Systems for creating arteriovenous (AV) fistulas

摘要

A system for creating an arteriovenous (AV) fistula comprises a vessel access sheath having a hollow interior and an exit port, a side access needle catheter configured to fit within the hollow interior of the sheath, a needle configured to be inserted into a blood vessel through the side access needle catheter, a toggle delivery catheter configured to fit within the hollow interior of the sheath, and a toggle apparatus configured to be delivered into a vessel through the toggle delivery catheter. The toggle apparatus comprises a shaft and a toggle member pivotably attached to a distal end of the shaft. A source of RF energy or resistive heat energy may be provided for application to the toggle member and/or to a heater insert in the toggle delivery catheter, for the purpose of creating the fistula.

主权项

1. An apparatus, comprising:
a first portion having a proximal end and a distal end and an outer surface defining an opening; a non-expandable second portion pivotably coupled to the first portion, the non-expandable second portion configured to be delivered through a lumen of the first portion and through a first body lumen and into a second body lumen; a first energy delivery portion, separate from and fixedly coupled to, the first portion; a second energy delivery portion, separate from and fixedly coupled to, the non-expandable second portion, the second energy delivery portion configured to directly mate with and oppose the first energy delivery portion; and an actuator configured to move the non-expandable second portion from a first position disposed apart from a wall of the second body lumen to a second position adjacent to the wall of the second body lumen to apply pressure and energy sufficient to induce cutting and welding of body tissue between the first portion and the non-expandable second portion, the actuator having a shaft coupled to the non-expandable second portion, the shaft slidably positioned within the lumen of the first portion, the non-expandable second portion being opposed to the outer surface of the first portion such that a width of the non-expandable second portion when in the second position is greater than a greatest width of the opening of the first portion and the non-expandable second portion extends across the opening when in the second position.