area 130 around the side opening 110 is that it can potentially prevent the outer tubular body 102 from bending unnecessarily due to the force applied when the inner tubular body 112 is actuated to redirect the device located within the inner tubular body 112. In some embodiments, the reinforced area 130 also appears Figure 2a to Figure 2b , Figure 3a to Figure 3b and Figure 4a to Figure 4b In the embodiments disclosed in.

[0104] Reference now Figure 2a to Figure 2b , shows a schematic diagram of an exemplary redirecting microcatheter 100 with a guide wire 202 according to some embodiments of the present invention. In some embodiments, the inner tubular body 112 allows for insertion of a guide wire 202 therein, e.g., the guide wire 202 is used to guide the redirecting microcatheter 100 to a desired location. In some embodiments, the redirecting microcatheter 100 is configured to allow for insertion and extraction of the guide wire 202 within the inner tubular body 112. In some embodiments, the distal end of the guide wire 202 can exit the inner tubular body 112 and the distal end 106 of the redirecting microcatheter 100 using the distal opening 108, e.g., Figure 2a 100. This will be referred to hereinafter as "distal withdrawal" of the guidewire. In some embodiments, this is permitted when the inner tubular body 112 is in a static position. In some embodiments, when actuated, the distal end of the guidewire 202 can use the side opening 110 to withdraw from the inner tubular body 112 and redirect the microcatheter 100, for example, as Figure 2bAs shown. This will be referred to hereinafter as "lateral withdrawal" of the guide wire. In some embodiments, the guide wire 202 is withdrawn from the distal end to the lateral withdrawal channel, or vice versa, requiring the guide wire 202 to be inserted into the inner tubular body 112 before actuating the inner tubular body 112 from one configuration (actuated or non-actuated) to another configuration.

[0105] In some embodiments, the wire 202 can be a 0.035 mm wire, or a 0.018 mm wire, or a 0.014 mm wire, or a 0.009 mm wire.

[0106] Exemplary Multi-Lumen Redirecting Microcatheter

[0107] Reference now Figure 3a to Figure 3b , shows an exemplary multi-lumen redirecting catheter 200 according to some embodiments of the present invention. In some embodiments, one or more of the components disclosed above are incorporated into a dedicated lumen, optionally into a dedicated elongated member (eg, a tube).

[0108] For example, in some embodiments, the actuator 118 is integrated into a dedicated tube 302 that extends from the proximal end 104 of the outer tubular body 102 to a location adjacent to the stent 124. In some embodiments, the dedicated tube 302 extends in an area within the outer tubular body 102 and outside the inner tubular body 112.

[0109] As another example, in some embodiments, the guidewire 202 is integrated into a dedicated tube 304 that extends from the proximal end 104 of the inner tubular body 112 to a position adjacent to the distal end 116 of the inner tubular body 112. In some embodiments, the dedicated tube 304 extends within a region within the inner tubular body 112.

[0110] Reference now Figure 4a to Figure 4b , shows another exemplary multi-lumen redirecting catheter 300 according to some embodiments of the present invention. In some embodiments, the actuator 118 is integrated into a dedicated tube 402 that extends from the proximal end 104 of the inner tubular body 112 to a position adjacent to the stent 124. In some embodiments, the dedicated tube 402 extends in a region within the inner tubular body 112. Additionally, in some embodiments, the guide wire 202 is integrated into a dedicated tube 404 that extends from the proximal end 104 of the inner tubular body 112 to a position adjacent to the distal end 116 of the inner tubular body 112. In some embodiments, the dedicated tube 404 extends in a region within the inner tubular body 112.

