Importance

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Abstract

A catheter apparatus is provided including an arterial catheter and a venous catheter wherein the distal ends of the catheter are insertable in an artery and a adjacent vein, respectively to a position adjacent a site for creating a fistula. The venous catheter includes a radially expandable structure adjacent the distal end which can be selectively extended outwardly to expand a portion of the wall of the vein adjacent the venous fistula site towards contact with the wall of the artery adjacent the arterial fistula site. The radially expandable structure of the venous catheter may include one or more balloons which can be inflated or a wire basket, or the vein can be expanded by injecting a fluid through an injection port into an isolated portion of the vein. The apparatus further includes a tool for creating an opening through the wall of the artery adjacent the arterial fistula site and an opening through the outwardly extending portion of the wall of the vein adjacent the venous fistula site to extend outwardly the portion of the wall of the vein towards contact with the wall of the artery. The tool may include a needle coupled to the arterial catheter adjacent the distal end of the arterial catheter, the needle being selectively switchable between a first, inactive configuration wherein the needle can be guided through the artery without causing trauma to the artery wall and a second, active configuration wherein the needle is operative to create the opening in the artery wall. The fistula between the openings may be completed with the aid of a stent, and the proximal portion of the vein blocked with an embolization device.

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First Claim