Methods and systems for treating obstructions in a body lumen

A method of treating a region of occluding material in a body lumen, comprising the steps of:

• a. introducing a first guidewire into the body lumen and through the region of occluding material;
• b. introducing a catheter over the first guidewire, the catheter having a removal mechanism disposed at its distal end;
• c. creating an initial pilot lumen through the occluding material;
• d. removing the first guidewire;
• e. introducing a second guidewire through a lumen of the catheter, the second guidewire having a guide section with a curved profile that is diametrically larger than the dimension of the removal mechanism;
• f. retracting the catheter and removal mechanism to a position along the second guidewire that is proximal to the occluding material;
• g. advancing the removal mechanism along the guide section to separate and remove a first curved channel in the occluding material;
• h. retracting the catheter and removal mechanism to a position along the second guidewire that is proximal to the occluding material;
• i. axially translating the guide section of the second guidewire within the occluding material;
• and
• j. advancing the removal mechanism along the guide section to separate and remove a second curved channel in the occluding material that is confluent with the first curved channel in the occluding material.

A method of treating a region of occluding material in a body lumen, comprising the steps of:

• a. creating an initial pilot lumen through the occluding material;
• b. introducing into the pilot lumen a guide mechanism having a curved profile which positions portions of the guide mechanism adjacent the occluding material;
• and
• c. advancing a removal mechanism along the guide mechanism to separate and remove a first plurality of generally confluent curved channels to form a first passageway through the occluding material which is diametrically larger than the pilot lumen.