[0111] Example handle

[0112] In some embodiments, the device includes a handle at the proximal end. In some embodiments, the handle includes a plurality of dedicated mechanisms to actuate one or more mechanisms of the catheter, as known in the art. In some embodiments, the handle includes an actuator to which the push-pull wire is connected. In some embodiments, a user actuates the actuator, thereby pulling the push-pull wire, thereby causing the inner tubular body to translate toward the one or more side openings. In some embodiments, the user actuates the actuator again to release and / or push the push-pull wire, thereby causing the inner tubular body to translate to its original position facing the distal opening of the device. In some embodiments, the actuator includes two modes: a free actuation mode, in which the user freely actuates the actuator from one position to another; a half-locked actuation mode, in which the actuation of the actuator is performed in steps, for example, each time the user actuates the actuator, the inner tubular body translates a certain amount, for example 10 degrees. In some embodiments, this means, for example, in order to move the inner tubular body to a 90-degree angle, the user needs to actuate the actuator nine times. In some embodiments, in the semi-locked actuation mode, after each actuation step, the actuator stays in the last actuated position. In some embodiments, in the free actuation mode, the user maintains tension on the push-pull wire by holding the actuator, and releasing the actuator allows the inner tubular body to return to a stationary, non-actuated position.

[0113] Various exemplary methods

[0114] Reference now Figure 5, a flow chart of an exemplary method according to some embodiments of the present invention is shown. In some embodiments, a user inserts the redirecting catheter into a patient 502. In some embodiments, the user inserts the guide wire into the redirecting catheter 504. In some embodiments, the guide wire is already in the redirecting catheter when the redirecting catheter is inserted into the patient. In some embodiments, the user guides the redirecting catheter to the desired position 506 using a variety of known methods, optionally using the guide wire to assist in the guidance. In some embodiments, at this point, the guide wire exits the redirecting catheter using a distal opening in the redirecting catheter. In some embodiments, at some point in the guidance, the user evaluates whether redirection of the redirecting catheter is required 508. In some embodiments, if the answer is no, the user continues to guide the redirecting catheter 510. In some embodiments, if the answer is yes, the user moves the guide wire proximally until the distal end of the guide wire reaches the inner tubular body 512. In some embodiments, once the distal end of the guide wire is within the inner tubular body, the user actuates the inner tubular body 514 to translate the distal end of the inner tubular body from a first position to a second position, wherein the first position is the position of the inner tubular body along the longitudinal axis of the redirecting catheter and the second position is the position where the distal end of the inner tubular body is redirected toward at least one side opening in the redirecting catheter. In some embodiments, the user then moves the guide wire 516 distally to withdraw the guide wire from at least one side opening in the redirecting catheter. In some embodiments, once the guide wire is in place, the user can push the redirecting catheter into the correct position. In some embodiments, once in the correct position, the user retracts the guide wire, returns the inner tubular body to a resting position, and continues to guide the device to the desired position.

[0115] Several exemplary markers

[0116] In some embodiments, an exemplary redirecting catheter includes one or more markings that help the user identify the direction in which the side opening 110 is facing. For example, a plurality of radiopaque markings are located near the side opening 110 and can be seen using a variety of known visualization techniques. In another example, the side opening 110 is marked, such as with a half or full circle around the opening itself. In some embodiments, a plurality of radiopaque markings are added, for example, in the form of dots, on the surface of the outer tubular body 102 and around the opening itself.

[0117] In some embodiments, multiple elements of the redirecting catheter can be made of or can have multiple radiopaque materials added. For example, one or more of the redirecting mechanism's actuator 118, stent 124, and a dedicated ring at the distal end of the outer tubular body 102 can be made of or can have multiple radiopaque materials added. In some embodiments, a potential advantage of the marker actuator 118 is that it will provide a "line" that directly shows the direction of the opening.

[0118] In some embodiments, additionally or alternatively, the redirecting catheter has a plurality of markings on the handle to indicate to the user the direction in which the side opening 110 faces.

[0119] In some embodiments, additionally or alternatively, the redirecting catheter includes an actuation element on the handle that, once actuated, performs the redirecting action. In some embodiments, the position of the actuation element on the handle indicates to the user the direction the opening is facing because it is located on the same side as the opening.

[0120] Exemplary Optional Stabilizers

[0121] Reference now Figure 6a to Figure 6b , shows an exemplary optional stabilizer according to some embodiments of the present invention. In some embodiments, an exemplary redirecting catheter 600 optionally includes a stabilizer 602. In some embodiments, the stabilizer 602 includes a line extending from the proximal end 104 of the outer tubular body 102 to the distal end 106. In some embodiments, the stabilizer 602 is located between the outer tubular body 102 and the inner tubular body 112. In some embodiments, the stabilizer 602 includes its own dedicated tube (not shown) or runs only within the lumen of the outer tubular body 102, the same as the inner tubular body 112.

