A catheter with proximal and distal ends having a spiral centering device attached near the catheter distal end. The spiral centering device has at least one spiral strut having a proximal end and a distal end. The spiral centering device resiliently tends to center the distal end portion of the catheter, steering the catheter away from the vessel wall during insertion through the vasculature and toward the treatment site. The spiral centering catheter may facilitate access to tortuous anatomy by preventing the distal catheter tip from catching on irregularities in the lumenal surface. If a stent is provided on the catheter, the spiral centering catheter may also facilitate uniform stent expansion by stabilizing the catheter during stent deployment.