The invention generally relates to method and apparatus for crossing an obstruction in a tubular member, and more particularly to a medical device method for crossing of a chronic occlusion in a subintimal or interstitial space of an artery.

A method of coupling a catheter tunneler adapter to a catheter is provided. The method includes providing a catheter having a lumen divider at a proximal end thereof; forming a receiving notch in the lumen divider by removing a center portion thereof such that two divider side portions remain; providing a catheter tunneler adapter having a distal end including a radially inward step which defines a contact surface configured to be received in the proximal end of the catheter; positioning the distal end of the catheter tunneler adapter within the catheter until the radially inward step engages the receiving notch; and securing the catheter tunneler adapter to the catheter.

A method of diverting fluid flow from a first vessel including an occlusion to a second vessel includes deploying a prosthesis at least partially in a fistula and making valves in the second vessel incompetent. Making the valves in the second vessel incompetent includes at least one of using a reverse valvulotome to cut the valves, inflating a balloon, expanding a stent, and lining the second vessel with a stent.

Apparatuses and methods described herein relate to treating cancerous tumors using radiation therapy and chemotherapy. In some embodiments, a method of treatment includes administering radiation therapy targeting a tumor, isolating a segment of a vessel proximate to the tumor, and administering a dose of a chemotherapeutic agent to the segment of the vessel. The method can further include waiting a period of time after administering the radiation therapy before administering the dose of the chemotherapeutic agent. In some embodiments, a catheter device including first and second occluding elements can be used to isolate the segment of the vessel.

A catheter has a guide-tip including at least one wing for crossing a CTO lesion in an artery via exploring the subintimal space. The catheter can includes one or more exit port(s) and radiopaque marker(s) for steering a re-entry wire through one of the exit ports. The catheter may include a number of spiral-cut sections with varying characteristics to provide different strength and flexibility along the axial direction.

A catheter system can include a tubular body, and at least one of a targeting system coupled to the tubular body, an expandable member, or a fluid injection port. A method of identifying a bifurcation can include inserting a catheter system into a first vessel, positioning the catheter system at a first location, expanding an expandable member to occlude the first vessel, delivering contrast material so the contrast material pooling proximate to the expandable member, and reviewing a shape of the contrast material in the first vessel under fluoroscopy.

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.

A power controller device and system allows verification, monitoring, and control of an arteriovenous (AV) fistula creation catheter which comprises a main housing having a power supply, an embedded electronic controller and a user interface display, and which is configured to allow connection to an intravascular catheter. When activated, the device verifies that a valid catheter is connected, downloads stored manufacturing calibration data from the catheter, and provides a user interface to allow initiation of AV fistula creation. Once creation of the AV fistula is initiated, the device provides closed loop control of the catheter heating element and provides a means of monitoring the catheter temperature and tip position to a prescribed parameter to automate the arteriovenous fistula creation procedure.

A method of operating a catheter assembly including monitoring a gap feedback signal indicative of a distance between a first tissue contact surface and a second tissue contact surface. Producing, via a user interface of the catheter assembly, a graphical depiction of the first tissue contact surface and the second tissue contact surface spaced apart from the first tissue contact surface by the distance. Producing, via the user interface of the catheter assembly, a gap distance warning when the gap feedback signal indicates that the distance is outside of a target gap range.

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 an intravascular device having a distal portion with a side port, inserting the device into the vascular lumen, positioning the distal portion in the vascular wall, directing the distal portion within the vascular wall such that the distal portion moves at least partially laterally, and directing the side port towards the vascular lumen.