Abstract

Methods for creating and maintaining an anastomosis between two adjacent blood vessels using percutaneous techniques, for use in hemodialysis procedures are disclosed and described.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A method of operating a catheter assembly including monitoring a gap feedback signal indicative of a distance between a first tissue contact surface and a second tissue contact surface. Producing, via a user interface of the catheter assembly, a graphical depiction of the first tissue contact surface and the second tissue contact surface spaced apart from the first tissue contact surface by the distance. Producing, via the user interface of the catheter assembly, a gap distance warning when the gap feedback signal indicates that the distance is outside of a target gap range.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 17/00 - Surgical instruments, devices or methods
• A61B 17/34 - TrocarsPuncturing needles
• A61B 18/14 - Probes or electrodes therefor
• A61M 1/36 - Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters
• A61M 25/04 - Holding devices, e.g. on the body in the body, e.g. expansible
• A61M 25/06 - Body-piercing guide needles or the like

Abstract

A method of producing an arteriovenous (AV) fistula includes producing an anastomosis between a primary blood vessel (e.g., a vein) and a secondary blood vessel (e.g., an artery). A collateral (or competing) blood vessel in fluid communication with one of the primary blood vessel or the secondary blood vessel is identified. A reversible flow restrictor is then applied to the collateral blood vessel to reduce a blood flow rate through the collateral blood vessel. In some embodiments, the anastomosis can be produced percutaneously. In some embodiments, the reversible flow restriction (or a portion thereof) can be removed from the collateral blood vessel. In other embodiments, the reversible flow restriction (or a portion thereof) can be adjusted to allow increased blood flow therethrough while within the collateral blood vessel.

IPC Classes  ?

• A61M 1/36 - Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation
• A61B 17/00 - Surgical instruments, devices or methods
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis

Abstract

A method of creating a native vessel bypass percutaneously includes steps of selecting a target procedural site adjacent to a paired artery and vein, usually near an occlusion or blockage disposed in the artery and advancing a catheter through the vein with its distal tip extending through the vessel walls into the adjacent artery. An anastomosis is formed by applying heat to tissue forming the vessel walls which is captured between surfaces on a proximal base and the distal tip of the catheter. The venous valves are disabled to permit retrograde venous flow of arterial blood, in order to bypass the arterial occlusion.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 17/00 - Surgical instruments, devices or methods
• A61B 17/34 - TrocarsPuncturing needles
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61M 25/09 - Guide wires

Abstract

A device and method for creating an arteriovenous (AV) fistula includes a proximal base having a distal diagonal end surface and a distal tip connected to the proximal base and movable relative to the proximal base. The distal tip has a proximal diagonal end surface. A heating assembly, including an energized heating element, is disposed one of the distal diagonal end surface and the proximal diagonal end surface. A passive heating assembly is disposed on the mating diagonal end surface. The distal diagonal end surface and the proximal diagonal end surface are adapted to contact opposing sides of a tissue portion to create a fistula. The angle of the proximal diagonal end surface matches the angle of the distal diagonal end surface, so that the two surfaces match one another during deployment.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating

Abstract

A device for creating a fistula between blood vessels operates in conjunction with a guidewire to locate and position itself so that it straddles both vessels and is able to draw them together. A fixing agent is released either from within the device or from an external needle, or both, into the procedural site. The fixing agent functions to hold the relative position of the two vessels, to seal the surrounding tissue so that any leaks that do occur don't spread into the tissue to create a hematoma, and to limit expansion of the fistula. After the vessels are in close proximity to each other and the fixing agent is applied, the device of the invention employs a cutting mechanism which opens a portal between the two vessels.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis

Abstract

A power controller device and system allows verification, monitoring, and control of an arteriovenous (AV) fistula creation catheter which comprises a main housing having a power supply, an embedded electronic controller and a user interface display, and which is configured to allow connection to an intravascular catheter. When activated, the device verifies that a valid catheter is connected, downloads stored manufacturing calibration data from the catheter, and provides a user interface to allow initiation of AV fistula creation. Once creation of the AV fistula is initiated, the device provides closed loop control of the catheter heating element and provides a means of monitoring the catheter temperature and tip position to a prescribed parameter to automate the arteriovenous fistula creation procedure.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 17/00 - Surgical instruments, devices or methods
• A61B 17/34 - TrocarsPuncturing needles
• A61B 18/14 - Probes or electrodes therefor
• A61M 1/36 - Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters
• A61M 25/04 - Holding devices, e.g. on the body in the body, e.g. expansible
• A61M 25/06 - Body-piercing guide needles or the like

Abstract

A method of operating a catheter assembly including monitoring a gap feedback signal indicative of a distance between a first tissue contact surface and a second tissue contact surface. Producing, via a user interface of the catheter assembly, a graphical depiction of the first tissue contact surface and the second tissue contact surface spaced apart from the first tissue contact surface by the distance. Producing, via the user interface of the catheter assembly, a gap distance warning when the gap feedback signal indicates that the distance is outside of a target gap range.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 17/00 - Surgical instruments, devices or methods
• A61B 17/34 - TrocarsPuncturing needles
• A61B 18/14 - Probes or electrodes therefor
• A61M 1/36 - Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters
• A61M 25/04 - Holding devices, e.g. on the body in the body, e.g. expansible
• A61M 25/06 - Body-piercing guide needles or the like

Abstract

A catheter having opposed tissue contacting surfaces for creating an anastomosis between two blood vessels is utilized to facilitate a method for percutaneously placing a biologic graft at a procedural site. The method may comprise steps of advancing a biologic graft over a guidewire into a blood vessel at a biologic graft attachment site, advancing a catheter over the guidewire, and creating an anastomosis between the biologic graft and the blood vessel by activating the catheter to apply energy to a vessel wall of the blood vessel and to a wall of the biologic graft.

