СПОСОБ ПРЕДОТВРАЩЕНИЯ ИЛИ ЛЕЧЕНИЯ УМЕНЬШЕНИЯ ДОСТУПА ДЛЯ ГЕМОДИАЛИЗА СОСУДОВ И УСТРОЙСТВО ДЛЯ ЕГО ОСУЩЕСТВЛЕНИЯ И ДРУГИЕ СОСУДИСТЫЕ ГРАФТЫ

... 1. Способ предотвращения или лечения васкулопролиферативного заболевания сосудов, включающий стадии экстраваскулярного и локального введения в структуру сосуда такого количества антипролиферативного агента, которое оказывает эффективное антипролиферативное действие. 2. Способ по п.1, отличающийся тем, что агент содержит рапамицин. 3. Способ по п.1, отличающийся тем, что антипролиферативный агент вводят периваскулярно. 4. Способ по п.1, отличающийся тем, что экстраваскулярное, местное введение осуществляют с помощью имплантируемой, элюирующей антипролиферативный агент, периваскулярной сосудистой манжеты, причем манжета содержит матриксный материал, пропитанный агентом. 5. Способ по п.4, отличающийся тем, что манжета в значительной степени охватывает сосуд. 6. Способ по п.4, отличающийся тем, что матриксный материал содержит фибрин. 7. Способ по п.4, отличающийся тем, что агент содержит рапамицин и гепарин. 8. Способ по п.4, отличающийся тем, что матриксный материал содержит коллаген. 9.

СИСТЕМА И СПОСОБ ПОВЫШЕНИЯ НАРУЖНОГО ДИАМЕТРА ВЕН И АРТЕРИЙ

Gefäßport, insbesondere für die Hämodialyse

IMPLANTIERBARES HERZUNTERSTÜTZUNGSSYSTEM

VORRICHTUNG ZUR DURCHFLUSSKONTROLLE

DIALYSEMASCHINE MIT EINER VORRICHTUNG ZUR ERFASSUNG DER ABTRENNUNG DER VENÖSEN NADEL VON EINEM PATIENTEN WÄHREND DER EXTRAKORPORALEN BLUTBEHANDLUNG

Dialysis port system and diaphragm

... 200-500 m/l blood can be pumped out, filtered and returned using a system of double ports with common vein connection plus dimensionally adjustable diaphragm as well as port diameter and volume and consistency of puncturing cannula and catheter. The system offers two separate blood input and return chambers to and from the vein and a modifiable septum diameter and material for repeated puncture, e.g. 500 times. The special cannula uses its mandril to pierce the self-sealing plastics diaphragm disc and connect beneath the skin to the blood vessel being tapped. The system necessarily includes blood filter unit prior to return to the vein, using the same system of cannulae, catheters and diaphragm etc.

Medical device

Arteriovenous Access Valve System and Process

There is provided a subcutanous arteriovenous graft system. The system comprises an arteriovenous graft (12) having an arterial end (14) and an opposite venous end (16), and at least one valve device (60,80) positioned at the arterial end of the arteriovenous graft (12). The valve device (60,80) may comprise a piston (72) in fluid communication with a fluid chamber (62), wherein, when a fluid is forced into the fluid chamber (62), the piston (72) closes which, in turn, constricts the arteriovenous graft (12). The valve device (60,80) may comprise a magnetically activated piston (84), wherein, when a magnetic field is placed in close proximity to the valve device (80), the piston (84)is moved for either opening or closing the valve device (80).

Apparatus and methods for preventing or treating failure or hemodialysis vascular access and other vascular grafts.

Implantable device containing resorbable matrix material and anti-proliferative drugs for preventing or treating failure of hemodialysis vascular access and other vascular grafts.

This invention is a prosthetic device generally placed on the outside surface of the vessel or graft which then elutes antiproliferative drugs or agents from a drug-eluting matrix material. Methods of perivascular antiproliferative drug administration also are disclosed.

Process and processor hyperthermic

Apparatus and methods for preventing or treating failure or hemodialysis vascular access and other vascular grafts.

ULTRASONIC INVESTIGATION OF VENOUS STRUCTURES

EXTRAKORPORALER CYCLE

IMPLANTIERBARES SYSTEM FOR HEART SUPPORT

DEVICE TO FLOW CONTROL

TRANSPLANT CATHETER F�R OF VASKULARES ENTRANCE SYSTEM

DEVICE FOR THE DETERMINATION OF THE BLOOD RECIRCULATION IN A VASCULAR ENTRANCE

DEVICES AND METHODS FOR FISTULA FORMATION

Abstract: A device for forming a fistula between two vessels comprising a handle; a first arm fixedly connected to the handle; and a second arm adjustably connected to the handle, wherein at least one of the first arm and the second arm comprises a fistula forming element.

BLOOD PUMP SYSTEMS AND METHODS

A blood pump system for persistently increasing the overall diameter and lumen diameter of peripheral veins and arteries by persistently increasing the speed of blood and the wall shear stress in a peripheral vein or artery for a period of time sufficient to result in a persistent increase in the overall diameter and lumen diameter of the vessel is provided. The blood pump system includes a blood pump, blood conduit(s), a control system with optional sensors, and a power source. The pump system is configured to connect to the vascular system in a patient and pump blood at a desired rate and pulsatility. The pumping of blood is monitored and adjusted, as necessary, to maintain the desired elevated blood speed, wall shear stress, and desired pulsatility in the target vessel to optimize the rate and extent of persistent increase in the overall diameter and lumen diameter of the target vessel.

Graft-catheter vascular access system

IMPLANTABLE DIALYSIS ACCESS PORT

Hemodialysis access system

A medical blood access system used for hemodialysis treatment to enable blood withdrawal for processing of blood by an external apparatus and return the same blood to a patient, comprising an interfacial fluid conduit between the machine and patient's blood supply which is repeatedly connectable along a guided pathway passing through epidermis and subcutaneous tissue via a naturally formed tissue tract to enter blood space, providing improved patient safely, convenience, effective prophylaxis, without bleeding or tissue trauma or pain, and is executable by the patient to precisely connect and disconnect with minimal disfigurement or life restrictions, and is useable on virtually all patients soon after placement and is robust and safe to high blood flow.

