A medical device is disclosed which may include an elongate luminal element configured for insertion into a natural body lumen. An elongate working member may positioned within the elongate luminal element. The elongate luminal element may include at least a first lumen which may extend along a longitudinal axis of the multi-lumen element. The working member may include an auger portion on a distal end thereof which may be configured to pierce tissue. In addition, the auger portion may be rotatable about the longitudinal axis.
