Patent ID: 8636715
Filing Date: 2014-01-28
Classification: A61M

Abstract:
1. A method for bypassing an obstruction in a blood vessel that has a true lumen and a vessel wall, and wherein the vessel wall has an intima, said method comprising the steps of: (A) advancing a first guidewire through into the blood vessel such that a distal portion of the first guidewire becomes positioned within a subintimal space adjacent to the obstruction; (B) providing or obtaining a catheter device that comprises; i) an elongate catheter body having a distal end and an outer diameter of no more than 0.080 inch, at least a portion of said catheter body comprising a) a solid core member having at least first and second lumens extending therethrough formed substantially of a material selected form the group consisting of: polyethylene, high density polyethylene, ultra-high molecular weight polyethylene or polypropylene and having at least one lumen extending therethrough, b) a substantially cylindrical braided layer disposed about the core member, said braided layer comprising a material selected from steel and armid fiber c) an outer layer disposed about said braided layer and (d) a distal tip member comprising a composite structure formed on flexible plastic disposed on a rigid housing; and ii) a laterally deployable member having a lumen and a distal end, said laterally deployable member being moveable between a retracted position wherein its distal end resides within a lumen of the core member and an extended position wherein its distal end extends laterally from the catheter body; (C) advancing the catheter body over the first guidewire and through a sheath of size 6 French or smaller, such that the distal end of the catheter body becomes positioned within the subintimal space; (D) advancing or extending the laterally deployable member from the catheter body into the true lumen of the blood vessel, distal to the obstruction; (E) advancing a second guidewire through the lumen of the laterally deployable member and into the true lumen of the blood vessel, distal to the obstruction; (F) retracting the laterally deployable member; (G) removing the catheter device and the first guidewire, leaving the second guidewire in place such that it extends through the true lumen of the blood vessel proximal to the obstruction, through the subintimal space and back into the true lumen of the blood vessel distal to the obstruction; and (H) advancing at least one working device over the second guidewire and using said at least one working device to modify the subintimal space to create a patent bypass channel through which blood may flow around the obstruction.