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 reentry device, and re-entering the true vascular lumen.

A needle-injection catheter includes a catheter body having a distal end, a proximal end, a stiff proximal portion, a flexible distal portion, and a delivery lumen extending therethrough. In a first embodiment, a straight injection needle extends coaxially from a distal tip of the flexible portion of the catheter body, and a plurality of penetration limiting elements positioned circumferentially about a base of the straight injection needle and configured to fold radially inwardly against a shaft of the needle when constrained in a tubular lumen and to extend radially outwardly when unconstrained. In a second embodiment, a helical needle extends from the distal tip of the flexible portion of the catheter body. The helical needle has at least one helical delivery lumen connected to receive an injectable substance from the delivery lumen of the catheter body.

A guide extension catheter includes a push member and a distal shaft coupled to and extending distally from the push member. The distal shaft includes a shaft wall and a passageway. The shaft wall includes a helically-shaped proximal end and a distal end. The helically-shaped proximal end coils helically about a first central longitudinal axis of the passageway of the distal shaft. The helically-shaped proximal end of the shaft wall defines a helically-shaped entry port of the distal shaft. The distal shaft may include a helically-shaped collar coupled to the helically-shaped proximal end of the distal shaft, the collar defining the helically-shaped entry port of the distal shaft.

The present disclosure relates to vascular devices such as guidewires and microcatheters having integrated coil sections for optimizing torquability, flexibility, and ability to shape and maintain the distal tip. A guidewire device includes a core and a tube structure coupled to the core such that at least a portion of the core passes into the tube structure. A distal section of the tube structure includes a spiral cut arrangement that configures the distal section as an integral coil integrally incorporated as part of the tube structure. The integrated coil configuration increases the flexibility of the tube structure to reduce the tendency of resilient forces from the tube structure to disrupt a shaped distal tip of the guidewire device.

In various examples, a guidewire with tactile feel is described. The guidewire includes an elongate core wire including a distal end, a proximal end, and a longitudinal axis extending along a length of the core wire from the distal end to the proximal end. A grip portion is disposed on the core wire. The grip portion is configured to provide tactile feel to a user of the guidewire. In some examples, a method for making the guidewire is also described.

A hollow stranded wire (2) has a first layers (4) and second layers (6). The second layer is located outside the first layer. The first layer is formed by twisting eight first element wires (8) which are flat wires. The second layer is formed by twisting eight second element wires (10) which are flat wires. A ratio (Ww/Tw) of a width Ww to a thickness Tw of each flat wire is from 2 to 11. A twisting direction of the second element wires is opposite that of the first element wires. A twisting angle of each first element wire is not greater than 85. A twisting angle of each second element wire is not greater than 85. A ratio (D/T) of an average diameter D to a thickness T of the hollow stranded wire is not less than 5 and not greater than 20.

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 reentry device, and re-entering the true vascular lumen.

A guidewire includes a core shaft, a coil body disposed around an outer periphery of the core shaft, and a resin layer. The resin layer includes a proximal end part disposed around an outer periphery of the coil body; a distal end part located between the core shaft and the coil body distal to the proximal end part and having an outer diameter that is smaller than an outer diameter of the proximal end part; and a tapered part located between the proximal end part and the distal end part and having an outer diameter that decreases in the distal direction. The distal end part of the coil body is not covered with the resin layer. The guidewire has improved rotation performance (operativity) while maintaining insertability, and a risk that a distal end the resin layer will detach from the guidewire is reduced.

A needle-injection catheter includes a catheter body having a distal end, a proximal end, a stiff proximal portion, a flexible distal portion, and a delivery lumen extending therethrough. In a first embodiment, a straight injection needle extends coaxially from a distal tip of the flexible portion of the catheter body, and a plurality of penetration limiting elements positioned circumferentially about a base of the straight injection needle and configured to fold radially inwardly against a shaft of the needle when constrained in a tubular lumen and to extend radially outwardly when unconstrained. In a second embodiment, a helical needle extends from the distal tip of the flexible portion of the catheter body. The helical needle has at least one helical delivery lumen connected to receive an injectable substance from the delivery lumen of the catheter body.

A guidewire includes, for example, a core shaft, a coil body having a distal end that is joined to the core shaft at a position spaced proximally from a distal end of the core shaft, and a coating agent covering an outer periphery of the core shaft and the coil body. The core shaft includes a bulge portion joined at a position spaced distally from the distal end of the coil body, and the coating agent covers the core shaft and the coil body from a distal side of the bulge portion to a proximal side of a proximal end of the coil body except for an interior of the coil body.