Vessel Treatment Systems, Methods, and Kits

One aspect of the invention provides a vessel treatment system including: a housing defining at least one opening adapted and configured to receive an anatomical vessel; and a humidifier in communication with the housing, the humidifier adapted and configured to introduce humidity into the housing to prevent desiccation of the anatomical vessel. Another aspect of the invention provides a kit including: the vessel treatment system as described herein; and a passivation agent. Another aspect of the invention provides a method for preparing a vein graft. The method includes: applying a tissue passivation agent to a resected anatomical vessel; and placing the resected anatomical vessel in a humidified chamber while the tissue passivation agent cures. 125 f 102\ ",110 13123 115 -130 127 -- 132 1221 120- ...

AN ELONGATE PERCUTANEOUS CANNULA

GRAFT-CATHETER VASCULAR ACCESS SYSTEM

A vascular access device, for implantation at least partially below the skin of a patient to provide an arteriovenous fistula, includes a graft portion coupled to a catheter portion. The graft portion is sutured to an opening in an artery while the catheter portion is inserted into a vein so that its end lies within the vein downstream from the point of entry into the vein. The device may be comprised of ePTFE with an outer polyurethane coating or the graft portion may comprise ePTFE with an outer polyurethane coating and the catheter portion may comprise polyurethane. There may also be an inner polyurethane coating. Alternatively, the device may be comprised entirely of polyurethane.

APPARATUS AND METHOD FOR DETECTING DISCONNECTION OF AN INTRAVASCULAR ACCESS DEVICE

An electrical circuit for measuring the resistance of a liquid between two electrodes comprises first and second capacitors connected respectively to the two electrodes, and a known reference resistor connected to the first capacitor. A voltage switching circuit provides a first reference voltage to the reference resistor and a lower second reference voltage to the second capacitor, alternating with the first reference voltage applied to the second capacitor and the second lower reference voltage applied to the first capacitor. A voltage is measured at the connection between the first capacitor and the reference resistor, and from this observed voltage and the value of the reference resistor, the resistance of the liquid is determined. The electrical circuit may be used in monitoring the continuity of a column of blood in a conduit leading to and from a blood vessel or graft to detect disconnection of a catheter from the blood vessel or graft.

APPARATUS AND METHOD FOR DETECTING DISCONNECTION OF AN INTRAVASCULAR ACCESS DEVICE

An apparatus and method are disclosed for detecting the disconnection of a vascular access device such as a needle, cannula or catheter from a blood vessel or vascular graft segment. A pair of electrodes is placed in direct contact with fluid or blood in fluid communication with the vascular segment. In one embodiment, the electrodes are incorporated into a pair of connectors connecting arterial and venous catheters to arterial and venous tubes leading to and from an extracorporeal blood flow apparatus. Wires leading from the electrodes to a detecting circuit can be incorporated into a pair of double lumen arterial and venous tubes connecting the blood flow apparatus to the blood vessel or vascular graft. The detecting circuit is configured to provide a low-voltage alternating current signal to the electrodes to measure the electrical resistance between the electrodes, minimizing both the duration and amount of current being delivered. Detection of an increase in electrical resistance between ...

METHODS FOR PREVENTING THE INTRODUCTION OF AIR OR FLUID REFLUX INTO THE BODY OF A PATIENT

METHODS FOR PREVENTING THE INTRODUCTION OF AIR OR FLUID REFLUX INTO THE BODY OF A PATIENT Methods and flow control devices for use in catheters or the like for preventing the introduction of air into the vascular system of a patient during intravenous or intraarterial procedures, as well as for preventing the reflux of fluids into the body of a patient.

METHOD AND APPARATUS FOR EFFECTING HYPERTHERMIC TREATMENT

A process of hyperthermic treatment of a patient which comprises the steps of establishing a sterile extracorporeal flow path for blood having an inlet, an outlet and a temperature control zone therebetween, establishing communication of the flow path inlet with the patient's bloodstream so that blood can he supplied to the extracorporeal flow path without adversely affecting the blood circulation in the area from which the blood is withdrawn, establishing communication of the flow path outlet with the patient's bloodstream so that blood is returned to the bloodstream in such a way as to be distributed systemically, pumping blood withdrawn from the patient's bloodstream through the temperature control zone at a controlled rate of at least approximately 1 liter per minute and returning the same to the patient's bloodstream to be distributed systemically, controlling the temperature of the blood flowing through the temperature control zone for an initial period during which the temperature ...

METHOD OF TREATING COPD WITH ARTIFICIAL ARTERIO-VENOUS FISTULA AND FLOW MEDIATING SYSTEMS

CYLINDRICAL STRUCTURE

The objective of the present invention is to provide a cylindrical structure with which excellent puncture resistance can be imparted while maintaining the flexibility of a base material, by covering the base material using a covering material having excellent flexibility. The present invention provides a cylindrical structure which is provided with a cylindrical base material and a covering material which covers the base material, wherein the covering material includes a copolymer having, as a monomer unit, a polymerizable monomer including a silicone monomer and a fluoroalkyl group.

DEVICE AND METHOD FOR ATRAUMATIC AND PERCUTANEOUS FORMATION OF AN ARTERIOVENOUS FISTULA

Provided herein are novel devices for the formation of arteriovenous fistulas, which may aid subjects in need of hemodialysis. The novel devices are provided in a non-surgical procedure, greatly decreasing the cost and increasing the convenience of placing an arteriovenous fistula. The devices are atraumatic, and consist of a sutureless anastomosis device and conduit. Methods and tools for placing the devices in vivo are disclosed, including a magnetic-assisted method.

SYSTEM AND METHOD FOR PERFORMING ALTERNATIVE AND SEQUENTIAL BLOOD AND PERITONEAL DIALYSIS MODALITIES

A dialysis system comprises a dialysis fluid pump, a dialysis fluid line, a blood filter in fluid communication with the dialysis fluid pump via the dialysis fluid line, an extracorporeal circuit connectable to a patient, a blood pump in fluid communication with the blood filter via the extracorporeal circuit, and a control unit programmed to (i) in a first treatment, prepare peritoneal dialysis treatment fluid by combining purified water with a peritoneal dialysis concentrate using the dialysis fluid pump and the dialysis fluid line, and (ii) in a second treatment, prepare hemodialysis treatment fluid by combining purified water with a blood treatment concentrate using the dialysis fluid pump and the dialysis fluid line.

MODULAR BLOOD TREATMENT SYSTEMS, UNITS, AND METHODS

A portable adapter is provided that can include a closure system configured to control the flow of blood and/or dialysate between the adapter and a blood treatment apparatus. Modular systems are also provided that include the portable adapter engaged with various units such as a portable blood processing module, a non-portable base module, and/or a remote module. Methods of conducting blood treatments such as blood circulation, hemodialysis, and hemofiltration, hemodiafiltration, using the modular systems are also provided. The systems, units, and methods enable the engagement and disengagement of the adapter from the various units to conduct, interrupt, and resume blood treatments without disconnecting the adapter from the vasculature of a patient. Modular systems including interchangeable portable and base modules configured for various blood treatments are also provided that can be engaged and disengaged with each other without disconnecting the portable module from the vasculature of ...