[0122] In some embodiments, the stabilizer 602 is a metal wire. In some embodiments, the diameter of the stabilizer 602 is about 150 mm to about 0.5 mm. In some embodiments, the stabilizer 602 is strong enough to prevent the outer tube from bending when the redirecting actuator is actuated, but weak enough not to affect the flexibility of the outer tube and therefore the flexibility of the redirecting catheter.

[0123] In some embodiments, during operation of the redirecting catheter 600, when the user desires to use the distal-most opening 108 of the outer tubular body 102 as an exit for the guidewire 202 - the distal end of the guidewire 202 exits, the stabilizer 602 remains within the lumen of the outer tubular body 102 - this is the inactive state of the stabilizing element, e.g. Figure 6a Shown schematically.

[0124] In some embodiments, as described above, during operation of the redirecting catheter 600, when the user wishes to redirect the guidewire 202 to exit through the side opening 110 - lateral exit, the user needs to bend the inner tubular body 112 toward the side opening 110 by actuating the actuator 118. In some embodiments, before or during activation of the redirecting mechanism, the user "activates" the stabilization mechanism by causing the stabilizer 602 to exit the lumen of the outer tubular body 102 through the distal-most opening 108 of the outer tubular body 102 - this is the active state of the stabilization element, such as Figure 6b In some embodiments, the stabilizer 602 is activated by pushing it forward toward the distal end of the redirecting catheter, and the stabilizer 602 is deactivated by pulling it backward toward the proximal end of the redirecting catheter.

[0125] In some embodiments, a potential advantage of having the stabilizer 602 is that it may be possible to avoid bending of the outer tubular body 102 during actuation of the redirection mechanism, ie, bending of the inner tubular body 112 during the redirection action.

[0126] Various exemplary methods of using stabilization elements

[0127] Reference now Figure 7, a flowchart of an exemplary method of using the stabilizer according to some embodiments of the present invention is shown. In some embodiments, a user inserts the redirecting catheter into a patient 702. In some embodiments, the user inserts the guide wire into the redirecting catheter 704. In some embodiments, the guide wire is already in the redirecting catheter when the redirecting catheter is inserted into the patient. In some embodiments, the user guides the redirecting catheter to the desired position 706 using a variety of known methods, optionally using the guide wire to assist in the guidance. In some embodiments, at this point, the guide wire exits the redirecting catheter using a distal opening in the redirecting catheter. In some embodiments, at some point in the guidance, the user assesses whether redirection of the redirecting catheter is required 708. In some embodiments, if the answer is no, the user continues to guide the redirecting catheter 710. In some embodiments, if the answer is yes, the user moves the guide wire proximally until the distal end of the guide wire reaches the inner tubular body 712. In some embodiments, once the distal end of the guide wire is within the inner tubular body, the user actuates the stabilizer by withdrawing the stabilizer from the distal end of the outer tubular body 714. In some embodiments, after activating the stabilizer, the user actuates the inner tubular body 716 to translate the distal end of the inner tubular body from a first position to a second position, wherein the first position is the position of the inner tubular body along the longitudinal axis of the redirecting catheter and the second position is the position where the distal end of the inner tubular body is redirected toward at least one side opening in the redirecting catheter. In some embodiments, the user then moves the guide wire 718 distally to exit the guide wire from at least one side opening in the redirecting catheter. In some embodiments, once the guide wire is in place, the user can push the redirecting catheter into the correct position. In some embodiments, once in the correct position, the user retracts the guide wire, returns the inner tubular body to a resting position, and continues to guide the device to the desired position.

[0128] The term "about" as used herein to refer to an amount or value means "within ±20%."

[0129] The terms "comprise," "comprising," "include," "including," "has," "having" and their cognates mean "including but not limited to."

[0130] The term "consisting of" means "including and limited to."

[0131] The term "essentially consisting of" means that the composition, method or structure may include additional ingredients, steps and / or parts, but only when the additional ingredients, steps and / or parts do not substantially change the basic characteristics and novel characteristics of the claimed composition, method or structure.

[0132] As used herein, the singular forms "a", "an" and "the" include plural references unless the context clearly dictates otherwise. For example, the term "a compound" or "at least one compound" may include a plurality of compounds, including mixtures thereof.

