Catheter system for vascular re-entry from a sub-intimal space
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.
1 . A method for accessing a true lumen of a blood vessel from a sub-intimal plane of the vessel, comprising:
identifying a site to enter the true lumen from a position in the sub-intimal plane distal to a chronic total occlusion (CTO);
determining an orientation of the true lumen with respect to the sub-intimal plane at the selected site;
physically securing tissue of the sub-intimal plane at the selected site; and
establishing a path from the sub-intimal plane into the vessel true lumen.
2 . A method for crossing a chronic total occlusion (CTO) in vasculature, comprising:
forming a track from a true lumen into a sub-intimal space of a blood vessel, wherein the track extends from a position proximal to the CTO in the true lumen to a position distal to the CTO in the sub-intimal space;
determining an orientation of the true lumen with respect to the sub-intimal plane at an identified re-entry site from a position in the sub-intimal plane, wherein the re-entry site is distal to the CTO;
physically securing tissue of the sub-intimal plane at the selected site; and
selectively forming a path from the sub-intimal plane back into the true lumen.
3 . A catheter system for accessing a true lumen of a blood vessel from a sub-intimal plane of the vessel, comprising:
at least one visualization element for determining an 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 distal to a chronic total occlusion (CTO);
at least one system for physically securing tissue of the sub-intimal plane at the entry site to the catheter system; and
at least one re-entry device for establishing and maintaining a path from the sub-intimal plane into the vessel true lumen.
4 . A catheter system for crossing chronic total occlusions (CTOs) in vasculature, comprising:
means for forming a track from a true lumen into a sub-intimal space of a blood vessel, wherein the track extends from a position proximal to the CTO in the true lumen to a position distal to the CTO in the sub-intimal space;
means for determining an orientation of the true lumen with respect to the sub-intimal plane at an identified re-entry site, wherein the re-entry site is distal to the CTO;
means for physically securing tissue of the sub-intimal plane at the selected site; and
means for selectively forming a path from the sub-intimal plane back into the true lumen.