HEMOFILTRATION DEVICE AND METHODS OF USE THEREOF

Parallel plate devices for hemofiltration or hemodialysis are provided. A parallel plate device includes a parallel plate assembly having an aligned stack of stackable plate subunits, each stackable plate subunit having a through channel for blood, where the blood channels are opened up at opposite ends of the parallel plate assembly. The parallel plate assembly is configured to form filtrate/dialysate channels interleaved with the blood channels, adjacent channels being separated by a silicon nanoporous filtration membrane. A blood conduit adaptor is attached to the parallel plate assembly at each of the ends, and is configured to distribute blood to or collect blood from the blood channels. Also provided are systems and methods for using the parallel plate devices.

DIAMETRICALLY ADJUSTABLE ENDOPROSTHESES AND ASSOCIATED SYSTEMS AND METHODS

A diametrically adjustable endoprosthesis includes a controlled expansion element extending along at least a portion of a graft and is supported by a stent. The controlled expansion element diametrically constrains and limits expansion of the endoprosthesis. Upon deployment from a smaller, delivery configuration, the endoprosthesis can expand to the initial diameter set by the controlled expansion element. Thereafter, the endoprosthesis can be further diametrically expanded (e.g., using balloon dilation) by mechanically altering the controlled expansion element.

AN EXTRACORPOREAL CELL-BASED THERAPEUTIC DEVICE AND DELIVERYSYSTEM

INTRAOSSEOUS INFUSION PORTS AND METHODS OF USE

Example embodiments are related to intraosseous infusion port (IOP) devices to provide access to bone marrow cavities. The IOP device according to example embodiments may comprise a proximal portion with a hollow chamber extending through the proximal portion, the hollow chamber having a proximal inlet for receiving an insertion device. The IOP device may also include an anchor portion positioned distally to the proximal portion, the anchor portion may be configured for anchoring the infusion port device in a bone, and an open-ended channel extending through the anchor portion, the channel being in fluid communication with the hollow chamber, such that, when the infusion port is implanted into a bone, the channel and the hollow chamber create a substantially straight pathway terminating at an opening at its distal end for insertion of the insertion device towards the bone marrow.

HEMODIALYSIS ACCESS SYSTEM

A medical blood access system used for hemodialysis treatment to enable blood withdrawal for processing of blood by an external apparatus and return the same blood to a patient, comprising an interfacial fluid conduit between the machine and patient's blood supply which is repeatedly connectable along a guided pathway passing through epidermis and subcutaneous tissue via a naturally formed tissue tract to enter blood space, providing improved patient safely, convenience, effective prophylaxis, without bleeding or tissue trauma or pain, and is executable by the patient to precisely connect and disconnect with minimal disfigurement or life restrictions, and is useable on virtually all patients soon after placement and is robust and safe to high blood flow.

SHEATH

The present application includes a sheath that is suitable for use in a variety of medical procedures. In one or more implementations, the sheath includes a shunt member, and a curvable portion. The curvable portion may be configured in various orientations to facilitate an intervention, such as a hemodialysis intervention, or the like, by an operator. The curvable portion may be configured to bend between a substantially straight configuration and a curved configuration. In implementations, the sheath may be configured to have detachable and/or interchangeable components (e.g., shunt member, curvable portion, etc.).

BLOOD PUMP SYSTEMS AND METHODS

The present invention relates to a rotary blood pump with a double pivot contact bearing system with an operating range between about 50 mL/min and about 1500 mL/min. The rotary blood pump is part of a blood pump system that includes blood conduit(s), a control system with optional sensors, and a power source. Embodiments of the present invention may include elements such as wear resistant bearing materials, a rotor back plate for magnetic attraction of the rotor to reduce bearing pivot bearing forces and wear, a rotor size and shape and a bearing gap that combine to create a hydrodynamic bearing effect and reduce bearing pivot bearing forces and wear, improved intravascular conduits with increased resistance to thrombosis, conduit insertion site cuffs to resist infection, and conduit side ports amenable to the easy insertion of guidewire and catheter-based medical devices.

BLOOD PUMP SYSTEMS AND METHODS

The present invention relates to a rotary blood pump with a double pivot contact bearing system with an operating range between about 50 mL/min and about 1500 mL/min. The rotary blood pump is part of a blood pump system that includes blood conduit(s), a control system with optional sensors, and a power source. Embodiments of the present invention may include elements such as wear resistant bearing materials, a rotor back plate for magnetic attraction of the rotor to reduce bearing pivot bearing forces and wear, a rotor size and shape and a bearing gap that combine to create a hydrodynamic bearing effect and reduce bearing pivot bearing forces and wear, improved intravascular conduits with increased resistance to thrombosis, conduit insertion site cuffs to resist infection, and conduit side ports amenable to the easy insertion of guidewire and catheter-based medical devices.

Differential Conductivity Recirculation Monitor

IMPLANTABLE HEART ASSIST SYSTEM

An extracardiac pumping system (10) for supplementing the circulation of blood through a patient without any component thereof being connected to the patient's heart, and method of using same. The extracardiac system comprises a pump (32) implanted subcutaneously at or about the patient's groin in a minimally-invasive procedure, wherein the pump is powered by a battery (44), and means for charging the battery extracorporeally, wherein the pump draws blood through an inflow conduit (50) fluidly coupled to the patient's femoral artery (26) via a subcutaneous anastomosis connection, and discharges blood through an outflow conduit (52) fluidly coupled to a peripheral artery that stems from the patient's aortic arch via a subcutaneous anastomosis connection. The pump may be operated continuously or in a pulsatile fashion, synchronous with the patient's heart, thereby potentially reducing the pumping load on the heart.

Appareil pour joindre ensemble une extrémité de chacun de deux conduits

DEVICE FOR THE EXECUTION OF A FEVER TREATMENT.

PROSTHESIS CIRCULATORY.

