Systems and methods 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. A device for creating an arteriovenous (AV) fistula, comprising:
a first member comprising a main body having a lumen and an opening; a second member disposed in said lumen, and configured to be moved distally out of said first member opening, and to advance through tissue while being distally moved; and a non-expandable third member deliverable through the lumen and being pivotably connected at a center of the non-expandable third member to a distal end of the second member and being actuatable between a first orientation wherein the non-expandable third member has a first dimension relative to the second member, and a second orientation wherein the non-expandable third member has a second dimension relative to the second member which is greater than the first dimension, the first orientation being adapted for advancement and retraction of the second member and the second orientation being adapted to move adjacent first and second blood vessels toward one another and to create an elongated communicating aperture in opposing sides of each of the first blood vessel and the second blood vessel; wherein the first member further comprises a first tissue contacting surface and the non-expandable third member comprises a second tissue contacting surface, the first and the second tissue contacting surfaces being opposed to one another such that a width of the second tissue contacting surface is not less than a width of the opening.