Patent ID: 7179270

Claim:
A method for bypassing an obstruction in a blood vessel having a wall and a subintimal tract that has been formed in said wall adjacent to the obstruction, said method comprising the steps of: A. providing a catheter device that comprises i) an elongate, flexible catheter body having a distal end, ii) a lumen extending longitudinally through at least a distal portion of the catheter body to permit the catheter device to be advanced over an elongate member, iii) a penetration member having a distal end, said penetration member being advanceable on an advancement trajectory and iv) an orientation element useable to enable the operator to determine the rotational orientation of the catheter body relative to the advancement trajectory of the penetrator to enable the operator to adjust the rotational orientation of the catheter body prior to advancement of the penetrator from the catheter body so that subsequent advancement of the penetrator on the advancement trajectory will cause the penetrator to advance to a target location; B. advancing the catheter device into the subintimal tract to a position where to distal end of the catheter body is positioned in the subintimal tract distal to the obstruction; C. rotationally orientating the catheter body with the aid of the orientation element such that, when the penetration member is subsequently advanced from the catheter body, the penetration member will enter the lumen of the anatomical conduit distal to the obstruction; D. advancing the penetration member from the catheter body and into the lumen of the anatomical conduit distal to the obstruction; E. providing an elongate member having a distal end; and, F. advancing the second elongate member trough the lumen of the penetration member to a position where the distal end of the second elongate member is within the lumen of the anatomical conduit distal to the obstruction.