An elongated catheter assembly defines a catheter lumen configured to receive the distal guidewire section of the guidewire, and also defines an axial portal and a radial portal. A guidewire deflector is mounted to the elongated catheter assembly. The guidewire deflector is configured to selectively deflect urged axial movement of the distal guidewire section of the guidewire away from the axial portal and radially toward the radial portal.

A catheter device having a distal tube portion having a longitudinal axis and a tube wall comprising at least one side port; and a guide tip mounted on the distal tube portion, the guide tip defining: a unitary body having an outer wall, and a plurality of indentations in the outer wall, wherein the indentations are oriented substantially parallel to the longitudinal axis, and wherein each indentation extends from a distal-most end of the guide tip to a proximal region of the guide tip.

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.

Systems and methods for positioning a wire for advancement through a vessel wall, and advancing it through one or more vessel walls, generally include a delivery catheter and an alignment catheter or a receiving catheter, and a guidewire. In some variations, the systems and methods may be used to bypass an occlusion or other barrier that may prevent advancement of a wire or tools through an endoluminal space. In these variations, the systems and methods include a delivery catheter, a bypass catheter, a receiving catheter, and a guidewire. The delivery and receiving catheters each generally include a side aperture, a deflection surface, and an alignment element, and the bypass catheter generally includes two side apertures, two deflectors, and two alignment elements. In some variations, the systems and methods may assist in treatment of a patient suffering from critical limb ischemia.

A delivery system can be provided with an ability to change its configurations to achieve both access to target anatomy and treatment thereof. Such treatments can include directing interventional devices around an occlusion. By providing different functionality at different stages, the need to exchange and replace tools at different stages can be reduced or eliminated. Accordingly, such operations can be completed more rapidly, efficiently, and safely.

Methods and devices are disclosed for passing Chronic Total Occlusion (CTO) from subintimal location and re-entry into a true-lumen of the patient using transient fenestration approach. The transient fenestration is induced by balloon dilatation within the CTO, and a guidewire quickly trails into a true lumen.

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.

The present invention discloses a catheter system, comprising: a catheter head having a lumen, a proximal end and a distal end, and an opening positioned at a bottom of the distal end; and a rotatable inner tube having a lumen positioned in the lumen and at a proximal end of the catheter head, the inner tube including a front end having an arcuate opening; wherein the rotatable inner tube can be rotated so that the arcuate opening thereon can be made to engage or disengage with the opening at the bottom of the distal end of the catheter head. The invention also provides a catheter system and method for re-entry of a vascular false lumen into a true lumen in a quick, accurate and low-risk way. The catheter system for re-entry of a vascular false lumen into a true lumen in a quick, accurate and low-risk way effectively solve the problems of difficult operation, inaccurate positioning, long operation time and easiness to cause acute occlusion and internal hemorrhage of the branch vessel when the guidewire is re-entering the true lumen in the prior art.

Devices, systems and methods for treating diseases and disorders effecting the cardiovascular system of the human body are disclosed. An exemplary device in accordance with this disclosure comprises a shaft, tip member fixed to the shaft, and a probe extending beyond a distal surface of the tip member. In some useful embodiments, the tip member is relatively atraumatic and the probe is shaped so as to be more likely to produce trauma than the tip member.

The guide catheter extension system for various intravascular procedures, including the reverse CART procedure, the thrombus removal, etc., has an enhanced ”capturing” capability. It is configured with a plastically expandable scaffold member forming an expandable “funnel-like” distal opening, and, once it has been advanced into the subintimal space, provides an enhanced capability of catching the retrograde wire or a thrombus, as required by the procedure. A balloon delivered to the target location in the blood vessel, by being inflated, opens the scaffold member to enhance the delivery of the retrograde wire or the thrombus into the guide catheter extension. When the guide catheter extension is no longer needed, the flared guide extension can be easily compressed and collapsed as it is drawn in the guiding catheter. For benefits of the thrombus removal, the balloon may be formed from a material loaded with a radiopaque material and prefabricated with micro pores. A thrombolytic agent can be delivered to the thrombus before the thrombus is conveniently captured in the expanded distal opening of the scaffold member and removed from the blood vessel by aspiration. The outer or inner catheter may be configured with a distal curved portion to enhance a rotational capability for displacement between the right and left pulmonary arteries.