IPC Classes  ?

• A61F 2/06 - Blood vessels
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 17/34 - TrocarsPuncturing needles
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61M 25/06 - Body-piercing guide needles or the like
• A61M 25/09 - Guide wires

Abstract

A power controller device and system allows verification, monitoring, and control of an arteriovenous (AV) fistula creation catheter which comprises a main housing having a power supply, an embedded electronic controller and a user interface display, and which is configured to allow connection to an intravascular catheter. When activated, the device verifies that a valid catheter is connected, downloads stored manufacturing calibration data from the catheter, and provides a user interface to allow initiation of AV fistula creation. Once creation of the AV fistula is initiated, the device provides closed loop control of the catheter heating element and provides a means of monitoring the catheter temperature and tip position to a prescribed parameter to automate the arteriovenous fistula creation procedure.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/14 - Probes or electrodes therefor
• A61M 1/36 - Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters
• A61B 17/00 - Surgical instruments, devices or methods
• A61M 25/04 - Holding devices, e.g. on the body in the body, e.g. expansible
• A61M 25/06 - Body-piercing guide needles or the like
• A61B 17/34 - TrocarsPuncturing needles

Abstract

A catheter having opposed tissue contacting surfaces for creating an anastomosis between two blood vessels is utilized to facilitate a method for percutaneously placing a biologic graft at a procedural site. The method may comprise steps of inserting a guidewire into a blood vessel, placing a sheath over the guidewire, advancing a biologic graft over the guidewire into the blood vessel at a biologic graft attachment site, advancing a catheter over the guidewire, pushing a distal tip of the catheter through the biologic graft, a vessel wall of the blood vessel, and into a lumen of the blood vessel, and creating an anastomosis between the biologic graft and the blood vessel by activating the catheter to apply energy to the vessel wall and to a wall of the biologic graft.

IPC Classes  ?

• A61F 2/06 - Blood vessels
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61M 25/09 - Guide wires
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61M 25/06 - Body-piercing guide needles or the like
• A61B 17/34 - TrocarsPuncturing needles

Abstract

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.

IPC Classes  ?

• A61M 1/36 - Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/14 - Probes or electrodes therefor
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
• A61B 17/32 - Surgical cutting instruments
• A61B 17/34 - TrocarsPuncturing needles
• A61M 25/09 - Guide wires
• A61N 7/02 - Localised ultrasound hyperthermia

Abstract

A method of creating an anastomosis includes steps of advancing a distal tip of a catheter device through a first blood vessel into a second blood vessel, while simultaneously advancing a proximal base of the device into the first vessel, contacting a wall of the first vessel with a distal blunt surface on the proximal base. A further step is to retract the distal tip so that a proximal blunt base of the distal tip contacts a wall of the second vessel, thereby capturing the two vessel walls between the blunt surfaces of the proximal base and the distal tip. A controlled pressure is applied between the two blunt surfaces to compress and stabilize the captured tissue and approximate the vessel walls. A clip is deployed through the captured tissue to hold the tissue in place during the anastomosis procedure. The anastomosis is created by applying cutting energy to the captured tissue.

IPC Classes  ?

• A61B 17/115 - Staplers for performing anastomosis, e.g. in a single operation
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A method of producing an arteriovenous (AV) fistula includes producing an anastomosis between a primary blood vessel (e.g., a vein) and a secondary blood vessel (e.g., an artery). A collateral (or competing) blood vessel in fluid communication with one of the primary blood vessel or the secondary blood vessel is identified. A reversible flow restrictor is then applied to the collateral blood vessel to reduce a blood flow rate through the collateral blood vessel. In some embodiments, the anastomosis can be produced percutaneously. In some embodiments, the reversible flow restriction (or a portion thereof) can be removed from the collateral blood vessel. In other embodiments, the reversible flow restriction (or a portion thereof) can be adjusted to allow increased blood flow therethrough while within the collateral blood vessel.

IPC Classes  ?

• A61M 1/36 - Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation
• A61B 17/00 - Surgical instruments, devices or methods
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis

Abstract

Methods for creating and maintaining an anastomosis between two adjacent blood vessels using percutaneous techniques, for use in hemodialysis procedures are disclosed and described.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes

Abstract

A method of producing an arteriovenous (AV) fistula includes producing an anastomosis between a primary blood vessel (e.g., a vein) and a secondary blood vessel (e.g., an artery). A collateral (or competing) blood vessel in fluid communication with one of the primary blood vessel or the secondary blood vessel is identified. A reversible flow restrictor is then applied to the collateral blood vessel to reduce a blood flow rate through the collateral blood vessel. In some embodiments, the anastomosis can be produced percutaneously. In some embodiments, the reversible flow restriction (or a portion thereof) can be removed from the collateral blood vessel. In other embodiments, the reversible flow restriction (or a portion thereof) can be adjusted to allow increased blood flow therethrough while within the collateral blood vessel.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61M 1/36 - Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation
• A61B 17/00 - Surgical instruments, devices or methods

Abstract

Methods for creating and maintaining an anastomosis between two adjacent blood vessels using percutaneous techniques, for use in hemodialysis procedures are disclosed and described.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A device for creating an arteriovenous (AV) fistula includes a proximal base having a distal tapered end surface and a distal tip connected to the proximal base and movable relative to the proximal base. The distal tip has a proximal tapered end surface. A first heating assembly, including an energized heating element, is disposed on at least one of the distal tapered end surface and the proximal tapered end surface. A second heating assembly, comprising a passive non-energized heat spreader, is disposed on the other one of the distal tapered end surface and the proximal tapered end surface. The distal tapered end surface and the proximal tapered end surface are adapted to contact opposing sides of a tissue portion to create the fistula. The taper of the proximal tapered end surface matches the taper of the distal tapered end surface, so that the two surfaces match one another.

