Cutting guide wire and method of use thereof

1. A guide wire comprising:

a helically wound coil having a proximal end and a closed distal end and a longitudinal movement axis, wherein the distal end of the helically wound coil is closed with a cap; and

a first deflection wire housed within the helically wound coil and having a proximal end and a distal end, wherein the first deflection wire, responsive to a translational displacement on the longitudinal movement axis in a distal direction, simultaneously acts to deflect the distal end of the helically wound coil in a first direction, the first direction being on an axis perpendicular to the longitudinal movement axis of the helically wound coil, while moving a first blade attaching to a distal portion of the first deflection wire from a retracted position to an extended position, the first blade in the retracted position being housed entirely within the cap and the first blade in the extended position extending from the cap.

2. The guide wire of claim 1 , further comprising a second deflection wire housed within the helically wound coil; wherein a distal end of the second deflection wire attaches to the distal end of the first deflection wire, and the second deflection wire, responsive to a translational displacement on the longitudinal movement axis, simultaneously deflects the distal end of the helically wound coil in a second direction, the second direction being opposite the first direction and on an axis perpendicular to the longitudinal movement axis of the helically wound coil, while moving a second blade attached to a distal end of the second deflection wire from a retracted position to an extended position, the second blade in the retracted position housed entirely within the cap and the second blade in the extended position extending distally from the cap.

3. The guide wire of claim 2 , further comprising a stability sheath positioned between the deflection wires and the helically wound coil.

4. The guide wire of claim 1 , wherein the first blade extends from a circumferential edge of the cap.

5. The guide wire of claim 1 , further comprising a longitudinal radiopaque marker line disposed on an exterior surface of the helically wound coil.

6. The guide wire of claim 1 , wherein the cap is tight-fitted into the distal tip of the coil to enable movement of the first blade from the retracted position to the extended position.

7. The guide wire of claim 1 , wherein the first blade in the retracted position is flush with an interior surface of the cap.

8. The guide wire of claim 1 , comprising a plurality of first blades attaching to the distal end of the first deflection wire.

9. The guide wire of claim 1 , further comprising a lubricious polymer coating surrounding the helically wound coil.

10. A guide wire comprising:

a helically wound coil having a proximal end and a distal end, wherein coils at the distal end are in a more relaxed state than coils at the proximal end;

a cap secured to the distal end of the helically wound coil;

a first deflection wire and a second deflection wire disposed within the helically wound coil and secured together at the distal end of the helically wound coil, the first deflection wire having a proximal end and a distal end and the second deflection wire having a proximal end and a distal end, wherein the first deflection wire extends from the proximal end of the helically wound coil to the distal end of the helically wound coil; and

a first blade attaching to the distal end of the first deflection wire and a second blade attaching to the distal end of the second deflection wire, the first blade housed within the cap when the first deflection wire is in a relaxed state and the first blade extended from the cap when the first deflection wire is in a deflection state, and the second blade housed within the cap when the second deflection wire is in a relaxed position and the second blade extended from the cap when the second deflection wire is in a deflection state.

11. A method of crossing an occlusion in a lumen of a patient vessel, the method comprising:

introducing a distal end of a guide wire into the patient vessel, wherein the guide wire comprises:

a helically wound coil having a proximal end and a closed distal end and a longitudinal movement axis, wherein the distal end of the helically wound coil is closed with a cap; and

a first deflection wire housed within the helically wound coil and having a proximal end and a distal end, wherein the first deflection wire, responsive to a translational displacement on the longitudinal movement axis in a distal direction, simultaneously acts to deflect the distal end of the helically wound coil in a first direction, the first direction being on an axis perpendicular to the longitudinal movement axis of the helically wound coil, while moving a first blade attaching to a distal portion of the first deflection wire from a retracted position to an extended position, the first blade in the retracted position being housed entirely within the cap and the first blade in the extended position extending distally from the cap; and

a second deflection wire housed within the helically wound coil; wherein a distal end of the second deflection wire attaches to the distal end of the first deflection wire, and the second deflection wire, responsive to a translational displacement on the longitudinal movement axis, simultaneously deflects the distal end of the helically wound coil in a second direction, the second direction being opposite the first direction and on an axis perpendicular to the longitudinal movement axis of the helically wound coil, while moving a second blade attaching to a distal end of the second deflection wire from a retracted position to an extended position, the second blade in the retracted position housed within the cap and the second blade in the extended position extending distally from the cap;

advancing the distal end of the guide wire to a first end of the occlusion;

translationally displacing the first deflection wire, whereby the distal end of the helically wound coil is deflected and the first blade is extended to contact and cut a wall of the vessel;

advancing the distal end of the guide wire to enter a subintimal layer of the wall of the vessel;

advancing the distal end of the guide wire through a subintimal region of the wall of the vessel, wherein the advancing through the subintimal region is in a direction substantially aligned with a path of the vessel and wherein the advancing is sufficient to position the distal end of the guide wire adjacent to a region of the vessel beyond the obstruction;

translationally displacing the first deflection wire or the second deflection wire, whereby the distal end of the helically wound coil is deflected to enter the lumen of the vessel at a second side of the obstruction.

12. The method of claim 11 , wherein the vessel is a vascular vessel.

13. The method of claim 12 , where the obstruction is a result of thrombosis.

14. The method of claim 11 , further comprising:

advancing a device comprising a balloon catheter over the guide wire;

positioning an expandable balloon portion of the balloon catheter within the subintimal region; and

expanding the balloon within the subinitimal region, whereby the subinitimal region is expanded.

15. The method of claim 14 , wherein the device further comprises an expandable stent positioned on the expandable balloon portion of the balloon catheter.

16. The method of claim 11 , further comprising:

advancing a device comprising an expandable stent over the guide wire;

positioning the expandable stent within the subintimal region; and

expanding the expandable stent within the subinitimal region, whereby the subinitimal region is expanded.

17. The method of claim 16 , wherein the expandable stent is a self-expandable stent.

18. The method of claim 16 , wherein the expandable stent is a balloon-expandable stent.

19. The method of claim 16 , wherein the expandable stent comprises a bioactive agent.

20. The method of claim 14 , wherein the expandable balloon portion of the balloon catheter comprises a bioactive agent.