[0133] Throughout this application, multiple embodiments of the present invention may be presented in the form of a range. It should be understood that the description in the form of a range is only for convenience and brevity, and should not be understood as a rigid limitation on the scope of the present invention. Therefore, it should be considered that the description of a range has specifically disclosed all possible sub-ranges and multiple individual numerical values ​​within the range. For example, it should be considered that the description of a range such as "from 1 to 6" should be considered to have explicitly disclosed sub-ranges, such as "from 1 to 3", "from 1 to 4", "from 1 to 5", "from 2 to 4", "from 2 to 6", "from 3 to 6", etc., as well as multiple individual numbers within the range, such as 1, 2, 3, 4, 5 and 6. This applies regardless of the width of the range.

[0134] Whenever a numerical range is indicated herein (e.g., "10-15," "10 to 15," or any pair of numbers linked by such another such range indication), it is intended to include any number (fractional or integral) within the indicated range limits, including the range limits, unless the context clearly dictates otherwise. The phrases "ranging between" a first indicated number and a second indicated number and "ranging from" a first indicated number, "to," "up to," "up to," or "through" (or another such range indicating term) a second indicated number are used interchangeably herein and are intended to include the first and second indicated numbers and all fractions and integrals therebetween.

[0135] Unless otherwise indicated, the various numbers used herein and any numerical ranges based thereon are approximations within the precision of reasonable measurements and rounding errors understood by those skilled in the art.

[0136] The term "method" as used herein refers to manners, means, techniques and procedures for accomplishing a given task, including but not limited to those known to practitioners in the fields of chemistry, pharmacology, biology, biochemistry and medicine or readily developable from known manners, means, techniques and procedures.

[0137] It will be appreciated that certain features of the invention, which for clarity are described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the invention, which for brevity are described in the context of a single embodiment, may also be provided separately, or in any suitable subcombination, or in any other described embodiment applicable to the invention. Certain features described in the context of various embodiments are not to be considered essential features of those embodiments, unless the embodiment does not function without those elements.

[0138] Various embodiments and aspects of the present invention as delineated hereinabove and as claimed in the claims section below find experimental / computational support in the following several exemplary embodiments.

[0139] Several exemplary embodiments

[0140] Reference is now made to the following exemplary embodiments, which together with the above descriptions illustrate some embodiments of the invention in a non-limiting fashion.

[0141] In some embodiments, the device is used as a reentry microcatheter for treating chronic total occlusions (CTO) in one or more of the coronary arteries, peripheral arteries, cerebral vessels, aortic arch vessels, intra-abdominal vessels, and peripheral arteries (e.g., leg arteries, including the superficial femoral artery, popliteal artery, anterior tibial artery, etc.).

[0142] In some embodiments, the device is used as a redirecting catheter, as described above.

[0143] In some embodiments, the common principle of both procedures is to facilitate the advancement of the guidewire at different angles into a branch vessel or side vessel for treatment, such as balloon angioplasty, stents, plug devices such as coils and / or drug delivery, such as chemotherapy. In some embodiments, the guidewire cannot enter the desired area due to excessive angles or the presence of certain obstructions such as stent struts. In some embodiments, the guidewire must first pass through a branch vessel or side vessel before a balloon catheter, stent catheter, or microcatheter (or drug therapy, embolic coils, etc.) can be delivered.

[0144] For example:

[0145] a. Coronary artery example:

[0146] i. The first example is an angulated great vessel, the angulated origin of the left anterior descending artery (LAD) or the circumflex artery (Cx) of the left main coronary artery, with a lesion distal to the LAD or Cx.

[0147] ii. The second example is an angled branch vessel, the angled diagonal branch of the LAD or the angled obtuse marginal branch of the circumflex or distal branch of the right coronary artery (RCA).

[0148] iii. A third example is after stent placement, the operator may want to access the diagonal side branches of a stented LAD or the obtuse edge branches of a stented Cx. The guidewire may not be able to be advanced between the struts of the stent to the branch vessel.

[0149] iv. A fourth example is attempting to advance a guidewire into a coronary artery or bypass graft that has a difficult to access origin (also called the ostia), and the guide catheter is unable to engage the ostia.

