In some implementations, a radially self-expanding endograft prosthesis is provided that includes (i) distal flange that is self-expanding and configured to flip generally perpendicularly with respect to a body of the prosthesis to help seat the prosthesis against a tissue wall, (ii) a distal segment extending proximally from the distal flange that has sufficient stiffness to maintain a puncture open that is formed through a vessel wall (iii) a compliant middle segment extending proximally from the distal segment, the middle segment being more compliant than the distal segment, and having independently movable undulating strut rings attached to a tubular fabric, the combined structure providing flexibility and compliance to allow for full patency while flexed, the segment being configured to accommodate up to a 90 degree bend, (iv) a proximal segment having a plurality of adjacent undulating strut rings that are connected to each other.

Apparatuses and methods for use in surgical vascular anastomotic procedures. Apparatus includes a blood vessel inner wall (BVIW) sealing and hole forming device, and a hole forming actuator. BVIW sealing and hole forming device includes a hole sealing device, and an anastomotic hole generating device. Hole sealing device includes a sheath that fully encloses and holds a self-expanding hole sealing assembly, a manual hole sealing controller assembly, and a flexible control wire enclosed within a flexible tube. Anastomotic hole generating device includes outer and inner assemblies, with a conically shaped anastomotic hole generating member. Hole forming actuator includes outer and inner assemblies. Also disclosed are procedures for performing surgical vascular anastomosis using the disclosed apparatuses and methods. Particularly applicable for use in clampless types of (end-to-side) surgical vascular anastomotic procedures, for performing coronary artery bypass grafting (CABG).

A method of establishing an anastomosis utilizing a harvested blood vessel includes connecting the blood vessel to an artery, thereby forming an anastomosis therebetween. The method further includes wrapping an outer surface of the blood vessel with a tubular support. The tubular support exerts a radially-inward force on the blood vessel.

Devices and methods of treating conditions cause or exacerbated by excessive fluid pressures or retentions, such as pulmonary hypertension, that involves shunting excessive fluid pressure from one bodily chamber or vessel to another bodily chamber or vessel.

A launching catheter for targeting a second vessel from a first vessel includes a catheter including a proximal portion and a distal portion including a needle aperture and a flat rectangular radiopaque marker. The flat rectangular radiopaque marker disappears under fluoroscopy upon rotation to provide information about rotational alignment of the launching catheter. The launching catheter includes a needle configured to extend through the needle aperture. A method of aligning the catheter includes rotating the catheter in a first blood vessel until the marker has a thickness (e.g., minimal thickness) under fluoroscopy. The thickness indicates rotational alignment of the catheter.

An apparatus for anastomosing a cut vessel is provided. The apparatus includes a first ring having an inner surface that defines inner lumen. The inner lumen is configured to receive a first vessel end of the cut vessel. The inner surface of the first ring has at least one spike configured to penetrate the first vessel end and secure the first ring to the first vessel end. A second ring has an inner surface defining an inner lumen configured to receive a second vessel end of the cut vessel. The inner surface of the second ring has at least one spike configured to penetrate the second vessel end and secure the second ring to the second vessel end. The first and second rings, after being secured to the first and second vessel ends, are configured to be joined together into direct engagement to anastomose the cut vessel.

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.

Transluminal access system includes a stent delivery catheter having a handle control mechanism. The catheter comprises a number of components for establishing an initial penetration between adjacent body lumens and subsequently implanting a stent or other luminal anchor therebetween. Manipulation of the stent components is achieved using control mechanisms on the handle while the handle is attached to an endoscope which provides access to a first body lumen.

A Doppler blood flow monitoring device (150) includes a signal generation module, a signal reception module, a signal filtration module, a signal conversion module, at least one speaker, and a user interface (304). The signal generation module is configured to send a signal to a probe (106) positioned in a probe receptacle on a vascular coupler positioned about a patients vessel. The signal reception module is configured to receive a return signal from the probe. The signal filtration module is configured to filter the return signal. The signal conversion module is configured to convert the filtered signal into an audible indication and a visual indication corresponding to a characteristic of blood flow in the patients vessel. The at least one speaker (214) is configured to emit the first audible indication. Additionally, the user interface is configured to display the visual indication.

Various aspects of the present disclosure are directed toward apparatuses, systems, and methods that include a medical device including a remotely actuated cross-sectional adjustment mechanism. The medical device may include a cross-sectional adjustment mechanism configured to actuate an implantable medical device between a first dimension and a second dimension that is larger than a first dimension to adjust an amount of fluid flow through the implantable medical device.