Chronic total occlusion crossing devices and methods

A device for crossing a lesion in a tissue lumen, comprising:

• a catheter;
• a crossing wire configured to pass through a lumen of the catheter, the crossing wire including a loop at a distal end of the crossing wire, the loop having a configuration that prevents a width of the loop from exceeding a width of the tissue lumen, and the loop having a pair of lateral opposing portions configured for alignment with a wall of the tissue lumen and a leading portion interconnecting the pair of lateral opposing portions, the leading portion being configured to interrogate the lesion;
• and
• a stationary inner catheter disposed within the catheter, the stationary inner catheter including a second lumen therein;
• wherein an outer surface of the stationary inner catheter is fixed to an inner surface of the catheter.

A device for crossing a lesion in a tissue lumen, comprising:

• a catheter forming a lumen;
• and
• a crossing wire configured to pass through the lumen of the catheter, the crossing wire including a primary shaft and a loop at a distal end of the primary shaft, the loop having a configuration that prevents a width of the loop from exceeding a width of the tissue lumen, and the loop having a leading portion configured to interrogate the lesion,
• wherein the crossing wire has a first configuration in which opposing lateral sides of the loop are not twisted or are twisted by a first amount, and a second configuration wherein the opposing lateral sides of the loop are twisted by a second amount that is different from the first amount,
• wherein the crossing wire can be changed from the first configuration to the second configuration by twisting the primary shaft at a position proximal to the catheter.

A method for crossing a chronic total occlusion (CTO), comprising:

• inserting a catheter having a looped wire with a rectangular cross-section disposed in a lumen of the catheter into an occluded vessel;
• extending a distal end of the looped wire beyond a distal end of the catheter to contact an occlusion, the looped wire being positioned such that a long edge of the rectangular cross-section contacts a wall of the occluded vessel;
• grasping the looped wire at a position proximal to a proximal end of the catheter;
• and
• rotating the grasped looped wire back and forth through an angle less than 360 degrees while maintaining the distal end of the looped wire in contact with the occlusion to erode the occlusion.