[0150] Other examples include: angulated lesions where the guidewire was not advanced along the intended path, branch vessels passing through stent struts, CTO proximal caps that were not in the correct location for initial penetration, and retrograde bypass grafts back into the native vessel.

[0151] b. Noncoronary example: A branch of the aortic arch (e.g., left subclavian, left carotid, brachiocephalic) that is inaccessible due to angulation and requires intervention in a branch vessel or branch of a branch vessel. For example, if a right radial approach is performed in a patient post bypass surgery and a left internal mammary artery (LIMA) injection is attempted to check bypass patency, it is difficult to access the left subclavian artery from the right radial approach due to the angulation that is created when accessing the left subclavian artery from that approach. While you can do this from the femoral approach, this may not be ideal for a number of reasons (excessive patient weight, severe peripheral vascular disease, etc.).

[0152] Other examples include: peripheral vessels (including abdominal and cervical / intracerebrovascular vessels), angular branch vessels, and the proximal cap of a CTO where the initial penetration position is incorrect.

[0153] Additionally, other examples of 0.035 mm redirecting microcatheters include: treatment of the lower extremities, abdomen, arcade vessels (e.g., left subclavian artery, left carotid artery, brachiocephalic artery including subclavian artery via right radial artery approach), and proximal cap of CTOs where the initial penetration position is incorrect. For example, in a post-bypass patient, it is extremely difficult to access the LIMA via right radial artery approach to check LIMA patency due to the angulation of the left subclavian artery to the aorta. While you could approach this case from a femoral approach, this may not be ideal for a number of reasons (excessive patient weight, severe peripheral vascular disease, etc.).

[0154] Additional examples include access to specific arteries in the abdomen (e.g., liver) for chemotherapy, or access to the endometrial arteries to treat leiomyomata (uterine fibroids). Sometimes in angled dissections, even though the guidewire can be advanced, the microcatheter will not follow and prolapse. There are also situations in the peripheral arteries where access to the superficial femoral artery can be challenging and the guidewire will only make contact with the deep femoral artery.

[0155] c. Additional examples include: access to specific arteries in the abdomen (eg, the liver) to deliver chemotherapy, or access to the endometrial arteries to treat leiomyomata (uterine fibroids).

[0156] Additional uses of the present invention may be LIMA angiography via the right radial artery approach, intraperitoneal chemotherapy in tortuous arteries (hepatocellular carcinoma, liver metastatic disease (colorectal cancer, pancreatic cancer, breast cancer), uterine fibroid embolization), coronary artery structural surgery (including access to the coronary sinus, coronary artery access after TAVI, paravalvular leaks), peripheral artery disease intervention in the lower limb flexure (especially below the knee), renal artery access, chronic total occlusion crossing (coronary artery and peripheral artery), creation of arteriovenous anastomosis, crossing atrial septal defect, patent foramen ovale and ventricular septal defects (VSD) One or more.

[0157] Although the present invention has been described in conjunction with its multiple specific embodiments, it is obvious that many substitutions, modifications and changes will be apparent to those skilled in the art. Therefore, it is intended to cover all such substitutions, modifications and changes that fall within the spirit and broad scope of the appended claims.

[0158] The applicant intends that all publications, patents and patent applications mentioned in this specification are hereby incorporated by reference in their entirety into this specification, to the same extent as each individual publication, patent or patent application is specifically and individually noted as being incorporated by reference herein when cited. In addition, any reference cited or indicated in this application should not be construed as admitting that these references can serve as prior art of the present invention. In terms of the use of section headings, they should not be construed as necessarily limiting. In addition, any priority document of the present application is hereby incorporated by reference in its entirety herein.

Claims

1. A redirecting microcatheter, characterized in that: The redirecting microcatheter comprises: a. an outer tubular body comprising a first proximal end and a first distal end; the first distal end comprising a distal opening and at least one side opening; b. an inner tubular body sized and shaped to be inserted into said outer tubular body; said inner tubular body comprising a second proximal end and a second distal end; said second distal end being adjacent to said at least one side opening; c. at least one actuator for translating the second distal end of the inner tubular body from an unactuated position, wherein in the unactuated position, the second distal end of the inner tubular body faces the distal opening, to an actuated position, wherein in the actuated position, the second distal end of the inner tubular body faces the one or more side openings in the outer tubular body.

