Methods and systems for bypassing an occlusion in a blood vessel
First Claim
1. A method for bypassing an occlusion in a blood vessel having a wall and a subintimal tract that has been formed in the wall adjacent to the occlusion, said method comprising the steps of:
- transluminally advancing a subintimal reentry guidewire through the subintimal tract from a near side of the occlusion to a position where a distal end of the subintimal reentry guidewire is positioned in the subintimal tract on a far side of the occlusion;
extending a planar, generally triangular cutting blade transversely from a distal side port of the subintimal reentry guidewire to extend beyond an outer surface of the subintimal reentry guidewire;
rotating the subintimal reentry guidewire with the cutting blade exposed to create a transverse cut in an intimal layer of the vessel wall on the far side of the occlusion;
retracting the cutting blade proximally into the distal side port of the subintinial reentry guidewire;
Advancing substantially an entire balloon over the subintimal reentry guidewire to the far side of the occlusion and adjacent the transverse cut in the intimal layer of the vessel wall; and
inflating the balloon to enlarge the transverse cut in the intimal layer of the vessel wall thereby creating a passageway through the intimal layer.
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Accused Products
Abstract
Methods and systems for re-entering the true lumen of a vessel after subintimally bypassing an occlusion in a blood vessel. A guidewire is positionable within a subintimal tract in a wall of the blood vessel with a distal end located beyond the occlusion. A hollow lumen of the guidewire includes a retractable blade slidably exposable adjacent a distal end thereof for rotary cutting or scoring the intima layer of the vessel wall to create a transverse cut or line of weakness in the intima. A balloon catheter is subsequently trackable over the guidewire and once inflated tears or otherwise ruptures the transverse cut, thereby creating or enlarging a passageway into the true lumen of the blood vessel beyond the occlusion.
42 Citations
13 Claims
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1. A method for bypassing an occlusion in a blood vessel having a wall and a subintimal tract that has been formed in the wall adjacent to the occlusion, said method comprising the steps of:
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transluminally advancing a subintimal reentry guidewire through the subintimal tract from a near side of the occlusion to a position where a distal end of the subintimal reentry guidewire is positioned in the subintimal tract on a far side of the occlusion; extending a planar, generally triangular cutting blade transversely from a distal side port of the subintimal reentry guidewire to extend beyond an outer surface of the subintimal reentry guidewire; rotating the subintimal reentry guidewire with the cutting blade exposed to create a transverse cut in an intimal layer of the vessel wall on the far side of the occlusion; retracting the cutting blade proximally into the distal side port of the subintinial reentry guidewire; Advancing substantially an entire balloon over the subintimal reentry guidewire to the far side of the occlusion and adjacent the transverse cut in the intimal layer of the vessel wall; and inflating the balloon to enlarge the transverse cut in the intimal layer of the vessel wall thereby creating a passageway through the intimal layer. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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Specification