DEVICE AND THE METHOD OF THE CONTROL OF ACCESS TO THE PATIENT, IN PARTICULAR ACCESS TO THE VESSEL WITH THE EXTRACORPOREAL WORKING OF THE BLOOD

Hemodialysis arterio-venous graft with a ring-like diameter-adjustable device

A ring device is integrated externally onto and around a regular hemodialysis arterio-venous graft conduit. The ring device is adjustable to reduce or to normalize (by rebounding) the diameter of the graft, and eventually to change blood flow through the graft. This ring device is designed such that it can be scaled up or down to change its diameter, and simultaneously the diameter of the associated graft prior to and even after its implantation into a patient's arm or leg. Since a hemodialysis arterio-venous graft is usually implanted superficially underneath skin, the device and its adjustable parts can be electively or urgently located and operated from outside by touching and pushing the skin, subcutaneous tissues and the device without a surgical incision. The ring device can be located anywhere within the graft and can function with a single ring or as a set of multiple rings.

Apparatus and method for cannulation of vascular access graft

BLOOD PUMPING SYSTEMS AND METHODS

Una bomba sanguínea giratoria con un sistema de soporte doble de contacto en pivote con un rango de operación de entre aproximadamente 50 ml/mm y aproximadamente 1500 ml/min, en donde la fuerza en el soporte superior es menor que 3N durante las velocidades de operación de hasta 6000 rpm. La bomba sanguínea giratoria es parte de un sistema de bombeo sanguíneo que incluye uno o unos conductos para sangre, un sistema de control con sensores opcionales y una fuente de energía. Las formas de realización de la presente pueden incluir elementos que están diseñados para aumentar el tiempo que la bomba sanguínea giratoria puede funcionar efectivamente in vivo que incluye materiales de soporte resistentes al desgaste, una placa posterior giratoria para atraer magnéticamente al rotor a fin de reducir las fuerzas de soporte y el desgaste en el pivote de soporte, un tamaño y forma de rotor y una separación de soporte que se combinan para crear un efecto de soporte hidrodinámico y reducir las fuerzas ...

HEMODIALYSIS VEIN PREPARATION APPARATUS AND METHODS

Methods and apparatus for applying focused pressure to a target vessel to dilate the target vessel for hemodialysis.

VASCULAR ACCESS SYSTEMS FOR HEMODIALYSIS

A hemodialysis and vascular access system comprises a subcutaneous composite PTFE Silastic arteriovenous fistula utilising an indwelling silastic venous end (12) which can be inserted percutaneously and a PTFE arterial end (10) which is anastomosed to an artery. Percutaneous access is then gained by direct puncture into a unique "needle receiving" site having a tubular passage (16) within a metal or plastic body (26) and a silicone upper surface (25) through which a needle is inserted to access the flow within the system. In an alternate embodiment without "needle sites", access may be gained by placing needles directly into the system i.e. the PTFE. The invention proposes an arterialized indwellling venous catheter where blood flows from an artery through the system and is returned to the venous system via an arrangement wherein the outflow openings are distinct and distant from the site where the system enters the vein. The site of blood returns to the venous system is not directly fixed ...

APPARATUS AND METHOD FOR THE DIALYSIS OF BLOOD

This invention is an improved apparatus and method for the dialysis of blood. The improved apparatus comprises a subcutaneous port, a catheter assembly (105) comprising a connector portion comprising a subcutaneous port element (115), and a catheter portion comprising a catheter element (120). The improved apparatus also comprises a novel percutaneous catheter assembly comprising a catheter portion comprising a catheter element (220), and a connector portion comprising an extra-coporeal connector element (25).

Implantable heart assist system and method of applying same

A method for further reducing the load on a heart suffering (ventricular size maintenance) from congestive heart failure comprising the application of a subcardiac pump having inflow and outflow conduits configured to fluidly connect to non-primary vessels in such a manner as to reduce the load on and/or the size of the heart prior to applying a device intended to reduce the stress on a wall of the ailing heart.

Percutaneous stent-graft and method for delivery thereof

A percutaneous stent-graft is disclosed for restoring blood flow between vessels. The stent-graft has a body implantable device and first and second peel-away retaining elements. Also disclosed are methods for deploying a stent-graft.

FOLLOW-UP OF THE VASCULAR ACCESS OF A DIALYZED PATIENT

The invention relates to a calculation and control system for the determination of the state of a vascular access of a patient intended to follow successive sessions of extracorporeal blood treatment by extraction and return of the blood via the vascular access, the system comprising: means for determining the value of at least one hemodynamic extracorporeal parameter of the patient for at least two sessions; means for determining the value of the purification effectiveness of the treatment for at least two sessions; programmed means for determining a risk score relating to the state of the vascular access of the patient as a function of at least two values of the hemodynamic extracorporeal parameter and of at least two determined values of the purification effectiveness.

Apparatus and method of monitoring a vascular access of a patient subjected to an extracorporeal blood treatment

In the apparatus and method for monitoring a vascular access ( 6 ) of an extracorporeal circuit ( 5; 10 ) of a patient, a control and calculation unit ( 17 ) varies a flow rate of a blood pump ( 9 ) predisposed to cause blood to circulate in the extracorporeal circuit. The control and calculation unit receives-the pressure values in the blood withdrawal line ( 5 ) and the blood return line ( 10 ) from two pressure sensors ( 8, 12 ); the pressure values are a series of different values of the blood flow rate. The control and calculation unit processes the data gathered by means of a mathematical model which describes the variation of pressure in the vascular access as a function of the flow rate, in order to determine the blood flow rate in the vascular access. The invention detects the presence and location of a stenosis at the vascular access of a patient subjected to a hemodialysis treatment.

METHODS FOR ROUTING A GUIDEWIRE FROM A FIRST VESSEL AND THROUGH A SECOND VESSEL IN LOWER EXTREMITY VASCULATURE

A catheter system can include a tubular body, and at least one of a targeting system coupled to the tubular body, an expandable member, or a fluid injection port. A method of identifying a bifurcation can include inserting a catheter system into a first vessel, positioning the catheter system at a first location, expanding an expandable member to occlude the first vessel, delivering contrast material so the contrast material pooling proximate to the expandable member, and reviewing a shape of the contrast material in the first vessel under fluoroscopy.

Externally adjustable blood flow valve

A valve installed in a blood vessel can be externally adjusted over a wide range of flow rates. Such a valve can be incorporated in an AV shunt or AV fistula to allow large flow during dialysis and small flow at all other times. The valve can be activated by finger pressure, hypodermic needle or by an electromagnetic field. The valve is shaped like a Venturi tube with round cross section and smooth diameter transition to minimize blood damage and clotting. Hemodynamic properties are further enhanced by keeping the part coming in contact with the blood a single continuous tubing.