2. The redirecting microcatheter according to claim 1, characterized in that: The actuator includes at least one retainer coupled to a location adjacent the second distal end of the inner tubular body and at least one wire coupled to the at least one retainer.

3. The redirecting microcatheter according to claim 1 or 2, characterized in that: The translating includes bending the second distal end of the inner tubular body at an angle of about 1 degree to about 150 degrees.

4. The redirecting microcatheter according to any one of claims 1 to 3, characterized in that: The translating includes bending the second distal end of the inner tubular body at an angle of approximately 90 degrees.

5. The redirecting microcatheter according to any one of claims 1 to 4, characterized in that: The at least one side opening is located at a distance of about 0.5 mm to about 10 mm from the distal opening.

6. The redirecting microcatheter according to any one of claims 1 to 5, characterized in that: The distal opening measures from about 0.015" to about 0.1".

7. The redirecting microcatheter according to any one of claims 1 to 6, characterized in that: The at least one side opening has a size of about 0.015" to about 0.1".

8. The redirecting microcatheter according to any one of claims 1 to 7, characterized in that: The outer tubular body is made of one or more of nylon, polyether block polyamide, polyurethane, metal, polytetrafluoroethylene and any combination thereof.

9. The redirecting microcatheter according to any one of claims 1 to 8, characterized in that: The outer tubular body is a braided / coiled shaft.

10. The redirecting microcatheter according to any one of claims 1 to 9, characterized in that: The outer tubular body has a length of about 90 cm to about 180 cm.

11. The redirecting microcatheter according to any one of claims 1 to 10, characterized in that: The outer tubular body is sized to fit through a 5F or 6F sheath.

12. The redirecting microcatheter according to any one of claims 1 to 10, characterized in that: The outer tubular body includes a reinforced region adjacent to and / or around the one or more side openings.

13. The redirecting microcatheter of claim 12, wherein: The reinforced region includes one or more metal elements configured to increase the stiffness level of the reinforced region.

14. The redirecting microcatheter according to any one of claims 1 to 13, characterized in that: The inner tubular body is made of a flexible material.

15. The redirecting microcatheter according to any one of claims 1 to 14, characterized in that: At least a portion of the inner tubular body is made of a flexible material.

16. The redirecting microcatheter according to any one of claims 1 to 15, characterized in that: At least a distal portion of the inner tubular body is made of a flexible material.

17. The redirecting microcatheter according to any one of claims 1 to 16, characterized in that: The flexible portion of the inner tubular body comprises a Shore durometer of about 20D to about 60D.

18. The redirecting microcatheter according to any one of claims 1 to 17, characterized in that: The inner tubular body is made of one or more of nylon, polyether block polyamide, polyurethane, metal, polytetrafluoroethylene and any combination thereof.

19. The redirecting microcatheter according to any one of claims 1 to 18, characterized in that: The outer tubular body is a braided / coiled shaft.

20. The redirecting microcatheter according to any one of claims 1 to 19, characterized in that: The inner tubular body has a length of about 100 mm to about 1800 mm.

21. The redirecting microcatheter according to any one of claims 1 to 20, characterized in that: The inner tubular body has a length approximately the same as the outer tubular body.

22. The redirecting microcatheter according to any one of claims 1 to 20, characterized in that: The second distal end extends to a distance of about 0.1 centimeters to about 1.5 centimeters from the first distal end.

23. The redirecting microcatheter according to any one of claims 1 to 21, characterized in that: The inner tubular body is configured to be withdrawn from the outer tubular body, thereby allowing other instruments to be inserted into the outer tubular body.

24. The redirecting microcatheter according to any one of claims 1 to 23, characterized in that: The inner tubular body is configured to allow other instruments to be inserted into itself without being withdrawn from the outer tubular body.

25. The redirecting microcatheter according to any one of claims 1 to 24, characterized in that: The at least one actuator is made of one or more of stainless steel, Nitinol, cobalt chromium, nylon, polyetheretherketone and Dynema.

26. The redirecting microcatheter according to any one of claims 1 to 25, characterized in that: The at least one retainer is a ring.

