Lumend, Inc.

Matthew R Selmon

Charles F Milo

Gerald L Hansen

Fred H Co

Ronald G French

Suresh Subraya Pai

Kent D Dell

Charles Gresl, Jr

Robert L Wynne

James William Vetter

Richard E Hill

Tomoaki Hinohara

E Richard Hill, Iii

Mark Campello

Amiel Aguilar

Benjamin J Clark

David J Kupiecki

Brent Seybold

Sergio Salinas

Kurt Sparks

Jeffrey L Emery

C Danielle Pinson

Allen W Madsen

Michael D Keleher

A catheter system and corresponding methods are provided for accessing a blood vessel true lumen from a sub-intimal plane of the vessel. The catheter system includes visualization elements for determining the orientation of the true lumen with respect to the sub-intimal plane at an identified entry site from a position in the sub-intimal plane. The entry site is distal to a chronic total occlusion (CTO). The catheter system also includes a system for physically securing tissue of the sub-intimal plane at the entry site to the catheter system. The attaching system reduces or eliminates catheter float within the sub-intimal space. The catheter system further includes re-entry devices to establish and maintain a path from the sub-intimal plane back into the vessel true lumen.

Catheter system for vascular re-entry from a sub-intimal space

An intravascular catheter system for the treatment of occluded blood vessels that includes tissue displacement or hinged expansion members that are movable from a closed to an open position. An actuating assembly may be provided for moving the tissue expansion members between an open and closed position to exert a substantially lateral distal end force upon the region surrounding an occluded blood vessel. The tissue expansion members may stretch apart, tear or otherwise disrupt a vascular occlusion sufficiently to create a pathway that may support the passage or placement of a guidewire or an interventional vascular device across the occlusion or obstruction. Methods of crossing or displacing a vascular occlusion are further provided that include the positioning of a vascular catheter having at least one hinged spreading member positioned at the distal region of the catheter that is responsive to directed force along the longitudinal axis of the catheter. A directed force is applied to the actuator in order to deploy the spreading member and displace a vascular occlusion creating a path to permit the passage of a guidewire or device therethrough.

Methods and apparatus for treating vascular occlusions

Total occlusions are crossed by passing a guidewire or other penetrating wire from a point proximal to the occlusion into a subintimal space between the intimal layer and adventitial layer of the blood vessel wall. The wire is advanced to a point distal to the occlusion and thereafter deflected back into the blood vessel lumen, typically using a deflecting catheter which is advanced over the guidewire after it has been positioned within the subintimal space. After the guidewire is returned to the blood vessel lumen, the deflecting catheter may be withdrawn and the guidewire is available for introduction of other interventional and diagnostic catheters.

Re-entry catheter

Method and apparatus for treating vascular occlusions

Methods and apparatus for crossing totally to substantially occluded blood vessels by passing a redirectable wire such as a guidewire from a relatively proximal point past the occlusion within a subintimal space formed between the intimal layer and the adventitial layer of a blood vessel wall. The wire may be advanced to a point distal to the occlusion, and thereafter deflected back into the blood vessel lumen, typically using a deflecting catheter which is advanced over the guidewire after it has been positioned within the subintimal space. The deflecting catheter may include a flapper valve assembly or preformed actuator wire for redirecting the guidewire. After the guidewire is returned to the blood vessel lumen, the deflecting catheter may be withdrawn, and the guidewire may be available for introduction of other interventional and diagnostic catheters for performing procedures such as stenting.

Vascular re-entry catheter

An intravascular catheter system for the treatment of occluded blood vessels that includes tissue displacement or hinged expansion members that are movable from a closed to an open position. An actuating assembly may be, provided for moving the tissue expansion members between an open and closed position to exert a substantially lateral distal end force upon the region surrounding an occluded blood vessel. The tissue expansion members may stretch apart, tear or otherwise disrupt a vascular occlusion sufficiently to create a pathway that may support the passage or placement of a guidewire or an interventional vascular device across the occlusion or obstruction. Methods of crossing or displacing a vascular occlusion are further provided that include the positioning of a vascular catheter having at least one hinged spreading member positioned at the distal region of the catheter that is responsive to directed force along the longitudinal axis of the catheter. A directed force is applied to the actuator in order to deploy the spreading member and displace a vascular occlusion creating a path to permit the passage of a guidewire or device therethrough.

Apparatus for treating vascular occlusions

A catherer system and method are provided including a blunt end assembly with a catheter and a blunt end member. The blunt end member includes jaw sections which have a first position or closed position for locating the blunt end member at the site of the occlusion within the native lumen of the blood vessel and a second position or open position wherein the jaw sections are able to press against the interior walls of the lumen adjacent the occlusion. The assembly includes an actuation member for moving the jaw sections from the closed to the open positions repeatedly resulting in a fracturing of the occlusion. A guide wire may be thread through an internal opening in the catheter and the blunt end member and after fracturing, across the occlusion.

Catheter system for treating a vascular occlusion

An apparatus is described for treating arterial occlusions combining an intraluminally operable catheter, having an occlusion-crossing working element, with a micro-invasive extraluminally operable locator for imaging the progress of the working element through the occlusion. Conical, abrasive, blunt-dissecting, and sharp-pointed, and steering and non-steering working elements including guide wires are described. Acoustic transducers and a flexible imaging tube are described for the locator. A suction cup is described for removably anchoring the imaging tube to a surface. A signal-emitting working element and cooperating signal-receiving locator are described. A method for treating arterial occlusions is described.

Catheter apparatus for treating arterial occlusions

An apparatus is described for treating arterial occlusions combining an intraluminally operable catheter having an occlusion-crossing working element, with an extraluminally operable locator for imaging the progress of the working element through the occlusion. Suction coupling means are described for removably anchoring the locator to a surface proximate the heart. A method for treating arterial occlusions is described in which the distal end of the catheter shaft exits a lumen of the locator, penetrates the arterial wall distal to the occlusion, crosses the occlusion retrograde and passes into a separately introduced standard intravascular catheter, whereupon the distal end of the shaft may be manipulated from the proximal end of the standard catheter. The proximal end of the shaft is then released from external attachments and drawn into the artery to perform treatment or guiding functions. Spatial interrelationships are observed real-time via the locator. Conical, abrasive, blunt-dissecting, sharp-pointed and guide-wire type working elements, steerable and non-steering, are described. Acoustic transducers and a flexible imaging tube are described for the locator. A signal-emitting working element and cooperating signal-receiving locator are described.

Catheter apparatus for guided transvascular treatment of arterial occlusions

Apparatus for crossing total occlusion in blood vessels

Methods and apparatus for crossing total occlusions in blood vessels

Methods and apparatus for crossing vascular occlusions

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Atherton, CA, United States of America

Matthew R Selmon