The present disclosure pertains to membranous tissue grafts comprising one or more pre-made attachment points. The one or more pre-made attachment points may include pre-made markings and/or pre-made suture holes. The membranous tissue grafts can be in the form of a tube. The membranous tissue grafts can also be rectangular in shape and can be used in a nerve repair by wrapping the severed or damaged nerve. In some embodiments, the membranous tissue grafts are suitable for repairing severed nerves that have a short gap or no gap with a gap of less than 5 mm between the severed stumps. Accordingly, methods are provided for repairing a damaged or severed nerve by implanting the membranous tissue grafts on to the damaged or severed nerve.

Stents and methods of using stents are provided. Stents of the invention provide external support structure for a blood vessel segment disposed within, wherein the stents are capable of resilient radial expansion in a manner mimicking the compliance properties of an artery. The stent may be formed of a knitted or braided mesh formed so as to provide the needed compliance properties. A venous graft with the stent and a vein segment disposed within is provided, wherein graft is capable of mimicking the compliance properties of an artery. Methods of selecting stents for downsizing and methods of using the stents of the invention in downsizing and smoothening are provided. Methods of replacing a section of an artery with a venous graft including a stent of the invention are provided. Methods of reducing intimal hyperplasia in implanted vein segment in a venous graft using stents of the invention are provided.

A system for coupling a first space within a body of a patient with a second space within the body of the patient including a flow connector insertable into the first and second spaces within the body and having a conduit having a wall forming a lumen therein and first and second orifices. A first retention member is engageable with a first portion of the first space within the body and has a first opening, and the flow connector is positioned within the first opening. A second retention member is engageable with the second space within the body, the second retention member has a second opening and the flow connector is positioned within the second opening. The second retention member interlocks with the first retention member.

A tool to fasten tissue or to fasten a prosthetic to tissue includes a gripper to hold one or more tissue portions, a needle, an actuator to drive the needle, a fastener cartridge to store one or more tissue fasteners, a holder cartridge to store one or more holders, and a holder applier to secure one of the holders on one of the fasteners. The actuator drives the needle and the needle pulls a first fastener from the fastener cartridge. The actuator drives the needle through the one or more tissue portions held by the gripper to form a hole in the tissue portions. The needle pulls a leading portion of the first fastener through the hole without a trailing portion of the first fastener being pulled through the hole. The holder applier secures a first holder from the holder cartridge onto the leading portion of the first fastener.

Devices, systems and methods are disclosed for the formation of an arteriovenous fistula in the limb of the patient. Embodiments include an apparatus for the creation, modification and maintenance of a fistula, including the modification of an existing dialysis fistula; and a method of supplying oxygenated blood to the venous circulation of a patient. A kit of anastomotic implants is described which supports a broad base of patient anatomies and fistula locations. The devices, systems and methods can be used to treat patients with one or more numerous ailments including chronic obstructive pulmonary disease, congestive heart failure, hypertension, hypotension, respiratory failure, pulmonary arterial hypertension, lung fibrosis and adult respiratory distress syndrome.

A surgical evaluation and guidance system for use in extravacular evaluation and guidance of fluid vessel surgeries, includes an optical coherence tomography engine; a vessel probe optically coupled to the optical coherence tomography engine; and a signal processing and display system adapted to communicate with the optical coherence tomography engine to receive imaging signals therefrom. An optical coherence tomography vessel probe for use in extravacular evaluation and guidance of fluid vessel surgeries, includes a probe body having a proximal end and a distal end; an optical relay system disposed within the probe body; and a vessel adapter at least one of attached to or integral with the probe body at the distal end of the probe body, wherein the vessel adapter defines a groove that is configured to accept one of a fluid vessel and a lymphaticovenous vessel.

The present disclosure is directed to devices for approximating body vessels and method for performing the same. In accordance with one aspect of the present disclosure, the device includes an inner member having a first expandable anchor operatively coupled near a distal end thereof, an outer member having a second expandable anchor, and a sleeve disposed about at least a portion of the inner member and the outer member.

Disclosed is a medical device that is capable of grasping multiple sites of one object or multiple objects simultaneously. The medical device includes a platform and a plurality of pincer sets that are attached to the platform. The plurality of pincer sets extend from the platform at varied lengths and at individually operable. Accordingly, a plurality of surgical sites are grasped simultaneously and independently using multiple pincer sets.

An endovascular anastomotic connector and method of using the same. The endovascular anastomotic connector includes a vascular conduit and a supply conduit. The vascular conduit has proximal and distal ends that reside within a vascular structure. The supply conduit extends at an angle from the vascular conduit. The proximal end of the supply conduit is configured to be attached to an auxiliary device.

The invention generally relates to catheter systems and methods for guided formation of vascular access sites (such as fistulas and grafts). According to certain aspects, a catheter system for forming a vascular access site include an elongate body comprising a distal end and configured to be inserted into a first vessel. The elongate body includes an exit port along its side that is proximal to the distal end. An imaging assembly is associated with the elongate body and configured to generate image data of the first vessel and a second vessel positioned next to the first vessel. For vascular access formation, a penetrating member of the catheter system extends out of the exit port and through a wall of the first vessel and a wall of the second vessel.