Catheter apparatus with telescoping lumen catheters and its use in methods for treating vasculatures

Abstract

The invention provides for methods and catheter apparatus for passing one or more guidewires (via the use of one or more telescoping guidewire lumens) through a chronic total occlusion of a vasculature. The catheter apparatus may include: a catheter shaft having a distal end; one or more telescoping guidewire lumen catheters passing longitudinally through the shaft, wherein the one or more guidewire lumen catheters are capable of telescoping beyond the distal end of the catheter shaft; an expansible distal portion of the shaft; and a retractable sheath covering at least a portion of the expansible distal portion of the shaft, wherein retracting the retractable sheath from the expansible distal portion of the shaft directly activates the expansible distal portion of the shaft causing expansion of the expansible distal portion of the shaft.

1 - 24 . (canceled) 
     
     
         25 . A catheter apparatus comprising:
 a catheter shaft having a catheter shaft distal end; and   a lumen catheter having a lumen catheter distal end, the lumen catheter having a retracted position and an advanced position,   wherein, in the retracted position, the lumen catheter distal end is approximately flush with the catheter shaft distal end, and   wherein, in the advanced position, the lumen catheter distal end extends beyond the catheter shaft distal end.   
     
     
         26 . The catheter apparatus of  claim 25 , wherein the catheter shaft distal end further comprises an expansible support structure,
 wherein, in the retracted position, the lumen catheter distal end is approximately flush with a distal end of the expansible support structure, and   wherein, in the advanced position, the lumen catheter distal end extends beyond the distal end of the expansible support structure.   
     
     
         27 . The catheter apparatus of  claim 25 , wherein the catheter shaft is a hollow body and lumen catheter extends through the hollow body. 
     
     
         28 . The catheter apparatus of  claim 25 , wherein the lumen catheter is a plurality of lumen catheters. 
     
     
         29 . The catheter apparatus of  claim 28 , wherein the catheter shaft is a solid tube having a lumen for each of the plurality of lumen catheters. 
     
     
         30 . The catheter apparatus of  claim 28 , wherein each of the plurality of lumen catheters is configured to move between the retracted position and the advanced position individually of the remaining lumen catheters. 
     
     
         31 . The catheter apparatus of  claim 28 , wherein the plurality of lumen catheters move between the retracted position and the advanced position jointly. 
     
     
         32 . The catheter apparatus of  claim 28 , wherein the plurality of lumen catheters are distributed approximately equidistant from each other. 
     
     
         33 . The catheter apparatus of  claim 25 , further comprising an actuator, the actuator configured to control movement of the lumen catheter. 
     
     
         34 . The catheter apparatus of  claim 25 , further comprising a sheath, the sheath configured to retract along the catheter shaft thus allowing the lumen catheter to move from the retracted position to the advanced position. 
     
     
         35 . The catheter apparatus of  claim 34 , wherein the sheath is further configured to advance along the catheter shaft thus allowing the lumen catheter to move from the advanced position to the retracted position.