27. The redirecting microcatheter of any one of claims 1 to 26, characterized in that: The at least one retainer is positioned on the flexible portion of the inner tubular body.

28. The redirecting microcatheter of any one of claims 1 to 27, characterized in that: The at least one retainer is located between about 1 mm and about 20 mm from the second distal end.

29. The redirecting microcatheter according to any one of claims 1 to 28, characterized in that: The at least one retainer is disposed about the inner tubular body.

30. The redirecting microcatheter of any one of claims 1 to 28, characterized in that: The at least one retainer is a groove on the surface of the inner tubular body.

31. The redirecting microcatheter of any one of claims 1 to 29, characterized in that: The at least one retainer is made of one or more of stainless steel, nitinol, cobalt chromium, nylon, polyetheretherketone, platinum iridium and gold.

32. The redirecting microcatheter of any one of claims 1 to 31, characterized in that: The inner tubular body is sized and shaped to allow insertion of at least one guide wire therein.

33. The redirecting microcatheter of any one of claims 1 to 32, characterized in that: The outer tubular body includes a first lumen within which the at least one actuator extends.

34. The redirecting microcatheter of any one of claims 1 to 33, characterized in that: The inner tubular body includes a second lumen within which the at least one actuator extends.

35. The redirecting microcatheter of any one of claims 1 to 34, characterized in that: The inner tubular body includes a third lumen into which the at least one guide wire is inserted.

36. The redirecting microcatheter of any one of claims 1 to 35, characterized in that: The redirecting microcatheter also includes at least one handle located proximal to the redirecting catheter, the at least one handle being configured to receive one or more of the first proximal end of the outer tubular body, the second proximal end of the inner tubular body, and the third proximal end of the actuator.

37. The redirecting microcatheter of any one of claims 1 to 36, characterized in that: The redirecting microcatheter also includes at least one marking configured to indicate a direction in which the one or more side openings face.

38. The redirecting microcatheter of claim 37, wherein: The at least one marker is a radiopaque marker.

39. The redirecting microcatheter of claim 37, wherein: The at least one marking is located at one or more of the following locations: on a surface of the outer tubular body, on a surface of the first distal end of the outer tubular body, adjacent to the one or more side openings, on the at least one actuator, and on the at least one retainer.

40. The redirecting microcatheter of any one of claims 1 to 39, characterized in that: The redirecting microcatheter further includes a stabilizer configured to prevent bending of the first distal end when the at least one actuator is actuated.

41. The redirecting microcatheter of claim 40, wherein: The stabilizer extends from the first proximal end to the first distal end.

42. The redirecting microcatheter of claim 40, wherein: The stabilizer extends within the lumen of the outer tubular body.

43. The redirecting microcatheter of claim 40, wherein: The stabilizer extends between the outer tubular body and the inner tubular body.

44. The redirecting microcatheter of claim 40, wherein: The stabilizer extends within the lumen of the outer tubular body but outside of the inner tubular body.

45. The redirecting microcatheter of claim 40, wherein: The stabilizer is configured to extend beyond the distal opening when actuated.

46. ​​A method of actuating a redirecting microcatheter according to claim 1 using a guide wire, characterized in that: The method comprises the following steps: a. retracting the guide wire from the distal opening of the redirecting microcatheter; b. actuating the inner tubular body, thereby translating the second distal end of the inner tubular body from an unactuated position, wherein in the unactuated position the second distal end of the inner tubular body faces the distal opening, to an actuated position, wherein in the actuated position the second distal end of the inner tubular body faces the one or more side openings in the outer tubular body; c. Moving the guidewire distally so that the guidewire exits the at least one side opening in the redirecting microcatheter.

47. The method of claim 46, wherein: The method also includes inserting the redirecting microcatheter into a patient.

48. The method according to claim 46 or 47, characterized in that: The method also includes using the guidewire to assist in guiding the redirecting microcatheter toward a desired location.

49. The method according to any one of claims 46 to 48, characterized in that: The inserting further comprises inserting the guidewire into the redirecting microcatheter.

50. The method according to any one of claims 46 to 49, characterized in that: The redirecting microcatheter already includes the guide wire inserted therein.

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