IPC Classes  ?

• A61B 18/14 - Probes or electrodes therefor
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A method of creating intravascular access includes positioning the main body of a device within a primary vessel and manipulating a guidewire having a second alignment member to a location proximate to an inner wall of a secondary vessel. Engaging the alignment member of the distal end of the device and the second alignment member of the guidewire through the respective walls of the primary and secondary vessels, so that the device and guidewire are in close proximity and in alignment, thereby pushing the primary and secondary vessels together. Extending the piercing member distally from the main body, through the wall of the primary vessel, and through an adjacent wall of the secondary vessel, so that the end of the piercing member is disposed within the secondary vessel and thereby creating a communicating aperture on the opposing walls of the primary and secondary vessel.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters
• A61M 25/06 - Body-piercing guide needles or the like
• A61M 25/09 - Guide wires
• A61M 25/00 - CathetersHollow probes

Abstract

A method of creating an AV fistula between adjacent first and second vessels includes inserting a guidewire from the first vessel into the second vessel. Inserting a catheter including a proximal member and a distal member over the guidewire such that a distal tip of the distal member comes into contact with a selected anastomosis site. Moving the distal member and the proximal member together to clamp tissue surrounding the aperture between the distal face of the proximal member and a proximal face on the distal member. Applying energy to an active heating member on the proximal member to cut and form the aperture, and to weld the edges thereof in order to create a desired fistula between the two vessels. Using a passive heating member disposed on the distal member to create a heating gradient across a tissue contacting surface of the distal member.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 18/14 - Probes or electrodes therefor

Abstract

A catheter system for creating an arteriovenous (AV) fistula includes a proximal base having a distal end surface. A distal tip is connected to the proximal base and is movable relative to the proximal base. The distal tip has a proximal end surface. The distal end surface and the proximal end surface are adapted to contact opposing sides of a tissue portion to create the fistula. A peripheral edge defines the distal end surface of the proximal base. A stop is formed in the peripheral edge and is configured to limit movement of the distal tip in a proximal direction.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 17/00 - Surgical instruments, devices or methods
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61M 25/00 - CathetersHollow probes
• A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
• A61M 25/06 - Body-piercing guide needles or the like

Abstract

A method of creating an arteriovenous (AV) fistula between first and second vessels includes inserting a catheter comprising a proximal member and a distal member into the first vessel so that the distal member comes into contact with a selected anastomosis site. Creating an aperture between the first and second vessels advancing the distal member into the second vessel. Clamping the first and second vessels together using the proximal and distal members. Applying energy to a heating member on one of the proximal and distal members to further cut the first and second vessels and shape the aperture. The step of applying energy to the heating member further cauterizes and welds an edge of the aperture in order to create the desired fistula between the first and second vessels.

IPC Classes  ?

• A61B 18/14 - Probes or electrodes therefor
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes

Abstract

A system and method are adapted for use to reduce the left atrium pressure by creating an inter-atrial shunt (IAS) between the left and right atrium, thereby reducing pulmonary congestion and resulting in a reduction in pulmonary congestion, thereby reducing symptomatic dyspnea and increasing the exercise capacity of treated patients.

IPC Classes  ?

• A61B 18/14 - Probes or electrodes therefor

Abstract

A catheter and tissue cutting system percutaneously permits the creation of an anastomosis between a first and second anatomical structure, such as a vein and an artery. The system comprises a catheter having a main body with a lumen and tapered distal tip, configured to be moved distally into the first anatomical structure over a primary guidewire. A cutting electrode is nested in the main body, with a lumen which tracks over a secondary guidewire, and is insertable into the secondary anatomical structure. An energy supply is operative to energize the cutting electrode in order to cut a tissue wall defining the first anatomical structure.

IPC Classes  ?

• A61B 18/14 - Probes or electrodes therefor
• A61M 25/00 - CathetersHollow probes
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters
• A61M 25/06 - Body-piercing guide needles or the like
• A61B 17/32 - Surgical cutting instruments
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61M 25/09 - Guide wires
• A61M 29/00 - Dilators with or without means for introducing media, e.g. remedies
• A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
• A61B 17/00 - Surgical instruments, devices or methods

Abstract

A device and method for creating an arteriovenous (AV) fistula includes a proximal base having a distal diagonal end surface and a distal tip connected to the proximal base and movable relative to the proximal base. The distal tip has a proximal diagonal end surface. A heating assembly, including an energized heating element, is disposed one of the distal diagonal end surface and the proximal diagonal end surface. A passive heating assembly is disposed on the mating diagonal end surface. The distal diagonal end surface and the proximal diagonal end surface are adapted to contact opposing sides of a tissue portion to create a fistula. The angle of the proximal diagonal end surface matches the angle of the distal diagonal end surface, so that the two surfaces match one another during deployment.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges

Abstract

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.

IPC Classes  ?

• A61B 18/14 - Probes or electrodes therefor
• A61M 1/36 - Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
• A61B 17/32 - Surgical cutting instruments
• A61B 17/34 - TrocarsPuncturing needles
• A61M 25/09 - Guide wires
• A61N 7/02 - Localised ultrasound hyperthermia
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A device for creating an arteriovenous (AV) fistula includes a proximal base having a distal tapered end surface and a distal tip connected to the proximal base and movable relative to the proximal base. The distal tip has a proximal tapered end surface. A first heating assembly, including an energized heating element, is disposed on at least one of the distal tapered end surface and the proximal tapered end surface. A second heating assembly, comprising a passive non-energized heat spreader, is disposed on the other one of the distal tapered end surface and the proximal tapered end surface. The distal tapered end surface and the proximal tapered end surface are adapted to contact opposing sides of a tissue portion to create the fistula. The taper of the proximal tapered end surface matches the taper of the distal tapered end surface, so that the two surfaces match one another.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A device for creating a fistula between blood vessels operates in conjunction with a guidewire to locate and position itself so that it straddles both vessels and is able to draw them together. A fixing agent is released either from within the device or from an external needle, or both, into the procedural site. The fixing agent functions to hold the relative position of the two vessels, to seal the surrounding tissue so that any leaks that do occur don't spread into the tissue to create a hematoma, and to limit expansion of the fistula. After the vessels are in close proximity to each other and the fixing agent is applied, the device of the invention employs a cutting mechanism which opens a portal between the two vessels.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis

