A fistula treatment system comprises a guide such as a guide coil 1101 which is adapted to extend partially around a tissue tract and an implant element 1102. The implant element 1102 is activated to draw tissue surrounding the tract inwardly.

The present disclosure provides a variety of prostheses, delivery systems and techniques to facilitate closure of transvascular or transcameral access ports. Various embodiments of prostheses are provided including a plurality of radially expandable discs that can be filled with material to facilitate coagulation and to reduce or stop leakage from punctures in vessel walls.

Forming a proximal anastomosis on an aortic wall includes method and instrumentation and apparatus for forming an aortic puncture and inserting into the vessel through the puncture a fluid-impervious sealing element with a protruding retainer. An anastomosis of a graft vessel over the puncture is partially completed with the retainer of the sealing element protruding through the partial anastomosis. The retainer facilitates removal of the sealing element from the partial anastomosis prior to completion of the procedure.

A medical device includes a fluid collection element, a fluid communication element and a pulling element. The pulling element is attached to a distal end of the fluid collection element and/or fluid communication element. The medical device can be included in a medical kit.

A method and apparatus for rectal fistula laser treatment wherein an insertion tube of a coupler is inserted into a fistula from proximal to distal end. The insertion tube is then purged using sterile water and/or air. A flexible optical waveguide is then inserted through the coupler including the insertion tube until the end of the optical waveguide protrudes 1-3 mm from the distal end of the insertion tube. The optical waveguide is secured to the coupler by a lock nut of the coupler. The insertion tube locked to the optical waveguide is withdrawn through the fistula while CO2 laser radiation is passed down the optical waveguide so that laser radiation is delivered to the inner wall of the fistula at a specific rate as the laser radiation treats the fistula.

Described are devices, methods, and systems useful in the treatment of fistulae, and in certain embodiments those having openings extending into the alimentary canal, such as anorectal fistulae. Illustratively, an anorectal fistula can be treated by placing a volumetric construct within the primary opening of the fistula. In certain embodiments, the volumetric construct can include a rolled remodelable material processed to form a substantially unitary body. Advantageous such remodelable materials can include collagenous extracellular matrix materials, such as small intestine submucosa.

Tissue plugs for occlusion of hollow anatomical structures and methods for their use are provided.

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.

Some aspects of the present invention are directed to unique products and methods for treating fistulae and other passageways and openings in the body. In some preferred forms, an inventive construct will include an elongate graft body that incorporates a plurality of sheet or sheet-like segments. The plurality of sheet or sheet-like segments, in some arrangements, will be stacked in a generally longitudinal direction along the length of the plug body, and optionally, the segments will be received over one or more elongate elements. Elongate elements of this sort can take a variety of forms including a suture, wire, filament, or other relatively thin-bodied elongate member, although in some forms, an elongate element will be or include a somewhat heftier structure such as a biodegradable or non-biodegradable three-dimensional body.

A method and apparatus for rectal fistula laser treatment wherein an insertion tube of a coupler is inserted into a fistula from proximal to distal end. The insertion tube is then purged using sterile water and/or air. A flexible optical waveguide is then inserted through the coupler including the insertion tube until the end of the optical waveguide protrudes 1-3 mm from the distal end of the insertion tube. The optical waveguide is secured to the coupler by a lock nut of the coupler. The insertion tube locked to the optical waveguide is withdrawn through the fistula while CO2 laser radiation is passed down the optical waveguide so that laser radiation is delivered to the inner wall of the fistula at a specific rate as the laser radiation treats the fistula.