Catheter apparatus and method for arterializing a vein
First Claim
1. A catheter apparatus for arterializing a vein by creating a fistula between the vein and an artery, the apparatus comprising:
- an arterial catheter having a distal end insertable to a position wherein the distal end is adjacent a site within the artery for the fistula, a venous catheter having a distal end insertable to a position wherein the distal end is adjacent a site within the vein for the fistula, the venous catheter including a radially expandable structure adjacent the distal end which selectively extends outwardly a portion of the wall of the vein adjacent the venous fistula site towards contact with the wall of the artery adjacent the arterial fistula site, a tool for creating an opening through the wall of the artery adjacent the arterial fistula site and an opening through the outwardly extending portion of the wall of the vein adjacent the venous fistula site, wherein the radially expandable structure of the venous catheter includes a wire basket deployable adjacent the distal end of the venous catheter, the wire basket being expandable with sufficient force to extend outwardly the wall of the vein towards contact with the arterial wall.
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Accused Products
Abstract
A catheter apparatus is provided including an arterial catheter and a venous catheter wherein the distal ends of the catheter are insertable in an artery and a adjacent vein, respectively to a position adjacent a site for creating a fistula. The venous catheter includes a radially expandable structure adjacent the distal end which can be selectively extended outwardly to expand a portion of the wall of the vein adjacent the venous fistula site towards contact with the wall of the artery adjacent the arterial fistula site. The radially expandable structure of the venous catheter may include one or more balloons which can be inflated or a wire basket, or the vein can be expanded by injecting a fluid through an injection port into an isolated portion of the vein. The apparatus further includes a tool for creating an opening through the wall of the artery adjacent the arterial fistula site and an opening through the outwardly extending portion of the wall of the vein adjacent the venous fistula site to extend outwardly the portion of the wall of the vein towards contact with the wall of the artery. The tool may include a needle coupled to the arterial catheter adjacent the distal end of the arterial catheter, the needle being selectively switchable between a first, inactive configuration wherein the needle can be guided through the artery without causing trauma to the artery wall and a second, active configuration wherein the needle is operative to create the opening in the artery wall. The fistula between the openings may be completed with the aid of a stent, and the proximal portion of the vein blocked with an embolization device.
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Citations
27 Claims
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1. A catheter apparatus for arterializing a vein by creating a fistula between the vein and an artery, the apparatus comprising:
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an arterial catheter having a distal end insertable to a position wherein the distal end is adjacent a site within the artery for the fistula, a venous catheter having a distal end insertable to a position wherein the distal end is adjacent a site within the vein for the fistula, the venous catheter including a radially expandable structure adjacent the distal end which selectively extends outwardly a portion of the wall of the vein adjacent the venous fistula site towards contact with the wall of the artery adjacent the arterial fistula site, a tool for creating an opening through the wall of the artery adjacent the arterial fistula site and an opening through the outwardly extending portion of the wall of the vein adjacent the venous fistula site, wherein the radially expandable structure of the venous catheter includes a wire basket deployable adjacent the distal end of the venous catheter, the wire basket being expandable with sufficient force to extend outwardly the wall of the vein towards contact with the arterial wall. - View Dependent Claims (2)
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3. A catheter apparatus for arterializing a vein by creating a fistula between the vein and an artery, the apparatus comprising:
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an arterial catheter having a distal end insertable to a position wherein the distal end is adjacent a site within the artery for the fistula, a venous catheter having a distal end insertable to a position wherein the distal end is adjacent a site within the vein for the fistula, the venous catheter including a radially expandable structure adjacent the distal end which selectively extends outwardly a portion of the wall of the vein adjacent the venous fistula site towards contact with the wall of the artery adjacent the arterial fistula site, and a tool for creating an opening through the wall of the artery adjacent the arterial fistula site and an opening through the outwardly extending portion of the wall of the vein adjacent the venous fistula site, wherein the tool includes a needle coupled to the arterial catheter adjacent the distal end of the arterial catheter, the needle being selectively switchable between a first, inactive configuration wherein the needle can be guided through the artery without causing trauma to the artery wall and a second, active configuration wherein the needle is operative to create the opening in the artery wall, and wherein the needle is hollow and terminates in a beveled, pointed tip, and wherein the tool further includes a wire selectively insertable through the needle, the wire having a generally blunt distal end, the wire and needle providing the inactive configuration when the distal end of the wire extends through the needle to a position at least flush with the needle tip, and the wire and needle providing the active configuration when the wire is retracted from the needle tip.
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4. A catheter apparatus for arterializing a vein by creating an opening in the vein wall and an opening in an arterial wall, and developing a fistula between the vein and the artery, the apparatus comprising:
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an arterial catheter having a distal end insertable to a position adjacent a site within the artery for the fistula, a venous catheter having a distal end insertable to a position adjacent a site within the vein for the fistula, the venous catheter including a wire basket adjacent the distal end of the venous catheter, the wire basket selectively deployable to extend the wall of the vein outwardly towards contact with the wall of the artery, and a tool for creating an opening through the wall of the artery and an opening through the wall of the vein adjacent the sites for the fistula. - View Dependent Claims (5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. A method of arterializing a peripheral vein by creating a fistul a between the vein and a peripheral artery, the method comprising:
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providing an arterial catheter having a distal end and inserting the arterial catheter into the artery to a position wherein the distal end is adjacent a site for the fistula within the artery;
providing a venous catheter having a distal end and inserting the venous catheter into the vein to a position wherein the distal end is adjacent a site for the fistula within the artery;
after positioning the arterial and venous catheters, radially expanding a portion of the vein wall adjacent the venous fistula site to bring the venous fistula site in closer proximity to the arterial fistula site;
after radially expanding the portion of the vein wall, creating an opening through the wall of the artery adjacent the arterial fistula site and creating an opening through the wall of the vein adjacent the venous fistula site, wherein the venous catheter includes a wire basket deployable adjacent the distal end of the venous catheter, and wherein the step of radially expanding a portion of the vein wall includes deploying the wire basket. - View Dependent Claims (24, 25, 26, 27)
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Specification