LUMINAL GRAFTS AND METHODS OF MAKING AND USING THE SAME

Luminal grafts and methods of making and using the same. An exemplary luminal graft of the present disclosure is configured as a generally tubular element configured for nerve cells to grow therethrough and comprises at least one sheet of biological tissue having elastin fibers and collagen fibers, with the elastin fibers being a dominant component thereof; and a plurality of microchannels formed on a surface of the at least one sheet of biological tissue, each of the microchannels extending longitudinally between a first end and a second end of the at least one sheet of biological tissue and configured to provide intraluminal structural guidance to nerve cells proliferating therethrough.

Drug Delivery Device and Method

Many people need vascular access for procedures such as hemodialysis. It is desirable that this access remain open or patent for the entire duration of the course of treatments. A drug delivery device and methods of using the device are introduced that delivery drug to venous anastomosis of a synthetic vascular access shunt. In some embodiments this device serves as the shunt connecting the target artery and vein to create the vascular access shunt.

Alternating circumferential bridge stent design and methods for use thereof

A stent includes a first section and a second section. The second section is aligned with the first section along a longitudinal axis of the stent. Each section includes a plurality of expandable modules and a plurality of bridging modules. Each expandable module includes a plurality of strut elements that join together at a plurality of apices. Each bridging module includes bridging elements that connect an apex of a first module with an apex of a second module. The plurality of expandable modules or the plurality of bridging modules in the first section are more radially stiff than the plurality of expandable modules or the plurality of bridging modules in the second section such that at least a portion of the first section is configured to be placed in a region of a vein subjected to physiologic compression.

ARTERIOVENOUS GRAFT FOR HEMODIALYSIS WITH PUNCTURE-RESISTANT POSTERIOR AND SIDE WALLS

IMPLANTABLE HEART ASSIST SYSTEM

An extracardiac pumping for supplementing the circulation of blood, including the cardiac output, in a patient without any component thereof being connected to the patient's heart, and methods of using same are disclosed. One embodiment of the intravascular extracardiac system (10) comprises a pump (32) with inflow (50) and outflow (52) conduits that are sized and configured to be implantable intravascularly through a non-primary vessel, whereby it may positioned where desired within the patient's vasculature. The system comprises a subcardiac pump that may be driven directly or electromagnetically from within or without the patient. The pump is configured to be operated continuously or in a pulsatile fashion, synchronous with the patient's heart, thereby potentially reducing the afterload of the heart. In another embodiment, the system is positioned extracorporeally, with the inflow conduit and outflow conduit applied percutaneously to a non-primary vessel for circulating blood to and ...

СПОСОБ ПРЕДОТВРАЩЕНИЯ ИЛИ ЛЕЧЕНИЯ УМЕНЬШЕНИЯ ДОСТУПА ДЛЯ ГЕМОДИАЛИЗА СОСУДОВ И УСТРОЙСТВО ДЛЯ ЕГО ОСУЩЕСТВЛЕНИЯ И ДРУГИЕ СОСУДИСТЫЕ ГРАФТЫ

Настоящая группа изобретений относится к медицине и включает способ для лечения или профилактики васкулопролиферативного заболевания сосудов и устройства для его осуществления. Существо изобретений заключается в локальном экстраваскулярном введении васкулопролиферативного соединения рапамицина, которое осуществляют с помощью устройства, размещаемого на внешней поверхности сосуда. Устройство представляет собой имплантируемую манжету, содержащую гибкий матриксный материал в форме цилиндрической трубки, которая имеет просвет, соответствующий размеру сосуда. Матриксный материал содержит диспергированный в нем антипролиферативный агент - рапамицин, который, постепенно высвобождаясь из манжеты, локально поступает в стенку сосуда. Изобретения обеспечивают эффективное уменьшение или предотвращение васкулярной пролиферации и гиперплазии клеток гладких мышц за счет длительного поступления постоянной концентрации рапамицина локально в стенку сосуда, в частности, в местах доступа для гемодиализа. 8 ...

СИСТЕМЫ КРОВЯНЫХ НАСОСОВ И СПОСОБЫ

Изобретение относится к медицинской технике. Система центробежного кровяного насоса содержит: центробежный насос, содержащий впуск, выпуск и импеллер, имеющий поворотный вал, выполненный с возможностью входа в зацепление с верхней поворотной несущей и с нижней поворотной несущей. Верхняя поворотная несущая проходит от верхней части корпуса во впуск. Нижняя поворотная несущая проходит от нижней части корпуса в его внутреннее пространство. Лопатки на верхней поверхности импеллера продолжаются радиально от центра импеллера. Магнит механически сцеплен с импеллером. Электрический двигатель для магнитного зацеплении с магнитом выполнен с возможностью вращения магнита и импеллера. Трубка входящего потока имеет диаметр 4-6 мм, первый ее конец соединен со впуском, а второй выполнен с возможностью ввода в просвет вены. Трубка входящего потока дополнительно содержит боковой порт. Трубка выходящего потока имеет внутренний диаметр 4-6 мм. Первый ее конец соединен с выпуском, а второй выполнен с возможностью ...

ИМПЛАНТИРУЕМАЯ ВСПОМОГАТЕЛЬНАЯ СЕРДЕЧНАЯ СИСТЕМА

Изобретение относится к устройствам для помощи сердцу и касается имплантируемой насосной системы для дополнения кровообращения пациента без соединения ее компонентов с сердцем пациента. Система содержит насос, имплантируемый подкожно в области паха пациента с помощью минимально инвазионной процедуры, причем насос питается от аккумулятора, и средство для зарядки аккумулятора из-за пределов тела. Насос всасывает кровь через канал входного потока, жидкостно связанный с бедренной артерией пациента посредством подкожного анастомозного соединения, а выводит кровь через канал выходного потока, жидкостно связанный с периферийной артерией, отходящей от дуги аорты пациента, посредством подкожного анастомозного соединения. Насос может действовать непрерывно или пульсирующим образом, синхронно с сердцем пациента, тем самым потенциально уменьшая насосную нагрузку на сердце. Изобретение обеспечивает поддержание нормальной гемодинамики у пациента. 9 з.п.ф-лы, 6 ил.

