Systems, devices and methods for antegrade dissection and reentry

A system for imaging a lumen, comprising:

• an imaging catheter comprising:
• a tubular body comprising:
• a proximal end region;
• a distal end region;
• and
• a middle region;
• an imaging lumen located along the proximal, middle and distal regions;
• a common guidewire lumen located along the proximal, middle and distal regions;
• a side ramp lumen located in the distal end region and connected to the common guidewire lumen, and comprising a distal opening in a sidewall of the tubular body;
• a distal guidewire lumen, located in the distal end region and connected to the common guidewire lumen, and comprising a distal opening at an endwall of the tubular body;
• at least one guidewire bias structure, the at least one guidewire bias structure selected from a group consisting of:
• a reduced diameter region at a junction of the distal guidewire lumen and the common guidewire lumen;
• an offset distance between a longitudinal axis of the common guidewire lumen and a longitudinal axis of the distal guidewire lumen;
• an angled flap at or proximal to a junction of the distal guidewire lumen and the common guidewire lumen;
• and
• a guidewire lumen bump at or proximal to the junction of the distal guidewire lumen and the common guidewire lumen;
• a proximal catheter assembly, comprising a catheter housing coupled to the proximal end region of the tubular body and a proximal optical connection interface;
• a first guidewire port in fluid communication with the common guidewire lumen;
• an imager port in fluid communication with the imaging lumen;
• and
• an imaging optical fiber connected to the proximal optical connection interface and
• extending along the imaging lumen.

A re-entry catheter system, comprising:

• an elongate catheter body, the catheter body comprising:
• a proximal end;
• a distal end;
• a common lumen extending from the proximal location at the proximal end to a distal location proximal to the distal end, comprising a first longitudinal central axis;
• a distal lumen extending from the distal location of the common lumen to the distal end of the catheter body, wherein the distal lumen has comprise a second longitudinal central axis that is parallel and offset from the first longitudinal central axis;
• and
• a side lumen extending distally from the distal location of the common lumen to a side wall location of the catheter body wherein the side wall location is proximal to the distal end of the catheter body;
• an imaging lumen extending from the proximal end of the catheter body;
• a proximal catheter handle coupled to the proximal end of the catheter body, the handle comprising:
• a catheter body rotator knob configured to rotate the catheter body relative to the proximal catheter handle;
• and
• an imaging catheter displacement knob configured to longitudinally displace an imaging catheter inserted into the catheter body relative to the catheter body.