An embodiment of the invention relates to a method of configuring blood vessels at an anastomosis, the method comprising: ensheathing a segment of a transected first blood vessel in a lumen of a sleeve so that an open end of the segment protrudes from a sleeve end; suturing edges of an incision made in a second blood vessel to the open end of the first blood vessel to create an anastomosis; and sliding the sleeve along the first blood vessel to position the sleeve at the anastomosis.

A method is used to manufacture an anvil of a circular surgical stapler. The anvil includes a head and a coupling feature that extends proximally from the head. The method includes forming each of the head and the coupling feature using at least one metal injection molding process. The method also includes after forming the coupling feature, machining a through bore into the coupling feature that extends completely through the coupling feature along a longitudinal axis of the coupling feature.

A vascular access device with arteriovenous fistula support includes a top portion and a bottom portion. The top portion has a partial artery channel, a partial vessel channel, and a partial arteriovenous joint between the partial artery channel and the partial vessel channel, where the partial vessel channel has a vascular access aperture for exposing the vessel. The bottom portion has a corresponding partial artery channel, partial vessel channel, and partial arteriovenous joint between the partial artery channel and the partial vessel channel. When the top portion is coupled to the bottom portion, the two partial artery channels couple together to form an artery channel, the two partial vessel channels couple together to form a vessel channel, and the two partial arteriovenous joints couple together to form an arteriovenous joint for an arteriovenous fistula.

Methods, devices, and kits for implanting a vascular graft to perform hemodialysis treatments on patients with renal failure are disclosed. The kits can include access devices comprised of an access catheter having a guidewire lumen and stylet lumen, a guide tube having a curved distal end, a stylet, an actuator handle and a vascular graft. The methods describe techniques for using the described kits and devices for performing vascular procedures, such as percutaneous implantation of the vascular graft.

Devices and methods are described for accessing the mediastinum without an intercostal incision and without deflating the lungs. In some embodiments, the devices and methods facilitate mediastinal access via a single percutaneous needle puncture. In some embodiments, a first puncture below the ribs or sternum, and a second puncture that is intercostal are used. Devices and methods to facilitate concurrent access to the pericardial and mediastinal spaces are also described. Multiple minimally invasive procedures are described that advantageously utilize the pericardial and mediastinal space access procedures.

An occlusive implant may include an expandable framework configured to shift between a collapsed configuration and an expanded configuration. The expandable framework includes a plurality of anchor members extending radially outward from the expandable framework in the expanded configuration, each anchor member including at least one base portion fixedly secured to the expandable framework and a plurality of anchor tips extending from each base portion. Each base portion extends longitudinally along the expandable framework. A method of making the occlusive implant may include forming the expandable framework, forming the plurality of anchor members, and fixedly attaching each base portion to the expandable framework such that each anchor member extends radially outward from the expandable framework in the expanded configuration and each base portion extends longitudinally along the expandable framework.

A method for treating a patient may include establishing an anastomosis between a pulmonary artery and an aorta; and pumping blood from the pulmonary artery to the aorta when the pulmonary artery has a pressure lower than or equal to a pressure of the aorta.

A self-closing device for implantation within a patient's body includes base material including an inner surface area for securing the base material to a tissue structure, and a plurality of support elements surrounding or embedded in the base material. The support elements are separable laterally within a plane of the base material to accommodate creating an opening through the base material for receiving one or more instruments through the base material, and biased to return laterally towards a relaxed state for self-closing the opening after removing the one or more instruments. The device may be provided as a patch or integrally attached to a tubular graft or in various shapes.

A circular stapling device is described that is particularly suited for creating stomas. The circular stapling device includes two tool assemblies. The first tool assembly is adapted to create a reinforced incision in tissue, e.g., the rectus sheath, through which a vessel portion, e.g., colon, small intestine, etc. can be pulled through during a surgical procedure. The second tool assembly is adapted to attach a stomal sleeve within the vessel portion such that the stomal sleeve extends from the stoma.

A punching device for punching a lumen and implanting an implant device includes at least the implant device for punching the lumen and for implantation into the lumen. In addition, the punching device includes an implantation device, a closure device, and an actuation device.