Abstract

A method of creating an anastomosis includes steps of advancing a distal tip of a catheter device through a first blood vessel into a second blood vessel, while simultaneously advancing a proximal base of the device into the first vessel, contacting a wall of the first vessel with a distal blunt surface on the proximal base. A further step is to retract the distal tip so that a proximal blunt base of the distal tip contacts a wall of the second vessel, thereby capturing the two vessel walls between the blunt surfaces of the proximal base and the distal tip. A controlled pressure is applied between the two blunt surfaces to compress and stabilize the captured tissue and approximate the vessel walls. A clip is deployed through the captured tissue to hold the tissue in place during the anastomosis procedure. The anastomosis is created by applying cutting energy to the captured tissue.

IPC Classes  ?

• A61B 17/115 - Staplers for performing anastomosis, e.g. in a single operation
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A catheter system includes a proximal base having a distal diagonal end surface and a distal tip connected to the proximal base and movable relative to the proximal base, wherein the distal tip has a proximal diagonal end surface. The distal diagonal end surface and the proximal diagonal end surface contact opposing sides of a tissue portion to create the fistula. A peripheral edge defines the proximal distal end surface. A proximal point is disposed on the peripheral edge. The proximal point comprises a shortened angle and a fully radiused edge relative to a remaining portion of the peripheral edge and a relief recess is disposed on a distal end of the proximal base, both for the purpose of minimizing tissue snagging.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61M 25/06 - Body-piercing guide needles or the like
• A61M 25/00 - CathetersHollow probes
• A61B 17/00 - Surgical instruments, devices or methods
• A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges

Abstract

A method of percutaneously creating a fistula includes inserting percutaneously a medical instrument to a target location having a first blood vessel and a second blood vessel. A fastener is then deployed via the medical instrument to the target location. The fastener is in a first configuration before the deploying and a second configuration after the deploying. The fastener limits relative movement between the first blood vessel and the second blood vessel when in the second configuration. An anastomosis between the first blood vessel and the second blood vessel is percutaneously produced.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 17/115 - Staplers for performing anastomosis, e.g. in a single operation
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters

Abstract

A method of percutaneously creating a fistula includes inserting percutaneously a medical instrument to a target location having a first blood vessel and a second blood vessel. A fastener is then deployed via the medical instrument to the target location. The fastener is in a first configuration before the deploying and a second configuration after the deploying. The fastener limits relative movement between the first blood vessel and the second blood vessel when in the second configuration. An anastomosis between the first blood vessel and the second blood vessel is percutaneously produced.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 17/12 - Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
• A61B 17/00 - Surgical instruments, devices or methods

Abstract

A catheter-based device tracks over a guidewire which has been placed from a first blood vessel into a second blood vessel. The distal tip of the catheter is advanced into the second vessel while a proximal member remains in the first vessel. Matching blunt tapered surfaces on each of the distal tip and the proximal member are clamped together, with adjacent walls of each vessel between them, after which a known, controlled pressure is applied between the two surfaces. Heat energy is then applied to the blunt surfaces for approximately 1-30 seconds to weld the walls of the two vessels together. After coaptation of the vessel walls, the heat is increased to then cut through the vessel walls to create a fistula of the desired size.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/14 - Probes or electrodes therefor
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A device for creating a fistula between blood vessels operates in conjunction with a guidewire to locate and position itself so that it straddles both vessels and is able to draw them together. A fixing agent is released either from within the device or from an external needle, or both, into the procedural site. The fixing agent functions to hold the relative position of the two vessels, to seal the surrounding tissue so that any leaks that do occur don't spread into the tissue to create a hematoma, and to limit expansion of the fistula. After the vessels are in close proximity to each other and the fixing agent is applied, the device of the invention employs a cutting mechanism which opens a portal between the two vessels.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis

Abstract

A catheter and tissue cutting system percutaneously permits the creation of an anastomosis between a first and second anatomical structure, such as a vein and an artery. The system comprises a catheter having a main body with a lumen and tapered distal tip, configured to be moved distally into the first anatomical structure over a primary guidewire. A cutting electrode is nested in the main body, with a lumen which tracks over a secondary guidewire, and is insertable into the secondary anatomical structure. An energy supply is operative to energize the cutting electrode in order to cut a tissue wall defining the first anatomical structure.

IPC Classes  ?

• A61B 18/14 - Probes or electrodes therefor
• A61M 25/00 - CathetersHollow probes
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters
• A61M 25/06 - Body-piercing guide needles or the like
• A61B 17/32 - Surgical cutting instruments
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61M 25/09 - Guide wires
• A61M 29/00 - Dilators with or without means for introducing media, e.g. remedies
• A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
• A61B 17/00 - Surgical instruments, devices or methods

Abstract

A catheter and tissue cutting system percutaneously permits the creation of an anastomosis between a first and second anatomical structure, such as a vein and an artery. The system comprises a catheter having a main body with a lumen and tapered distal tip, configured to be moved distally into the first anatomical structure over a primary guidewire. A cutting electrode is nested in the main body, with a lumen which tracks over a secondary guidewire, and is insertable into the secondary anatomical structure. An energy supply is operative to energize the cutting electrode in order to cut a tissue wall defining the first anatomical structure.

