Hydraulic auto crossing balloon/catheter

An apparatus for crossing a tissue region, the apparatus comprising:

• a catheter sized and shaped for vascular access and including an elongate body extending between a proximal end and a distal end;
• a tip section arranged at the distal end of the elongate body, the tip section including:
• a needle portion arranged at a distal end of the tip section and configured to puncture the tissue region in a first configuration to create an opening therein and retract within the tip section in a second configuration, and
• a balloon arranged proximally of the needle portion and configured to dilate the opening in the tissue region and pass a portion of the tip section through the opening while in a partially inflated configuration;
• and
• a hydraulic actuator coupled to a proximal end of the catheter and configured to drive the needle portion through the tissue region and assist in the balloon passing the tip section through the opening.

A method for crossing a tissue region, the method comprising:

• arranging a tip section of a catheter on the tissue region, the catheter being sized and shaped for vascular access and including an elongate body extending between a proximal end and a distal, the tip section including a needle portion and a balloon having a first section and a second section with at least a portion of the second section being coupled to the tip section;
• puncturing the tissue region using the needle portion to create an opening using a hydraulic actuator coupled to a proximal end of the catheter to drive the needle portion through the tissue region;
• retracting the needle portion within the tip section;
• advancing the balloon within the opening in the tissue region;
• dilating the opening in the tissue region by inflating the balloon with the first section being configured to inflate prior to the second section;
• and
• passing at least a portion of the tip section through the opening in the tissue region using the hydraulic actuator.