Methods and devices for bidirectional crossing of an obstruction

A retrograde catheter for introduction into a vascular lumen and retrograde advancement to a treatment site, comprising:

• an elongate, flexible tubular body having a proximal end and a distal end;
• a first lumen extending between a proximal opening adjacent the proximal end and a side port spaced proximally apart from the distal end;
• and
• a second lumen extending proximally from the distal end to a second lumen proximal port.

A retrograde catheter for introduction into a vascular lumen and retrograde advancement to a treatment site, comprising:

• an elongate, flexible tubular body having a proximal end and a distal end;
• a central lumen extending between a proximal opening adjacent the proximal end and the distal end;
• a side port spaced proximally apart from the distal end and in communication with the central lumen;
• and
• a moveable ramp adjacent the side port.

An antegrade catheter for accessing a vascular lumen, comprising:

• an elongate, flexible tubular body having a proximal end and a distal end;
• a first lumen extending between a proximal opening adjacent the proximal end and a side port spaced proximally apart from the distal end;
• and
• a second lumen extending proximally from the distal end to a second lumen proximal port, wherein at least a portion of the tubular body in between the side port and the distal port is not aligned with a longitudinal axis of the proximal end of the tubular body.

A method of crossing a vascular obstruction in a patient, comprising the steps of:

• advancing a first catheter transvascularly in a first direction towards a vascular obstruction, the first catheter having a first central lumen in communication with a first side port;
• advancing a second catheter transvascularly in a second, opposite direction towards the obstruction, the second catheter having a second central lumen in communication with a second side port;
• aligning the first and second side ports to place the first central lumen in communication with the second central lumen;
• and
• advancing a wire through the first and second side ports such that a first end of the wire is on a first side of the obstruction and a second end of the wire is on a second side of the obstruction.