Guidewire positioning catheter

A catheter device for positioning a guidewire across an occluded portion of a vessel, the catheter device comprising:

• an elongate catheter body having a central lumen and a steerable distal end, the steerable distal end comprising a scaffold including a narrow solid band that extends longitudinally along the elongate catheter body;
• a rotatable distal tip comprising one or more channeled flutes extending around the rotatable distal tip so as to form a plurality of cutting edges, wherein the steerable distal end is configured to controllably deflect the rotatable distal tip;
• a driveshaft extending within the central lumen of the elongate catheter body and configured to rotate the rotatable distal tip, the driveshaft configured to move longitudinally in a distal direction relative to the elongate catheter body to cause at least a portion of the rotatable distal tip to extend from a protected position inside the elongate catheter body to an exposed position outside of the elongate catheter body, wherein a force applied to the driveshaft in the distal direction relative to the elongate catheter body causes the elongate catheter body to bend toward the narrow solid band and to activate the steerable distal end;
• and
• a proximal handle region including a control for rotating the driveshaft and distal tip in a forward direction to cut tissue with the plurality of cutting edges and in a reverse direction to bluntly contact tissue.