Disclosed embodiments include apparatuses, systems, and methods for facilitating anastomosis between bodily passages. In an illustrative embodiment, an eversion mechanism is configured to engage a first external surface of a receiving passage adjacent a first opening in the receiving passage in order to create a receiving flange presenting a first interior face. A donor support mechanism is configured to support a donor passage with an opening in an end in an everted position that forms a donor flange presenting a second interior face. The donor support mechanism is further configured to present the second interior face of the donor flange against the first interior face of the receiving flange to present a passage juncture. A suturing mechanism is configured to motivate a filament through a helical path around the passage juncture to suture the second interior face of the donor passage to the first interior face of the receiving passage.

A transection device including a curved tubular body extending from a proximal end to a distal end, having a wall and an internal chamber and a receiving chamber. The receiving chamber may be defined by the distal end and an opening in the wall, and said distal end may have a surface facing the receiving chamber and an outside surface comprising an elongated region. A protrusion may extend from the distal end towards the center of said opening. A cutting member may be positioned within said curved tubular body and may be moveable between an initial position and an extended position and at least a portion of the cutting member may extend into the receiving chamber. A depressible member may be configured to move the cutting member and a compression member may extend between the cutting member and the depressible member. Some embodiments may utilize an electrosurgical cutting member.

This document relates to the apparatus and methods used in the minimally invasive creation of arteriovenous fistula (AVF). In particular, the invention relates to the creation of an AVF using catheters and an alignment methodology that is based upon detection of asymmetric electric fields. The invention finds particular application in vascular access (VA) in the hemodialysis (HD) population.

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.

Devices, systems, and methods for reducing stress on a blood vessel are disclosed herein. A damping device (100) configured in accordance with embodiments of the present technology can include an anchoring member (104) coupled to a flexible, compliant damping member (102) including a generally tubular sidewall having an outer surface (115), an inner surface (113) defining a lumen configured to direct blood flow, a first end portion (106) and a second end portion (108), and a damping region (120) between the first and second end portions (106, 108). The inner and outer surfaces (113, 115) of the damping member (102) can be spaced apart by a distance that is greater at the damping region (120) than at either of the first or second end portions (106, 108). When blood flows through the damping member (102) during systole, the damping member (102) absorbs a portion of the pulsatile energy of the blood, thereby reducing a magnitude of the pulse pressure transmitted to a portion of the blood vessel distal to the damping device (100).

There is provided a lumen maintenance catheter used for vascular suture, in which an operator can stably grip the catheter to improve the operability, and the entire catheter is prevented from entering a blood vessel. The lumen maintenance catheter for vascular suture includes a shaft having flexibility and a bulging part bulging in a radial direction at a distal end of the shaft, wherein the shaft includes a small diameter part on a distal end side, and a large diameter part larger in diameter than the small diameter part, on a rear end side, the small diameter part and the large diameter part are connected by an inclined part that is inclined so that a diameter of the shaft increases toward the rear end side, and the rigidity of the shaft increases as the diameter increases.

Embodiments may include an attachable fastener, which may include a bondable material that may be secured to the end of an end effector. Vibration may be tuned to occur at a distal end of the fastener. Accordingly, the fastener may be used to generate heat at a distal point of contact. If the contact surface contains bondable material, that material may be softened. If the fastener includes bondable material at the point of contact, that material may also be softened by heat produced by vibration at the contact area. A hard implant or another polymeric material may function as the anvil.

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.

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.

Apparatus and methods for controlled arterial/venous access are provided. The apparatus and methods may include a section of tubing anastomosed to a bodily lumen. A lumen clamping means may utilize a clamp manipulator to effectively seal the tubing, and the manipulator may be operated by two fingers. A needle receptor may be utilized, and the receptor may utilize a rotating member to guide a needle inserted from outside the body, in order ensure accurate placement into a channel. The channel may be in liquid communication with the tubing. The manipulator and the needle receptor may be palpable from outside the body.