Methods and devices for crossing chronic total occlusions
First Claim
1. A method of treating a blood vessel with an intravascular device, the blood vessel having a vascular wall defining a vascular lumen containing an occlusion therein, the occlusion being disposed between a proximal segment of the vascular lumen and a distal segment of the vascular lumen, the method comprising:
- inserting the intravascular device into the vascular lumen, the intravascular device including a shaft defining a longitudinal axis and a tip located at a distal end of the shaft, wherein an outer diameter of the tip is greater than a diameter of the distal end of the shaft, a proximal portion of the tip tapering towards the shaft, and wherein the intravascular device defines a device lumen;
rotating the intravascular device about the longitudinal axis to produce relative motion at an interface between the tip and surrounding tissue;
advancing the tip out of the proximal segment of the vascular lumen into the vascular wall;
advancing the intravascular device within the vascular wall to establish a channel in the vascular wall extending longitudinally across the occlusion;
advancing the tip of the intravascular device into the distal segment of the vascular lumen distal of the occlusion;
positioning a guidewire through the device lumen and into the vascular lumen beyond the occlusion; and
withdrawing the intravascular device over the guidewire.
2 Assignments
0 Petitions
Accused Products
Abstract
The present disclosure is directed to a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method may include providing an intravascular device having a distal portion and a longitudinal axis and inserting the intravascular device into the vascular lumen. The method may further include positioning the distal portion in the vascular wall, rotating the intravascular device about the longitudinal axis, and advancing the intravascular device within the vascular wall.
-
Citations
47 Claims
-
1. A method of treating a blood vessel with an intravascular device, the blood vessel having a vascular wall defining a vascular lumen containing an occlusion therein, the occlusion being disposed between a proximal segment of the vascular lumen and a distal segment of the vascular lumen, the method comprising:
-
inserting the intravascular device into the vascular lumen, the intravascular device including a shaft defining a longitudinal axis and a tip located at a distal end of the shaft, wherein an outer diameter of the tip is greater than a diameter of the distal end of the shaft, a proximal portion of the tip tapering towards the shaft, and wherein the intravascular device defines a device lumen; rotating the intravascular device about the longitudinal axis to produce relative motion at an interface between the tip and surrounding tissue; advancing the tip out of the proximal segment of the vascular lumen into the vascular wall; advancing the intravascular device within the vascular wall to establish a channel in the vascular wall extending longitudinally across the occlusion; advancing the tip of the intravascular device into the distal segment of the vascular lumen distal of the occlusion; positioning a guidewire through the device lumen and into the vascular lumen beyond the occlusion; and withdrawing the intravascular device over the guidewire. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
-
-
15. A method of treating a blood vessel with an intravascular device, the blood vessel having a vascular wall defining a vascular lumen containing an occlusion therein, the occlusion being disposed between a proximal segment of the vascular lumen and a distal segment of the vascular lumen, the method comprising:
-
inserting an intravascular device into the vascular lumen, the intravascular device having a radiopaque marker, the intravascular device including a shaft defining a longitudinal axis and a tip located at a distal end of the shaft, wherein an outer diameter of the tip is greater than a diameter of the distal end of the shaft, a proximal portion of the tip tapering towards the shaft, the tip having a flat distal face, and wherein the intravascular device defines a device lumen; advancing the tip between the occlusion and an adventitia of the vascular wall; rotating the intravascular device to produce relative motion at an interface between the tip and surrounding tissue; advancing the tip between the adventitia and an intima of the vascular wall to a location distal of the occlusion; advancing the tip into the distal segment of the vascular lumen from the location distal of the occlusion; positioning a guidewire through the device lumen and into the vascular lumen beyond the occlusion; and withdrawing the intravascular device over the guidewire. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
-
-
27. A method of treating a blood vessel with an intravascular device, the blood vessel having a vascular wall defining a vascular lumen containing an occlusion therein, the occlusion being disposed between a proximal segment of the vascular lumen and a distal segment of the vascular lumen, the method comprising:
-
positioning the intravascular device proximate the occlusion, the intravascular device including a shaft defining a longitudinal axis and a tip located at a distal end of the shaft, wherein an outer diameter of the tip is greater than a diameter of the distal end of the shaft, a proximal portion of the tip transitioning toward the diameter of the shaft, the intravascular device including a handle assembly disposed about the shaft, the handle assembly having a first portion and a second portion, and wherein the intravascular device defines a device lumen; rotating the first portion of the handle assembly relative to the second portion thus causing the handle assembly to grip the shaft at a first location along the longitudinal axis and cause rotation of the tip; advancing the tip of the intravascular device within the vascular wall to a location within the vascular wall distal of the occlusion to establish a channel in the vascular wall extending longitudinally across the occlusion; advancing the tip into the distal segment of the vascular lumen from the location within the vascular wall distal of the occlusion; positioning a guidewire through the device lumen and into the vascular lumen beyond the occlusion; and withdrawing the intravascular device over the guidewire. - View Dependent Claims (28, 29, 30, 31, 32, 33, 34, 35, 36)
-
-
37. A method of treating a blood vessel with an intravascular device, the blood vessel having a vascular wall defining a vascular lumen containing an occlusion therein, the occlusion being disposed between a proximal segment of the vascular lumen and a distal segment of the vascular lumen, the method comprising:
-
inserting an intravascular device having a shaft with a longitudinal axis into the vascular lumen, wherein a tip is fixed to a distal end of the shaft, wherein an outer diameter of the tip is greater than a diameter of the distal end of the shaft, and a handle assembly is attached to a proximal end of the shaft, and wherein the intravascular device defines a device lumen; positioning the tip near the occlusion; advancing the tip between the occlusion and an adventitia of the vascular wall; rotating the handle assembly to cause rotation of the tip about the longitudinal axis between the occlusion and the adventitia while advancing the tip to a location distal of the occlusion; wherein rotating the handle assembly and advancing the tip occur simultaneously, the intravascular device being rotated at least a plurality of revolutions at a rotational speed between about 50 revolutions per minute and about 150 revolutions per minute; passing the tip into the distal segment of the vascular lumen from the location distal of the occlusion; positioning a guidewire through the device lumen and into the vascular lumen beyond the occlusion; and withdrawing the intravascular device over the guidewire. - View Dependent Claims (38, 39, 40, 41, 42, 43, 44, 45, 46, 47)
-
Specification