Atherectomy with subintimal space

1. A method for treating a stenotic vessel, the method comprising:

inserting a directional guide member of a dissecting device into a subintimal space of a blood vessel, the dissecting device including the directional guide member and a cutting member located proximally to a distal end of the directional guide member;

cutting a stenotic region within the blood vessel with the cutting member while advancing the distal end of the directional guide member through the subintimal space; and

wherein the directional guide member does not extend through an outer surface of the subintimal space.

2. The method of claim 1 , wherein the cutting of the stenotic region further comprises:

cutting media or intima between the directional guide member and the cutting member, wherein the cutting member has a tubular cutting member.

3. The method of claim 1 , comprising:

placing a portion of the cutting member in the subintimal space.

4. The method of claim 1 , comprising:

limiting a rotation of the cutting member within the blood vessel with the directional guide member.

5. The method of claim 1 , comprising:

dilating the subintimal space with the directional guide member after inserting the directional guide member into the subintimal space; and

cutting the subintimal space where dilated by the directional guide member.

6. The method of claim 1 , comprising:

repeating at least once, an entry of either the directional guide member or the cutting member into a true lumen of the blood vessel.

7. The method of claim 1 , comprising:

guiding the dissecting device into the subintimal space on a guide wire, the guide wire extending through at least a portion of the directional guide member and exiting the directional guide member on the distal end of the directional guide member.