IPC Classes  ?

• A61B 18/14 - Probes or electrodes therefor
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

Systems and methods for creating an arteriovenous (AV) fistula comprise an elongate member, a distal member connected to the elongate member and movable relative to the elongate member, and a heating member disposed on at least one of the movable distal member and the elongate member. The distal member comprises structure for capturing tissue to be cut to create the fistula, and the heating member is adapted to cut through the tissue to create the fistula. The elongate member comprises an elongate outer tube. A shaft connects the distal member to the elongate member, and is extendable and retractable to extend and retract the distal member relative to the elongate member.

IPC Classes  ?

• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 18/14 - Probes or electrodes therefor
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
• A61B 17/32 - Surgical cutting instruments
• A61B 18/24 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibreHand-pieces therefor with a catheter

Abstract

A method of creating an anastomosis includes steps of advancing a distal tip of a catheter device through a first blood vessel into a second blood vessel, while simultaneously advancing a proximal base of the device into the first vessel, contacting a wall of the first vessel with a distal blunt surface on the proximal base. A further step is to retract the distal tip so that a proximal blunt base of the distal tip contacts a wall of the second vessel, thereby capturing the two vessel walls between the blunt surfaces of the proximal base and the distal tip. A controlled pressure is applied between the two blunt surfaces to compress and stabilize the captured tissue and approximate the vessel walls. A clip is deployed through the captured tissue to hold the tissue in place during the anastomosis procedure. The anastomosis is created by applying cutting energy to the captured tissue.

IPC Classes  ?

• A61B 17/115 - Staplers for performing anastomosis, e.g. in a single operation
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis

Abstract

A device for creating intravascular access and guidewire placement includes a main body having a lumen and a piercing member disposed in the lumen. The piercing member moves distally out of the lumen and pierces tissue while moving. A needle guide is provided for guiding the piercing member, the needle guide having a distal end which comprises a first alignment member. A guidewire has a distal tip with a second alignment member disposed on the guidewire distal tip. The first alignment member may comprise a magnetic attachment, at least one magnetic implant, a proximity sensor, an ultrasonic sensor, or other suitable system for alignment of devices disposed on opposing sides of opaque tissue. Similarly, the second alignment member may comprise a magnetic attachment or implant, a proximity sensor, or an ultrasonic sensor.

IPC Classes  ?

• A61M 25/09 - Guide wires
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters
• A61M 25/06 - Body-piercing guide needles or the like
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61M 25/00 - CathetersHollow probes

Abstract

A device for creating intravascular access and guidewire placement includes a main body having a lumen and a piercing member disposed in the lumen. The piercing member moves distally out of the lumen and pierces tissue while moving. A needle guide is provided for guiding the piercing member, the needle guide having a distal end which comprises a first alignment member. A guidewire has a distal tip with a second alignment member disposed on the guidewire distal tip. The first alignment member may comprise a magnetic attachment, at least one magnetic implant, a proximity sensor, an ultrasonic sensor, or other suitable system for alignment of devices disposed on opposing sides of opaque tissue. Similarly, the second alignment member may comprise a magnetic attachment or implant, a proximity sensor, or an ultrasonic sensor.

IPC Classes  ?

• A61M 25/06 - Body-piercing guide needles or the like
• A61M 25/09 - Guide wires
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters

Abstract

A method of creating an AV fistula between adjacent first and second blood vessels, includes steps of cutting a hole through the adjacent walls of the first and second blood vessels and inserting a welding catheter into the first vessel, and through the hole into the second vessel, so that a distal end of the welding catheter is disposed within the second vessel. A portion of wall defining the welding catheter is then expanded radially outwardly, and the expanded wall portion is pulled proximally to engage the wall of the second blood vessel and to pull it toward the wall of the first blood vessel. Then, a portion of wall proximal to the first expanded wall portion and disposed in the first blood vessel is expanded radially outwardly, thereby capturing the walls of each of the second and first blood vessels between the two expanded wall portions. Cutting elements on the expanded wall portions are then energized to create a tissue welded elongate aperture between the first and second blood vessels.

IPC Classes  ?

• A61B 17/17 - Guides for drills
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/14 - Probes or electrodes therefor
• A61B 17/00 - Surgical instruments, devices or methods
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Goods & Services

Medical and surgical catheters; medical apparatus and instruments for use in surgery; medical instruments for use in the fields of vascular surgery, oncology, and nephrology, namely, devices for creating arteriovenous fistulas; surgical and medical apparatus and instruments for use in vascular surgery; surgical devices and instruments; surgical instruments and apparatus; surgical instruments for use in vascular surgery; surgical instruments, namely, catheters, medical introducers, medical introducer sets comprised of medical access needles, guidewires, and medical introducers

Abstract

A method of creating an AV fistula between adjacent first and second blood vessels, includes steps of cutting a hole through the adjacent walls of the first and second blood vessels and inserting a welding catheter into the first vessel, and through the hole into the second vessel, so that a distal end of the welding catheter is disposed within the second vessel. A portion of wall defining the welding catheter is then expanded radially outwardly, and the expanded wall portion is pulled proximally to engage the wall of the second blood vessel and to pull it toward the wall of the first blood vessel. Then, a portion of wall proximal to the first expanded wall portion and disposed in the first blood vessel is expanded radially outwardly, thereby capturing the walls of each of the second and first blood vessels between the two expanded wall portions. Cutting elements on the expanded wall portions are then energized to create a tissue welded elongate aperture between the first and second blood vessels.

IPC Classes  ?

