Devices and methods for treating lower extremity vasculature

摘要

A method of diverting fluid flow from a first vessel including an occlusion to a second vessel includes deploying a prosthesis at least partially in a fistula and making valves in the second vessel incompetent. Making the valves in the second vessel incompetent includes at least one of using a reverse valvulotome to cut the valves, inflating a balloon, expanding a stent, and lining the second vessel with a stent.

主权项

1. A method of modifying a vessel including making valves in the vessel incompetent and covering collateral vessels of the vessel, the method comprising:
forming a fistula between a first vessel and the vessel, wherein the first vessel is an artery and the vessel is a vein, wherein forming the fistula comprises:
inserting a first catheter into the first vessel, the first catheter comprising:
an ultrasound emitting transducer, anda needle configured to radially extend from the first catheter;inserting a second catheter into the vessel, the second catheter comprising an ultrasound receiving transducer;emitting an ultrasound signal from the ultrasound emitting transducer; andafter the ultrasound signal is received by the ultrasound receiving transducer, extending the needle from the first catheter, wherein extending the needle comprises exiting the first vessel, traversing interstitial tissue between the first vessel and the vessel, and entering the vessel; deploying a prosthesis at least partially in the fistula, wherein after deploying the implantable prosthesis, blood is diverted from the first vessel to the vessel through the prosthesis; and making valves in the vessel incompetent, wherein making the valves in the vessel incompetent comprises:
using a reverse valvulotome to cut the valves, andlining the vessel with a stent-graft, wherein lining the vessel comprises covering the collateral vessels of the vessel, wherein the stent-graft is separate from the prosthesis, and wherein a proximal segment of the stent-graft longitudinally overlaps a distal segment of the prosthesis.