Device and method for vascular re-entry

Abstract

In a method for re-entry from extraluminal space into the central lumen of a vessel, a guidewire is advanced into the extraluminal space of the vessel, and then a directional catheter is advanced over the guidewire through the extraluminal space. Thereafter, the guidewire is removed from the directional catheter, an ultrasound device is placed through the directional catheter, and the ultrasound device is advanced through the extraluminal space into the central lumen and then activated.

What is claimed is: 
     
         1 . A kit comprising:
 an energy catheter adapted to supply energy to the outside of the wall of the central lumen located within a body when a distal end of the catheter is located extraluminally to the vessel; and   an access catheter adapted to enter the extraluminal space and guide an energy catheter into the extraluminal space.   
     
     
         2 . The kit of  claim 1  wherein the energy catheter is based on any one or any combination of the following energies: ultrasound, vibrational, rotational, radiofrequency, microwave or laser. 
     
     
         3 . The kit of  claim 2  wherein the energy catheter comprises a proximal end outside of the body and an energy source is adapted to deliver energy to the proximal end of the energy catheter. 
     
     
         4 . The kit of  claim 3  wherein the energy is ultrasound. 
     
     
         5 . The kit of  claim 4  wherein the energy catheter comprises an ultrasound transmission member that is adapted to receive energy from the energy source at the proximal end of the energy catheter and adapted to transmit energy to the distal end of the energy catheter. 
     
     
         6 . The kit of  claim 5  wherein the ultrasound transmission member comprises a super-elastic material. 
     
     
         7 . The kit of  claim 6  wherein the energy source includes a control device comprising circuitry to select between operation modes including continuous, pulse, or a combination of both. 
     
     
         8 . The kit of  claim 7  wherein the control device further comprises circuitry to vary the ultrasound frequency from 10 Hz to 20 MHz. 
     
     
         9 . The kit of  claim 8  wherein the proximal end of the energy catheter fluidly communicates with the distal end of the energy catheter and the energy catheter comprises a proximal port that connects cooling fluid to the proximal end of the energy catheter. 
     
     
         10 . The kit of  claim 9  where in the distal end of the ultrasound transmission member comprises a tip. 
     
     
         11 . The kit of  claim 10  wherein the access catheter comprises a curved or bent distal end. 
     
     
         12 . The kit of  claim 11  wherein the access catheter comprises a deflectable or steerable tip.