• A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
• A61B 18/14 - Probes or electrodes therefor
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A catheter-based device tracks over a guidewire which has been placed from a first blood vessel into a second blood vessel. The distal tip of the catheter is advanced into the second vessel while a proximal member remains in the first vessel. Matching blunt tapered surfaces on each of the distal tip and the proximal member are clamped together, with adjacent walls of each vessel between them, after which a known, controlled pressure is applied between the two surfaces. Heat energy is then applied to the blunt surfaces for approximately 1-30 seconds to weld the walls of the two vessels together. After coaptation of the vessel walls, the heat is increased to then cut through the vessel walls to create a fistula of the desired size.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/14 - Probes or electrodes therefor
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A device for creating an arteriovenous (AV) fistula includes a proximal base having a distal tapered end surface and a distal tip connected to the proximal base and movable relative to the proximal base. The distal tip has a proximal tapered end surface. A first heating assembly, including an energized heating element, is disposed on at least one of the distal tapered end surface and the proximal tapered end surface. A second heating assembly, comprising a passive non-energized heat spreader, is disposed on the other one of the distal tapered end surface and the proximal tapered end surface. The distal tapered end surface and the proximal tapered end surface are adapted to contact opposing sides of a tissue portion to create the fistula. The taper of the proximal tapered end surface matches the taper of the distal tapered end surface, so that the two surfaces match one another.

IPC Classes  ?

• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

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.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/14 - Probes or electrodes therefor
• A61M 1/36 - Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
• A61B 17/32 - Surgical cutting instruments
• A61B 17/34 - TrocarsPuncturing needles
• A61M 25/09 - Guide wires
• A61N 7/02 - Localised ultrasound hyperthermia
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A device for allowing passage of a guidewire from a primary blood vessel to an adjacent secondary blood vessel includes a main body having a primary lumen and a secondary lumen, and a piercing member disposed in the secondary lumen, and configured to be moved distally out of the secondary lumen, and to pierce through tissue while being distally moved. A third lumen located within the piercing member is configured to allow placement of a guidewire from the primary blood vessel to the adjacent secondary blood vessel. In one embodiment, the secondary lumen is configured to allow articulation of the distal end of the piercing element. The piercing member has a sharp point on one end to facilitate cutting a small communicating aperture from the primary blood vessel to the secondary blood vessel.

IPC Classes  ?

• A61B 17/34 - TrocarsPuncturing needles
• A61B 17/00 - Surgical instruments, devices or methods
• A61M 25/06 - Body-piercing guide needles or the like
• A61M 25/09 - Guide wires
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis

Abstract

A catheter system includes a proximal base having a distal diagonal end surface and a distal tip connected to the proximal base and movable relative to the proximal base, wherein the distal tip has a proximal diagonal end surface. The distal diagonal end surface and the proximal diagonal end surface contact opposing sides of a tissue portion to create the fistula. A peripheral edge defines the proximal distal end surface. A proximal point is disposed on the peripheral edge. The proximal point comprises a shortened angle and a fully radiused edge relative to a remaining portion of the peripheral edge and a relief recess is disposed on a distal end of the proximal base, both for the purpose of minimizing tissue snagging.

IPC Classes  ?

• A61B 18/14 - Probes or electrodes therefor
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61M 25/00 - CathetersHollow probes
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters

Abstract

A catheter system includes a proximal base having a distal diagonal end surface and a distal tip connected to the proximal base and movable relative to the proximal base, wherein the distal tip has a proximal diagonal end surface. The distal diagonal end surface and the proximal diagonal end surface contact opposing sides of a tissue portion to create the fistula. A peripheral edge defines the proximal distal end surface. A proximal point is disposed on the peripheral edge. The proximal point comprises a shortened angle and a fully radiused edge relative to a remaining portion of the peripheral edge and a relief recess is disposed on a distal end of the proximal base, both for the purpose of minimizing tissue snagging.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
• A61M 25/06 - Body-piercing guide needles or the like
• A61M 25/00 - CathetersHollow probes

Abstract

A device and method for creating an arteriovenous (AV) fistula includes a proximal base having a distal diagonal end surface and a distal tip connected to the proximal base and movable relative to the proximal base. The distal tip has a proximal diagonal end surface. A heating assembly, including an energized heating element, is disposed one of the distal diagonal end surface and the proximal diagonal end surface. A passive heating assembly is disposed on the mating diagonal end surface. The distal diagonal end surface and the proximal diagonal end surface are adapted to contact opposing sides of a tissue portion to create a fistula. The angle of the proximal diagonal end surface matches the angle of the distal diagonal end surface, so that the two surfaces match one another during deployment.

IPC Classes  ?

• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 17/00 - Surgical instruments, devices or methods
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges

Abstract

Systems and methods for creating an arteriovenous (AV) fistula comprise an elongate member, a distal member connected to the elongate member and movable relative to the elongate member, and a heating member disposed on at least one of the movable distal member and the elongate member. The distal member comprises structure for capturing tissue to be cut to create the fistula, and the heating member is adapted to cut through the tissue to create the fistula. The elongate member comprises an elongate outer tube. A shaft connects the distal member to the elongate member, and is extendable and retractable to extend and retract the distal member relative to the elongate member.

IPC Classes  ?

• A61B 5/1491 - Heated applicators
• A61B 18/14 - Probes or electrodes therefor
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
• A61B 17/32 - Surgical cutting instruments
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/24 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibreHand-pieces therefor with a catheter

Abstract

A device for extending, elongating, or repairing a previously created arteriovenous fistula between a first blood vessel and an adjacent second blood vessel includes a main body having a primary lumen and an articulating jaw member disposed at the distal end of the main body. The jaw member is configured with two elements to allow rotation of one element about a pivot point to grasp tissue while being rotated. The jaw member is also configured to allow thermal energy delivery to one or both elements of the jaw member that allow tissue welding and cutting. A second lumen located within one element of the jaw member is configured to allow advancement over a guidewire into the second vessel while the other element of the jaw member remains within the first blood vessel at the position where the arteriovenous fistula, or aperture, exists between the first and second blood vessel.

