devices and methods for the treatment of chronic total occlusions are provided . one disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein . the method includes providing an intravascular device having a distal portion , inserting the device into the vascular lumen , positioning the distal portion in the vascular wall to at least partially surround the occlusion , and removing at least a portion of the surrounded occlusion from the lumen .