Endovascular devices and methods for exploiting intramural space

摘要

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a re-entry device, and re-entering the true vascular lumen.

主权项

1. A method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein, the method comprising:
inserting a guidewire or crossing device into the vascular lumen; positioning a distal portion of the guidewire or crossing device in the vascular wall; advancing an intravascular device over the guidewire or crossing device, the intravascular device defining a tubular body and a lumen, and having a distal portion including a side port and lateral projections, wherein each of the lateral projections includes a delivery configuration and a deployed configuration, wherein the lateral projections are formed from a single tubular member and are completely external the lumen in both the delivery and the deployed configurations; positioning the distal portion of the intravascular device in the vascular wall; directing the lateral projections laterally within the vascular wall such that the lateral projections are in the deployed configuration; causing the intravascular device to assume an arbitrary one of two possible orientations relative to the vascular lumen, the two possible orientations comprising a first orientation in which the side port is directed toward the vascular lumen and a second orientation in which the side port is directed about 180 degrees away from the vascular lumen; advancing a distal end of a reentry device through the side port and determining which of the first orientation and the second orientation is the current orientation of the intravascular device; and advancing the distal end of the reentry device into the vascular lumen if it is determined that the current orientation of the intravascular device is the first orientation.