СИСТЕМА И СПОСОБ УВЕЛИЧЕНИЯ НАРУЖНОГО ДИАМЕТРА ВЕН

УСТРОЙСТВО И СПОСОБЫ РЕАЛИЗАЦИИ ПЕРФУЗИОННОГО НАСОСА

... 1. Система перфузионного насоса, содержащая:центробежный перфузионный насос с рабочим диапазоном от около 50 мл/мин до около 1500 мл/мин, содержащий:корпус насоса с установленным впускным отверстием для приема крови и направления крови на крыльчатку, при этом корпус насоса имеет верхний упорный подшипник, проходящий от верхней части корпуса к впускному отверстию, и нижний упорный подшипник, проходящий от нижней части корпуса во внутреннее пространство корпуса;крыльчатку, подвешенную внутри корпуса, при этом первый зазор между крыльчаткой и верхней частью корпуса лежит в диапазоне от около 0,05 мм до 0,2 мм, крыльчатка, содержащую:ось крыльчатки, имеющую первый конец для зацепления с верхней осью и второй конец для зацепления с нижней осью;множество лопаток, расположенных на верхней поверхности крыльчатки и направленных радиально от центра крыльчатки, лопатки, заставляющие кровь, принимаемую через впускное отверстие, проходить через корпус насоса к выпускному отверстию; ипо меньшей мере ...

Implantierbares Shuntsystem

Die Erfindung umfaßt ein Shuntsystem für eine Drainage.

ZUGANGSVORRICHTUNG MIT VENTIL UND KOMBINERTEM VERRIEGELUNGSELEMENT FÜR VERFAHREN ZUR FLÜSSIGKEITSÜBERTRAGUNG

Vorrichtung und Verfahren zur Schwingungsanregung wenigstens eines Abschnitts einer Gefäßzugangseinrichtung zu deren Überwachung

Die vorliegende Erfindung betrifft eine Vorrichtung (13) zum Überwachen einer Gefäßzugangseinrichtung (5), mit wenigstens einem Siganlgeber (15) zum Erzeugen von Schwingungen zum Anregen der Gefäßzugangseinrichtung (5) oder des Abschnitts hiervon zum Schwingen, wenigstens einem Signalempfänger (15) zum Erfassen von Schwingungen der Gefäßzugangseinrichtung (5) oder des Abschnitts hiervon und wenigstens einer Auswerteeinrichtung (16) zum Auswerten der erfassten Schwingungen. Ferner wird ein Verfahren zum Überwachen der Gefäßzugangseinrichtung (5) unter Verwenden der erfindungsgemäßen Vorrichtung (13) angegeben.

IMPLANTIERBARES SYSTEM ZUR HERZUNTERSTÜTZUNG

Arterial haemodialysis graft

IMPLANTIERBARES HEART SUPPORT SYSTEM

MORE CATCH-STEADILY HYDROCEPHALI SHUNT

KAN�LE ALSO AGAIN ORIENTATIONS POINT

APPARATUS FOR THE MONITORING OF AN ENTRANCE WITH ELECTRODES FROM CONDUCTIVE POLYMER MATERIALS

DIALYSIS MACHINE WITH A DEVICE TO THE COLLECTION OF THE SEPARATION OF THE VENOUS NEEDLE OF A PATIENT DURING THE EXTRAKORPORALEN BLOOD TREATMENT

ARTIFICIAL BLOOD VESSEL

Apparatus for vascular access for chronic hemodialysis

System and method for noninvasive hemodynamic measurements in hemodialysis shunts

BLOOD PUMP SYSTEMS AND METHODS

The present invention relates to a rotary blood pump with a double pivot contact bearing system with an operating range between about 50 mL/min and about 1500 mL/min. The rotary blood pump is part of a blood pump system that includes blood conduit(s), a control system with optional sensors, and a power source. Embodiments of the present invention may include elements such as wear resistant bearing materials, a rotor back plate for magnetic attraction of the rotor to reduce bearing pivot bearing forces and wear, a rotor size and shape and a bearing gap that combine to create a hydrodynamic bearing effect and reduce bearing pivot bearing forces and wear, improved intravascular conduits with increased resistance to thrombosis, conduit insertion site cuffs to resist infection, and conduit side ports amenable to the easy insertion of guidewire and catheter-based medical devices.

Anastomotic devices and methods

Exemplary embodiments comprise AV fistulas and other anastomotic devices for creating new or reinforcing existing side-branch vessels, and/or bridging neighboring vessels together. An exemplary embodiment may comprise a sidewall port, such as a flanged sidewall port, and/or flow frame design, such as a partially bare, flexible stent or a whisk, for purposes of creating a transmural flow. Another exemplary embodiment may comprise a compliant vessel support to aid in the transition from device to vessel and/or vessel to device, and to promote vessel dilation.

Vascular stent devices and methods

Described here are devices, systems, and methods for cannulating a vessel. Generally, the method may comprise advancing a stent into a first vessel and deploying the stent in the first vessel to hold open one or more valves. This may permit retrograde blood flow through the blood vessel in peripheral vasculature and aid in cannulation of the blood vessel.

Vascular access system with connector

A connector for fluidly coupling proximal and distal tubular segments of a fluid conduit is provided. In one embodiment, the connector can include a connector body having an outer surface defining a first outer perimeter and an inner surface defining a lumen. The connector can also include a connecting device having an open configuration and a plurality of closed configurations. The connecting device can include first and second members configured to engage each other to secure the fluid conduit to the connector. The connecting device can also include a plurality of closed configurations for securing fluid conduits of different sizes.

System and method for performing alternative and sequential blood and peritoneal dialysis modalities

A dialysis system (10a) includes: a dialysis fluid pump receptacle (64) actuated by a dialysis fluid pump actuator; a dialysis fluid line (70); a blood filter (40) in fluid communication with the dialysis fluid pump receptacle via the dialysis fluid line; an extracorporeal circuit (16); a blood pump receptacle (30a, 30b) actuated by a blood pump actuator and in fluid communication with the blood filter via the extracorporeal circuit; and a control unit (50) that (i) in a first treatment pumps peritoneal dialysis fluid through the dialysis fluid pump receptacle, the dialysis fluid line, the blood filter, the extracorporeal circuit and the blood pump receptacle to the patient's peritoneum operating the dialysis fluid pump actuator and the blood pump actuator at a first pressure, and (ii) in a second treatment pumps blood through the extracorporeal circuit, the blood pump receptacle and the blood filter operating the blood pump actuator at a second, different pressure.

METHOD OF TREATING TRAUMATIC BRAIN INJURY

The present invention concerns methods of treating a patient suffering from a traumatic brain injury (TBI), comprising contacting said patient's blood with a sorbent for an inflammatory mediator and kits for performing such treatments.

VASCULAR STENT DEVICES AND METHODS

Described here are devices, systems, and methods for cannulating a vessel. Generally, the method may comprise advancing a stent into a first vessel and deploying the stent in the first vessel to hold open one or more valves. This may permit retrograde blood flow through the blood vessel in peripheral vasculature and aid in cannulation of the blood vessel.

