Catheter apparatus and methods for treating vasculatures

Abstract

A catheter apparatus may have a flexible shaft, guidewire lumens passing through the shaft, and a positioning device for positioning the guidewires relative to an external lumen. The positioning device may be an expansible scaffold covered with a retractable sheath. The positioning device may also be one or more balloons that are inflated through an inflation port in the shaft. The catheter apparatus may be operated by inserting a guide catheter into a vasculature with a chronic total occlusion, inserting the catheter apparatus into the guide catheter, and advancing the guidewires through the guidewire lumens and into contact with a chronic total occlusion. The positioning device may be activated before and/or between attempts to pass the guidewires through the chronic total occlusion to interrogate various parts of the chronic total occlusion.

1 . A catheter apparatus comprising:
 a flexible shaft,   guidewire lumens passing longitudinally through the shaft, and   a positioning means for positioning distal ends of the guidewire lumens relative to an inner wall of an external lumen.   
     
     
         2 . The apparatus of  claim 1 , further comprising a retractable sheath surrounding the guidewire lumens. 
     
     
         3 . The apparatus of  claim 1 , wherein the positioning means is an expansible scaffold. 
     
     
         4 . The apparatus of  claim 3 , wherein the guidewire lumens are coupled to the expansible scaffold. 
     
     
         5 . The apparatus of  claim 1 , wherein the positioning means is one or more sponges. 
     
     
         6 . The apparatus of  claim 5 , wherein the guidewire lumens are embedded in the one or more sponges. 
     
     
         7 . The apparatus of  claim 1 , wherein the positioning means is a shape-memory means integrated with the guidewire lumens. 
     
     
         8 . The apparatus of  claim 1 , wherein the positioning means is a deflectable tip. 
     
     
         9 . The apparatus of  claim 1 , wherein the positioning means is one or more balloons. 
     
     
         10 . The apparatus of  claim 9 , wherein the one or more balloons are inflated through an inflation port running longitudinally in the shaft. 
     
     
         11 . The apparatus of  claim 9 , wherein the one or more balloons is a balloon with a substantially planar distal surface. 
     
     
         12 . The apparatus of  claim 11 , wherein the guidewire lumens are extruded through the distal surface of the balloon. 
     
     
         13 . The apparatus of  claim 9 , wherein the one or more balloons surround distal ends of the guidewire lumens. 
     
     
         14 . The apparatus of  claim 1 , wherein the positioning means is a rotatable core within the shaft. 
     
     
         15 . The apparatus of  claim 1 , wherein the guidewire lumens are adapted to be positioned eccentrically relative to an inner wall of an external lumen. 
     
     
         16 - 23 . (canceled)