IPC Classes  ?

• A61B 18/14 - Probes or electrodes therefor
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/24 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibreHand-pieces therefor with a catheter
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

An AV fistula between first and second blood vessels is created by forming a hole through adjacent walls of the vessels and inserting a welding catheter into the first vessel, and through the hole into the second vessel, so that a distal end of the catheter is disposed within the second vessel. A portion of wall defining the welding catheter is then expanded radially outwardly, and the expanded wall portion is pulled proximally to engage the wall of the second blood vessel and to pull it toward the wall of the first blood vessel. A portion of wall proximal to the first expanded wall portion and disposed in the first blood vessel is expanded radially outwardly, thereby capturing the walls of each of the second and first blood vessels between the two expanded wall portions. Cutting elements are energized to create a tissue welded elongate aperture between the blood vessels.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves

Abstract

A device for allowing passage of a guidewire from a primary blood vessel to an adjacent secondary blood vessel includes a main body having a primary lumen and a secondary lumen, and a piercing member disposed in the secondary lumen, and configured to be moved distally out of the secondary lumen, and to pierce through tissue while being distally moved. A third lumen located within the piercing member is configured to allow placement of a guidewire from the primary blood vessel to the adjacent secondary blood vessel. In one embodiment, the secondary lumen is configured to allow articulation of the distal end of the piercing element. The piercing member has a sharp point on one end to facilitate cutting a small communicating aperture from the primary blood vessel to the secondary blood vessel.

IPC Classes  ?

• A61B 17/34 - TrocarsPuncturing needles
• A61B 17/00 - Surgical instruments, devices or methods
• A61M 25/06 - Body-piercing guide needles or the like
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis

Abstract

A device for creating an arteriovenous (AV) fistula includes a proximal base having a distal tapered end surface and a distal tip connected to the proximal base and movable relative to the proximal base. The distal tip has a proximal tapered end surface. A first heating assembly, including an energized heating element, is disposed on at least one of the distal tapered end surface and the proximal tapered end surface. A second heating assembly, comprising a passive non-energized heat spreader, is disposed on the other one of the distal tapered end surface and the proximal tapered end surface. The distal tapered end surface and the proximal tapered end surface are adapted to contact opposing sides of a tissue portion to create the fistula. The taper of the proximal tapered end surface matches the taper of the distal tapered end surface, so that the two surfaces match one another.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A device for creating an arteriovenous (AV) fistula includes a proximal base having a distal tapered end surface and a distal tip connected to the proximal base and movable relative to the proximal base. The distal tip has a proximal tapered end surface. A first heating assembly, including an energized heating element, is disposed on at least one of the distal tapered end surface and the proximal tapered end surface. A second heating assembly, comprising a passive non-energized heat spreader, is disposed on the other one of the distal tapered end surface and the proximal tapered end surface. The distal tapered end surface and the proximal tapered end surface are adapted to contact opposing sides of a tissue portion to create the fistula. The taper of the proximal tapered end surface matches the taper of the distal tapered end surface, so that the two surfaces match one another and fully engage with one another when engaged.

IPC Classes  ?

• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 17/34 - TrocarsPuncturing needles

Abstract

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.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/14 - Probes or electrodes therefor
• A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A device for extending, elongating, or repairing a previously created arteriovenous fistula between a first blood vessel and an adjacent second blood vessel includes a main body having a primary lumen and an articulating jaw member disposed at the distal end of the main body. The jaw member is configured with two elements to allow rotation of one element about a pivot point to grasp tissue while being rotated. The jaw member is also configured to allow thermal energy delivery to one or both elements of the jaw member that allow tissue welding and cutting with DC, RF, Laser or Ultrasonic energy. A second lumen located within one element of the jaw member is configured to allow advancement over a guidewire into the second vessel while the other element of the jaw member remains within the first blood vessel at the position where the arteriovenous fistula, or aperture, exists between the first and second blood vessel.

IPC Classes  ?

• A61M 25/14 - Arrangement or shape of fluid flow passages, e.g. of plural fluid passages
• A61M 25/09 - Guide wires

Abstract

A catheter-based device tracks over a guidewire which has been placed from a first blood vessel into a second blood vessel. The distal tip of the catheter is advanced into the second vessel while a proximal member remains in the first vessel. Matching blunt tapered surfaces on each of the distal tip and the proximal member are clamped together, with adjacent walls of each vessel between them, after which a known, controlled pressure is applied between the two surfaces. Heat energy is then applied to the blunt surfaces for approximately 1-30 seconds to weld the walls of the two vessels together. After coaptation of the vessel walls, the heat is increased to then cut through the vessel walls to create a fistula of the desired size.

IPC Classes  ?

• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/14 - Probes or electrodes therefor
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A device for allowing passage of a guidewire from a primary blood vessel to an adjacent secondary blood vessel includes a main body having a primary lumen and a secondary lumen, and a piercing member disposed in the secondary lumen, and configured to be moved distally out of the secondary lumen, and to pierce through tissue while being distally moved. A third lumen located within the piercing member is configured to allow placement of a guidewire from the primary blood vessel to the adjacent secondary blood vessel. In one embodiment, the secondary lumen is configured to allow articulation of the distal end of the piercing element. The piercing member has a sharp point on one end to facilitate cutting a small communicating aperture from the primary blood vessel to the secondary blood vessel.

IPC Classes  ?

• A61B 17/34 - TrocarsPuncturing needles
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis

Goods & Services

Vascular surgical instruments, namely, catheters and medical introducer sets comprised of medical access needles, guidewires, medical introducers, power supplies, power interface cables

Goods & Services

Vascular surgical instruments, namely, catheters and medical introducer sets comprised of medical access needles, guidewires, medical introducers, power supplies, power interface cables

Abstract

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.

