Endovascular devices and methods for exploiting intramural space
First Claim
Patent Images
1. A method of facilitating vascular treatment via a vascular wall defining a vascular lumen having an occlusion disposed therein, the method comprising:
- providing an intravascular device having a distal intramural portion;
inserting the intramural portion into the vascular lumen;
passing the intramural portion from the vascular lumen into the vascular wall proximal of the occlusion;
moving the intramural portion within the vascular wall in a longitudinal direction;
moving the intramural portion within the vascular wall in a circumferential direction such that the intramural portion has a concave side facing the vascular lumen;
providing a re-entry device having a tissue penetrating tip;
orienting the tip as a function of the concave side of the intramural portion such that the tip is pointed toward the vascular lumen;
causing the tip to penetrate tissue to pass from within the vascular wall to within the vascular lumen; and
passing the intramural portion from the vascular wall into the vascular lumen distal of the occlusion such that the intravascular device extends from the vascular lumen proximal of the occlusion, transmurally adjacent the occlusion, to the vascular lumen distal of the occlusion.
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Accused Products
Abstract
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 providing a first intravascular device having a distal portion with a concave side, inserting the first device into the vascular lumen, positioning the distal portion in the vascular wall, and orienting the concave side of the distal portion toward the vascular lumen.
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Citations
63 Claims
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1. A method of facilitating vascular treatment via a vascular wall defining a vascular lumen having an occlusion disposed therein, the method comprising:
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providing an intravascular device having a distal intramural portion;
inserting the intramural portion into the vascular lumen;
passing the intramural portion from the vascular lumen into the vascular wall proximal of the occlusion;
moving the intramural portion within the vascular wall in a longitudinal direction;
moving the intramural portion within the vascular wall in a circumferential direction such that the intramural portion has a concave side facing the vascular lumen;
providing a re-entry device having a tissue penetrating tip;
orienting the tip as a function of the concave side of the intramural portion such that the tip is pointed toward the vascular lumen;
causing the tip to penetrate tissue to pass from within the vascular wall to within the vascular lumen; and
passing the intramural portion from the vascular wall into the vascular lumen distal of the occlusion such that the intravascular device extends from the vascular lumen proximal of the occlusion, transmurally adjacent the occlusion, to the vascular lumen distal of the occlusion.
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2. A method of facilitating vascular treatment by positioning a device intravascularly such that the device extends from a vascular lumen proximal of an occlusion, transmurally adjacent the occlusion, to the vascular lumen distal of the occlusion, wherein an intramural portion of the device has a concave side that facilitates orientation toward the vascular lumen.
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3. A method of facilitating vascular treatment via a vascular wall defining a vascular lumen, the method comprising:
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providing a first intravascular device having a distal intramural portion;
positioning the intramural portion in the vascular wall; and
moving the intramural portion within the vascular wall in a circumferential direction such that the intramural portion has a concave side facing the vascular lumen. - View Dependent Claims (4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein, the method comprising:
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providing a first intravascular device having a distal portion;
providing a re-entry device having a distal portion configured to penetrate the vascular wall toward the vascular lumen and configured to not penetrate the vascular wall thereafter;
inserting the first device into the vascular lumen;
positioning the distal portion of the first device in the vascular wall;
positioning the distal portion of the re-entry device in the distal portion of the first intravascular device; and
penetrating the vascular wall toward the vascular lumen. - View Dependent Claims (17, 18, 19, 20, 21, 22)
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23. A method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein, the method comprising:
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providing a first intravascular device having a distal portion with lateral projections;
inserting the first device into the vascular lumen;
positioning the distal portion in the vascular wall; and
directing the lateral projections in substantially equal and opposite directions within the vascular wall. - View Dependent Claims (24, 25, 26, 27, 28, 29)
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30. A method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein, the method comprising:
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providing a first intravascular device having a distal portion with a concave side;
inserting the first device into the vascular lumen;
positioning the distal portion in the vascular wall; and
orienting the concave side of the distal portion toward the vascular lumen. - View Dependent Claims (31, 32, 33, 34, 35, 36, 37, 38, 39)
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40. A method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein, the method comprising:
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providing a first intravascular device having a distal portion with a keying element;
providing a re-entry device having a keyed distal portion;
inserting the first device into the vascular lumen;
positioning the distal portion of the first device in the vascular wall;
orienting the distal portion of the first device toward the vascular lumen; and
orienting the keyed distal portion of the re-entry device with respect to the keying element of the first device such that the re-entry device is oriented toward the vascular lumen. - View Dependent Claims (41, 42, 43, 44, 45)
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46. A method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein, the method comprising:
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providing a first intravascular device having a distal portion with a concave side;
providing a re-entry device having a curved distal portion;
inserting the first device into the vascular lumen;
positioning the distal portion of the first device in the vascular wall;
orienting the concave side of the distal portion of the first device toward the vascular lumen; and
orienting the curved distal portion of the re-entry device with respect to the concave side of the distal portion of the first device such that the re-entry device is oriented toward the vascular lumen. - View Dependent Claims (47, 48, 49, 50, 51)
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52. A method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein, the method comprising:
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providing a first intravascular device having a distal portion;
providing a re-entry device having a rotational cutting distal portion;
inserting the first device into the vascular lumen;
positioning the distal portion of the first device in the vascular wall; and
positioning the rotational cutting distal portion of the re-entry device in the distal portion of the first device. - View Dependent Claims (53, 54, 55)
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- 56. A device for facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein, the device comprising an elongate shaft having a distal portion sized and configured to be deployed in the vascular wall, the distal portion having a bend in a longitudinal direction and in a radial direction.
Specification