Systems, apparatus and methods for treating blood vessels

A method for treating a blood vessel including a blood vessel wall defining a blood vessel lumen, the blood vessel lumen being at least partially obstructed by an occlusion, the occlusion dividing the lumen into a proximal lumen segment and a distal lumen segment, the method comprising:

• positioning an orienting element of an orienting catheter inside an intrawall space located distal of the occlusion from the proximal lumen segment, the intrawall space being located between an intima and an adventitia of the blood vessel wall;
• positioning an occluding element of an occlusion catheter in the proximal lumen segment at a location near the occlusion, the occluding element comprising a balloon;
• inflating the balloon of the occlusion catheter in the proximal lumen segment so as to isolate a target volume, the target volume including the intrawall space;
• reducing the pressure inside the target volume;
• deploying the orienting element in the intrawall space so that the orienting catheter assumes an orientation in which a port of the orienting catheter is directed toward the distal lumen segment;
• and
• advancing a distal end of a reentry device from the port through the intima and into the distal lumen segment.

A method for treating a blood vessel including a blood vessel wall defining a blood vessel lumen, the blood vessel lumen being at least partially obstructed by an occlusion, the occlusion dividing the lumen into a proximal lumen segment and a distal lumen segment, the method comprising:

• positioning an orienting element of an orienting catheter inside an intrawall space located distal of the occlusion from the proximal lumen segment, the intrawall space being located between an intima and an adventitia of the blood vessel wall;
• positioning an occluding element of an occlusion catheter in the proximal lumen segment at a location near the occlusion, the occluding element comprising a balloon;
• inflating the balloon of the occlusion catheter in the proximal lumen segment so as to isolate a target volume, the target volume including the intrawall space;
• reducing the volume of the target volume so that the intima presses against the orienting element of the orienting catheter;
• deploying the orienting element in the intrawall space so that the orienting catheter assumes an orientation in which a port of the orienting catheter is directed toward the distal lumen segment;
• and
• advancing the distal end of a reentry device from the port through the intima and into the distal lumen segment.