ENDOVASCULAR ANASTOMOTIC CONNECTOR DEVICE, DELIVERY SYSTEM, AND METHODS OF DELIVERY AND USE

An endovascular anastomotic connector (58) and method of using the same. The endovascular anastomotic connector includes a vascular conduit (62) and a supply conduit (64). The vascular conduit (62) has proximal and distal ends that reside within a vascular structure. The supply conduit (64) extends at an angle from the vascular conduit (62). The proximal end of the supply conduit (64) is configured to be attached to an auxiliary device (56).

CATHETER/FISTULA NEEDLE TO BLOODLINE CONNECTION ASSURANCE DEVICE

In general, multiple embodiments of a catheter/fistula needle to bloodline connection assurance device (20), which secures and strengthens a connection between an extension tube end of a catheter (2) or fistula needle and a bloodline are provided. A first embodiment of the assurance device is configured to be compatible with any industrial catheter/fistula needle female luer connector and is specifically configured for use with a bloodline connector (8) having locking clips (14) which are biased slightly outwardly from the bloodline connector. The first embodiment of the assurance device is cylindrical and includes clamshell halves (22a, 22b) that open rotatably about at least one hinge (24a, 24b). The first embodiment of the assurance device includes an upper, threaded portion and a lower housing portion. The interior wall of the upper portion defines a plurality of barbs (36) configured to engage with distal or movable ends of the locking claps. Each locking clip is biased slightly outwardly ...

ANASTOMOTIC DEVICES AND METHODS

Exemplary embodiments comprise AV fistulas and other anastomotic devices for creating new or reinforcing existing side-branch vessels, and/or bridging neighboring vessels together. An exemplary embodiment may comprise a sidewall port, such as a flanged sidewall port, and/or flow frame design, such as a partially bare, flexible stent or a whisk, for purposes of creating a transmural flow. Another exemplary embodiment may comprise a compliant vessel support to aid in the transition from device to vessel and/or vessel to device, and to promote vessel dilation.

DEVICE AND METHOD FOR MONITORING ACCESS TO A PATIENT, IN PARTICULAR ACCESS TO VESSELS DURING EXTRACORPOREAL BLOOD TREATMENT

The invention relates to a device and to a method wherein access to a pat ient, in particular access to vessels, can be monitored during extracorporea l blood treatment during which a loop (27) is formed in the arterial and/or venous line (6, 7). Inventive means (26) for fixing a section of the line in the form of a loop are provided. When the line is stressed under tension, t he loop contracts until the line finally kinks. The modification of the diam eter of the line and finally the formation of a kink in the line leads to a rise of pressure in the line, which is monitored by a pressure monitoring de vice. If the pressure exceeds a predetermined threshold value, the aspiratin g cannula is in danger of slipping out of the vessel access, has partially o r has completely slipped out thus allowing the threshold value to be determi ned for prealarms or alarms.

METHOD FOR MONITORING HYPERTENSION-AFFECTED HEMODIALYZED PATIENTS

The invention relates to a calculation and control system for determining whether a patient intended to follow several haemodialysis treatment sessions belongs to one group taken from several groups of hypertensive patients, the system comprising: a) means for determining the value of at least one parameter representative of the change in weight of the patient between dialyses for at least two sessions; b) means for determining the value of at least one parameter representative of the plasma conductivity of the patient for at least two sessions; c) means for determining the value of a parameter representative of the ion mass transfer of the treatment for at least two sessions; and d) programmed means for determining whether the patient belongs to a group of hypertensive patients depending on the change in weight of the patient between dialyses and/or on the plasma conductivity and/or on the ion mass transfer.

APPARATUS FOR CONFIGURING AN ARTERIOVENOUS FISTULA

An embodiment of the invention relates to an apparatus for supporting first (AR) and second (VN) blood vessels connected by an anastomosis at a fistula (AVJ), the apparatus comprising: a coupler (120) that seats on and couples to the first blood vessel; and a sleeve (110) connected to the coupler that ensheathes a portion of the second blood vessel in the vicinity of the fistula.

Method and apparatus for machine error detection by combining multiple sensor inputs

One of the most significant safety concerns in the automation of extracorporeal blood treatments such as dialysis is the risk of blood leakage. Extracorporeal blood treatment systems draw blood at such a high rate that a loss of integrity in the blood circuit can be serious. There are a number of mechanisms for detecting and preventing leaks, but none is perfect. This tends to limit the use of such equipment in unsupervised settings, such as the home will be limited. Some leak detection schemes can be made sensitive enough to detect the barest of leaks, but when this is done, they result in too many false positives. The invention combines information from multiple inputs to enhance sensitivity in leak detection and reduce the problem of false positives.

Vascular Shield and Delivery System

Devices for providing physical support to vascular regions including vascular regions that may contain an anastomosis region are disclosed. These devices may also deliver therapeutic agents to the vascular region. Methods for using these devices are disclosed, as well.

Implantable dialysis access port

An implantable access port in accordance with one embodiment of the invention comprises a hollow port casing having a first channel, a second channel and a third channel. A self-sealing insert may be disposed within the third channel. The implantable access port may further comprise a graft having a first branch, a second branch, and a third branch, the first branch extending from the first channel and adapted to be anastomosed to a vessel at a first location, the second branch extending from the second channel and adapted to be anastomosed to a vessel in a second location, the third branch extending at least partially into the third channel, wherein the third branch is disposed between the self-sealing insert and the hollow port casing. Methods for performing medical procedures associated with the implantable access port are also disclosed. 1. An implantable access port comprising:a hollow port casing having a first channel, a second channel and a third channel;a self-sealing insert disposed within said third channel; and, a graft having a first branch, a second branch, and a third branch, said first branch extending from said first channel and adapted to be anastomosed to a first vessel at a first location, said second branch extending from said second channel and adapted to be anastomosed to a second vessel in a second location, said third branch extending at least partially into said third channel, wherein said third branch is disposed between said self-sealing insert and said hollow port casing.2. The implantable access port of claim 1 , wherein said first vessel and said second vessel are portions of the same vessel.3. The implantable access port of claim 2 , wherein said first location and said second location are discrete locations on said vessel.4. The implantable access port of claim 3 , wherein said vessel is an artery and blood is permitted to flow continuously through said graft once anastomosed to said artery in said first location and said second ...

