SUPPORT CATHETER AND GUIDEWIRE KIT FOR CROSSING A VASCULAR OCCLUSION
The present disclosure relates generally to the use of medical devices for the treatment of vascular conditions. In particular, the present disclosure provides devices and methods of using a kit, which includes a guidewire and a support catheter, both of which are capable of penetrating a calcified and/or fibrous total occlusion. The guidewire and the support catheter each comprise an expandable member adjacent its distal end. The guidewire and support catheter are used in cooperation with one another to cross an occlusion in a step-wise fashion by alternately deploying and retracting the expandable member of the support catheter while the guidewire is inserted into the occlusion and deploying the expandable member of the guidewire while the support catheter is inserted into the occlusion.
1 . A kit comprising:
a catheter having a proximal end and a distal end, wherein the catheter comprises an expandable member adjacent its distal end; and
a guidewire having a proximal end and a distal end, wherein the guidewire is configured to be disposed radially within the catheter, wherein the guidewire comprises an expandable member adjacent its distal end.
2 . The kit of claim 1 , wherein the expandable member of the catheter comprises at least one of an expandable braided element, an expandable coiled wire, pivotable barbs, a radially expandable hypotube, and expandable ribbon.
3 . The kit of claim 1 , wherein the expandable member of the guidewire comprises at least one of an expandable braided element, an expandable coiled wire, pivotable barbs, a radially expandable hypotube, and expandable ribbon.
4 . A method of crossing an occlusion within a vasculature of a subject, the method comprising:
introducing a kit within the vasculature of the subject, the kit comprising:
a catheter having a proximal end and a distal end, wherein the catheter comprises an expandable member adjacent its distal end; and
a guidewire having a proximal end and a distal end, wherein the guidewire is configured to be disposed radially within the catheter, wherein the guidewire comprises an expandable member adjacent its distal end;
positioning the guidewire and the catheter adjacent the occlusion within the vasculature;
advancing the guidewire into the occlusion;
expanding the expandable member of the guidewire into the occlusion;
advancing the catheter into the occlusion over the guidewire;
expanding the expandable member of the catheter into the occlusion;
retracting the expandable member of the guidewire from the occlusion; and
advancing the guidewire through the occlusion.
5 . The method of claim 4 , further comprising the step of removing the catheter from the vasculature.
6 . The method of claim 4 , wherein the expandable member of the catheter comprises at least one of an expandable braided element, an expandable coiled wire, pivotable barbs, a radially expandable hypotube, and expandable ribbon.
7 . The method of claim 4 , wherein the expandable member of the guidewire comprises at least one of an expandable braided element, an expandable coiled wire, pivotable barbs, a radially expandable hypotube, and expandable ribbon.
8 . A method of removing a portion of an occlusion within a vasculature of a subject, the method comprising:
introducing a kit within the vasculature of the subject, the kit comprising:
a catheter having a proximal end and a distal end, wherein the catheter comprises an expandable member adjacent its distal end; and
a guidewire having a proximal end and a distal end, wherein the guidewire is configured to be disposed radially within the catheter, wherein the guidewire comprises an expandable member adjacent its distal end;
positioning the guidewire and the catheter adjacent the occlusion within the vasculature;
advancing the guidewire into the occlusion;
expanding the expandable member of the guidewire into the occlusion;
advancing the catheter into the occlusion over the guidewire;
expanding the expandable member of the catheter into the occlusion;
retracting the expandable member of the guidewire from the occlusion;
advancing the guidewire through the occlusion;
removing the catheter from the vasculature;
introducing an atherectomy device into the vasculature over the guidewire and removing the portion of the occlusion from the vasculature with the atherectomy device.
9 . The method of claim 8 , wherein the atherectomy device is a laser ablation catheter.
10 . The method of claim 8 , wherein the expandable member of the catheter comprises at least one of an expandable braided element, an expandable coiled wire, pivotable barbs, a radially expandable hypotube, and expandable ribbon.
11 . The method of claim 8 , wherein the expandable member of the guidewire comprises at least one of an expandable braided element, an expandable coiled wire, pivotable barbs, a radially expandable hypotube, and expandable ribbon.