IPC Classes  ?

• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/14 - Probes or electrodes therefor
• A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body

Abstract

A device for creating an arteriovenous (AV) fistula comprises an elongate member, a distal member connected to the elongate member and movable relative to the elongate member, and a heating member disposed on at least one of the movable distal member and the elongate member. The distal member comprises structure for capturing tissue to be cut to create the fistula, and the heating member is adapted to cut through the tissue to create the fistula. The elongate member comprises an elongate outer tube. A shaft connects the distal member to the elongate member, and is extendable and retractable to extend and retract the distal member relative to the elongate member.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/14 - Probes or electrodes therefor
• A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
• A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
• A61B 17/32 - Surgical cutting instruments
• A61B 18/24 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibreHand-pieces therefor with a catheter

Abstract

A device for creating intravascular access and guidewire placement includes a main body having a lumen and a piercing member disposed in the lumen. The piercing member moves distally out of the lumen and pierces tissue while moving. A needle guide is provided for guiding the piercing member, the needle guide having a distal end which comprises a first alignment member. A guidewire has a distal tip with a second alignment member disposed on the guidewire distal tip. The first alignment member may comprise a magnetic attachment, at least one magnetic implant, a proximity sensor, an ultrasonic sensor, or other suitable system for alignment of devices disposed on opposing sides of opaque tissue. Similarly, the second alignment member may comprise a magnetic attachment or implant, a proximity sensor, or an ultrasonic sensor.

IPC Classes  ?

• A61M 25/01 - Introducing, guiding, advancing, emplacing or holding catheters
• A61M 25/06 - Body-piercing guide needles or the like
• A61M 25/09 - Guide wires

Abstract

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.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/14 - Probes or electrodes therefor

Abstract

A device for creating an arteriovenous (AV) fistula comprises an elongate member, a distal member connected to the elongate member and movable relative to the elongate member, and a heating member disposed on at least one of the movable distal member and the elongate member. The distal member comprises structure for capturing tissue to be cut to create the fistula, and the heating member is adapted to cut through the tissue to create the fistula. The elongate member comprises an elongate outer tube. A shaft connects the distal member to the elongate member, and is extendable and retractable to extend and retract the distal member relative to the elongate member.

IPC Classes  ?

• A61B 17/32 - Surgical cutting instruments
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
• A61B 18/14 - Probes or electrodes therefor

Abstract

A device for allowing passage of a guidewire from a primary blood vessel to an adjacent secondary blood vessel includes a main body having a primary lumen and a secondary lumen, and a piercing member disposed in the secondary lumen, and configured to be moved distally out of the secondary lumen, and to pierce through tissue while being distally moved. A third lumen located within the piercing member is configured to allow placement of a guidewire from the primary blood vessel to the adjacent secondary blood vessel. In one embodiment, the secondary lumen is configured to allow articulation of the distal end of the piercing element. The piercing member has a sharp point on one end to facilitate cutting a small communicating aperture from the primary blood vessel to the secondary blood vessel.

IPC Classes  ?

• A61M 25/06 - Body-piercing guide needles or the like
• A61M 25/09 - Guide wires

Abstract

A catheter-based device tracks over a guidewire which has been placed from a first blood vessel into a second blood vessel. The distal tip of the catheter is advanced into the second vessel while a proximal member remains in the first vessel. Matching blunt tapered surfaces on each of the distal tip and the proximal member are clamped together, with adjacent walls of each vessel between them, after which a known, controlled pressure is applied between the two surfaces. Heat energy is then applied to the blunt surfaces for approximately 1-30 seconds to weld the wal ls of the two vessels together. After coaptation of the vessel walls, the heat is increased to then cut through the vessel walls to create a fistula of the desired size.

IPC Classes  ?

• A61F 2/06 - Blood vessels
• A61M 25/09 - Guide wires
• A61M 29/04 - Dilators made of swellable materials
• A61M 39/08 - TubesStorage means specially adapted therefor

Abstract

A device for extending, elongating, or repairing a previously created arteriovenous fistula between a first blood vessel and an adjacent second blood vessel includes a main body having a primary lumen and an articulating jaw member disposed at the distal end of the main body. The jaw member is configured with two elements to allow rotation of one element about a pivot point to grasp tissue while being rotated. The jaw member is also configured to allow thermal energy delivery to one or both elements of the jaw member that allow tissue welding and cutting with DC, RF, Laser or Ultrasonic energy. A second lumen located within one element of the jaw member is configured to allow advancement over a guidewire into the second vessel while the other element of the jaw member remains within the first blood vessel at the position where the arteriovenous fistula, or aperture, exists between the first and second blood vessel.

IPC Classes  ?

• A61B 17/29 - Forceps for use in minimally invasive surgery
• A61B 18/14 - Probes or electrodes therefor

Abstract

A device for creating an arteriovenous (AV) fistula includes a proximal base having a distal tapered end surface and a distal tip connected to the proximal base and movable relative to the proximal base. The distal tip has a proximal tapered end surface. A first heating assembly, including an energized heating element, is disposed on at least one of the distal tapered end surface and the proximal tapered end surface. A second heating assembly, comprising a passive non-energized heat spreader, is disposed on the other one of the distal tapered end surface and the proximal tapered end surface. The distal tapered end surface and the proximal tapered end surface are adapted to contact opposing sides of a tissue portion to create the fistula. The taper of the proximal tapered end surface matches the taper of the distal tapered end surface, so that the two surfaces match one another and fully engage with one another when engaged.

IPC Classes  ?

• A61B 17/11 - Surgical instruments, devices or methods for closing wounds or holding wounds closedAccessories for use therewith for performing anastomosisButtons for anastomosis
• A61B 17/34 - TrocarsPuncturing needles
• A61B 18/04 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
• A61B 18/08 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes