Guide-wire sleeve for facilitation of lesion crossing

A sleeve for installation on a guide wire inserted through a mammalian vessel having an occlusion therein, the sleeve consisting essentially of:

• a hollow tip located at a distal end of the sleeve for passage of the wire therethrough, wherein:
• the tip provides a leading edge;
• and
• a smooth outer surface extends longitudinally from said leading edge, the outer surface shaped to primarily operate as a wedge to force an occlusion surface in abutment with the guidewire radially outwardly as the sleeve is advanced through the occlusion through which the wire has been inserted.

A method of traversing an occlusion of an animal vessel, the method comprising:

• inserting a guide wire into the vessel and at least partially through the occlusion to create a channel at least partially through the occlusion;
• passing a hollow elongated sleeve, having a tapered distal tip, along the guide wire;
• and
• advancing the sleeve into the occlusion so as to force material of said occlusion outwardly from the guide-wire to thereby dilate the channel primarily by wedging without substantial removal of material from said occlusion.

A kit for treatment of a mammalian vessel having an occlusion, the kit comprising:

• a guide-wire having a diameter for inserting into the vessel and advancing at least partially across the occlusion;
• and
• an elongated hollow smooth sleeve having a distal end and a proximal end, and defining a lumen for fitting receipt of the guide-wire therethrough, the lumen having a diameter which is about 0.001 to about 0.004 inches greater than the diameter of the guide-wire,
• the distal end providing a tapered distal tip that is shaped to operate as a wedge to spread apart surrounding portions of said occlusion as said distal end is advanced over the guide-wire through said occlusion.

A device for use with a monorail delivery system for treatment of a mammalian vessel having an occlusion, the device comprising:

• an elongated hollow sleeve having a distal end and a proximal end, the sleeve having a length up to about 26 cm, the sleeve defining a lumen for receipt of a guide-wire therethrough, the sleeve further defining a guide-wire exit port proximal from the distal end;
• and
• a pusher wire operatively coupled about a proximal end of the sleeve;
• wherein
• the distal end of the sleeve provides a tapered distal tip that is shaped to operate as a wedge to spread apart surrounding portions of said occlusion crossed by the guide-wire as said distal end is advanced over the guide-wire through said occlusion.

A method of traversing an occlusion of an animal vessel, the method comprising:

• inserting a guide wire into the vessel and at least partially through the occlusion to create a channel at least partially through the occlusion;
• passing a hollow elongated sleeve, having a tapered distal tip, along the guide wire;
• and
• advancing the sleeve into the occlusion so as to dilate a channel containing the guide wire primarily by forcing said occlusion radially outwardly from the guide-wire.

A kit for treatment of a mammalian vessel having an occlusion, the kit comprising:

• a guide-wire having a diameter for inserting into the vessel and advancing at least partially across the occlusion;
• and
• an elongated hollow smooth sleeve having a distal end and a proximal end, and defining a lumen for receipt of the guide-wire therethrough, the guide-wire diameter being at least 78 percent of a diameter of the lumen,
• the distal end providing a tapered distal tip that is shaped to operate as a wedge to spread apart surrounding portions of said occlusion as said distal end is advanced over the guide-wire through said occlusion.