Abstract: A device to be used in connection with revascularization, especially of the coronary arteries, makes it possible for conventional techniques such as angioplasty or atherectomy to be employed in totally or severely occluded blood vessels deemed otherwise impassable by a guide wire. A guide wire passage is created by providing a catheter with a retractable cutting head or laser source that penetrates the atheromatic material in a blood vessel. The device is centered and stabilized in the vessel by a circumferential balloon so that the passage through the atheromatic material is in the desired direction. The circumferential balloon also prevents blood flow in the event of a break in the blood vessel wall.