Method for treating vascular occlusion

A method for bypassing a vascular occlusion, comprising:

• placing a catheter comprising an elongated flexible catheter shaft with a radially steerable distal end zone and a working element disposed in the distal end zone in a lumen of a vessel;
• rotating an imaging shaft of an imaging device operatively disposed in the distal end zone and measuring the rotation using a hollow shaft motor and rotation encoder;
• directing an optical beam emitted from an optical fiber disposed within the imaging shaft through a distal optical window of the imaging shaft at an angle with respect to a longitudinal axis of the imaging shaft and at an azimuthal angle dependent upon a rotational position of the imaging shaft so as to acquire an image of a vessel interior proximate the distal end of the catheter shaft;
• placing the working element in the lumen proximate to the occlusion using the image;
• manipulating tissue of the occlusion using a plurality of rigid, opposing opening members of the working element, wherein each of the rigid, opposing opening members projects distally from the distal end of the catheter shaft, and wherein upon opening, the members act to urge apart or fracture tissues they are in contact with;
• and
• manipulating and directing the working element using the image until the working element is observed to have established a path through the occlusion.