Re-entry catheter

A method for crossing a total occlusion, said method comprising:

• forming a track from a lumen in the blood vessel into a space between an intimal layer and an adventitial layer of the blood vessel, said track extending from proximal of the total occlusion to past the total occlusion, and
• deflecting a wire from the track back into the blood vessel at a location distal to the total occlusion.

A method for crossing a total occlusion in a blood vessel, said method comprising:

• advancing a wire through a lumen of the blood vessel into a space between an intimal layer and an adventitial layer of the blood vessel to create a track in said space past the total occlusion;
• and
• selectively forming a passage from the track back into the blood vessel lumen at a location distal to the total occlusion.

A method for crossing a total occlusion in a blood vessel, said method comprising:

• advancing a wire through a lumen of the blood vessel into a space between an intimal layer and an adventitial layer of the blood vessel;
• and
• deflecting a wire from the subintimal space back into the blood vessel lumen a location distal to the total occlusion.

An improved method for advancing a guidewire thorough a subintimal space between an intimal layer and an adventitial layer and past a total, occlusion in a blood vessel, wherein the improvement comprises selectively deploying the guidewire through a passage from the subintimal space back into the blood vessel lumen.

A wire deflection system comprising:

• a catheter body having a proximal end, a distal end, and at least one lumen extending through at least a distal portion thereof, wherein said lumen has a distal opening and a lateral opening;
• and
• a cannula having a proximal end, a distal end, and at least one lumen extending through a distal portion thereof, wherein said distal portion has a pre-formed resilient curve and wherein said distal portion of the cannula is slidably disposed in the lumen of the catheter body to assume (a) a straightened configuration with said cannula lumen axially aligned within the distal opening of the catheter body when the cannula is proximally retracted within the catheter body and (b) a curved configuration with the cannula extending laterally through the lateral opening of the catheter body when the cannula is distally advanced within the catheter body.