Blood flow controllers and methods

Blood flow restrictors are discussed. In some examples, a blood flow restrictor apparatus is configured to be placed within a destination vessel for an arteriovenous hemodialysis access. In an example, the apparatus includes a tubular portion including a delivery configuration and a deployed configuration. In a further example, a size-limiting portion is configured to constrain a size of the tubular portion in the deployed configuration. The tubular portion, in some examples, includes a first portion including a first size substantially matching an interior size of the destination vessel with the tubular portion in the deployed configuration. In another example, the tubular portion includes a second portion constrained by the size-limiting portion to include a second size smaller than the first size of the tubular portion.

Transvascular Access Methods

Various methods employing transvascular access devices are described, including a method of placing a central catheter in a peripheral vein in an arm of a patient; a method of providing percutaneous access to the heart of a patient; a method of clearing a clotted arteriovenous dialysis graft; a method of creating multiple access points into a single blood vessel; a method of creating an AV fistula in a patient; and a method of providing a bypass to a blockage in a popliteal artery in a patient. 1. A method of placing a central catheter in a peripheral vein in an arm of a patient , the method comprising:inserting an access device percutaneously through an entry site in a femoral vein of the patient, the access device comprising a vascular catheter;advancing a distal end of the vascular catheter from the entry site to an exit site in the peripheral vein;advancing a puncture tool from the distal end of the catheter through the peripheral vein wall and skin of the patient at the exit site; andafter the step of advancing the puncture tool, inserting the central catheter into the peripheral vein at the exit site.2. The method of wherein the peripheral vein comprises a cephalic vein.3. The method of wherein the peripheral vein comprises a basilic vein.4. The method of wherein the peripheral vein comprises a brachial vein.5. A method of providing percutaneous access to the heart of a patient claim 1 , the method comprising:inserting an access device percutaneously through an entry site in a femoral artery of the patient, the access device comprising a vascular catheter;advancing a distal end of the vascular catheter from the entry site to an exit site in an axillary artery of the patient;advancing a puncture tool from the distal end of the catheter through the axillary artery wall and skin of the patient at the exit site;after the step of advancing the puncture tool, inserting a cardiac access catheter into the axillary artery at the exit site; andadvancing the cardiac ...

Arteriovenous Graft for Hemodialysis with Puncture-Resistant Posterior and Side Walls

An arteriovenous dialysis access graft configured to be implanted in a subject includes: at least one flexible conduit having first and second end portions, wherein the first end portion is configured to connect to an artery of the subject and the second end portion is configured to connect to a vein of the subject such that blood flows through the at least one conduit; and at least one cannulation chamber positioned between the first end portion and the second end portion of the at least one conduit. The chamber includes: an elongated housing having an inlet and an outlet, a posterior wall, a pair of sidewalls, and an open anterior portion defining a cannulation port; and a self-sealing material extending across the cannulation port. The posterior wall and the sidewalls of the housing are formed of a substantially rigid material. 1. An arteriovenous dialysis access graft configured to be implanted in a subject , comprising:at least one flexible conduit having first and second end portions, wherein the first end portion is configured to connect to an artery of the subject and the second end portion is configured to connect to a vein of the subject such that blood flows through the at least one conduit from the first end portion to the second end portion; and an elongated housing having an inlet at a first end thereof and an outlet at a second, opposed end thereof, a posterior wall, a pair of sidewalls, and an open anterior portion defining a cannulation port, wherein the cannulation port has a length that spans at least a major portion of a length of the housing;', 'a self-sealing material extending across the cannulation port; and', 'a longitudinal passageway defined by the housing and the self-sealing material that extends from the inlet to the outlet of the housing;, 'at least one cannulation chamber positioned between the first end portion and the second end portion of the at least one conduit, the chamber comprisingwherein the posterior wall and the sidewalls ...

SYSTEM AND METHODS FOR CONTROLLING RETROGRADE CAROTID ARTERIAL BLOOD FLOW

A retrograde flow system is configured for treating an artery. The system includes an arterial access device adapted to be introduced into an artery and receive blood flow from the artery. A shunt fluidly is connected to the arterial access device, wherein the shunt provides a pathway for blood to flow from the arterial access device to a return site. A flow control assembly is coupled to the shunt and is adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. A shut-off valve assembly automatically blocks fluid flow through the shunt in response to injection of the fluid into the arterial access device. 1. A retrograde flow system for treating an artery , comprising:an arterial access device adapted to be introduced into an artery and receive blood flow from the artery;a shunt fluidly connected to the arterial access device, wherein the shunt provides a pathway for blood to flow from the arterial access device to a return site;a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state; anda shut-off valve assembly that regulates fluid flow through the shunt, wherein the shut-off valve assembly automatically blocks fluid flow through the shunt in response to injection of the fluid into the arterial access device.2. A system as in claim 1 , further comprising a fluid line that communicates with the shut-off valve assembly and the arterial access device claim 1 , wherein the fluid line provides a pathway for injecting fluid into the arterial access device claim 1 , and wherein the fluid line communicates an injection pressure to the shut-off valve assembly.3. A system as in claim 2 , wherein the flow control assembly comprises a single housing through which at least a portion of the shunt and a portion of the fluid line pass through.4. A system as in claim 1 , wherein the shut ...

Hybrid arteriovenous shunt

An apparatus for positioning a graft and catheter operable for subcutaneous access to the vascular system of a patient. A surgically created, hybrid arteriovenous shunt is provided which comprises a flexible graft and a venous outflow catheter connected to the graft via surgical anastomosis over a cuff. The graft is connected to an arterial source and then to a single lumen venous outflow catheter which deposits dialyzed blood directly into the heart at the right atrium. Methods of surgical placement and performing hemodialysis using embodiments of the apparatus are provided.

Anastomotic connector

An anastomotic connector comprises a generally tubular access port having a first end and a second end, a generally tubular main body portion having a first end and a second end, wherein the second end of the main body portion is positioned adjacent to the second end of the access port such that the main body portion and access port are in fluid communication, and an anchor member received, within the access port and having a plurality of fingers that are extendable from the first end thereof. The fingers of the anchor member are movable between a loaded position wherein the fingers are substantially parallel to a center axis of the access port and an expanded position wherein the fingers are substantially perpendicular to the center axis of the access port.

METHOD FOR THE PERCUTANEOUS CREATION OF AN ARTERIOVENOUS FISTULA (AVF)

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. 1. A method for improving venous access in a patient in need thereof by creating a fistula between a first vessel and a second vessel , the method comprising the steps of:a) inserting, via a percutaneous route, a first device into the first vessel, wherein the first device comprises a catheter that comprises a directional signal source, and wherein the first device further comprises a penetrating element that is capable of being advanced radially outwardly from the first device, the direction of advancement of the penetrating element being aligned to a directional signal produced by the directional signal source;b) inserting, via a percutaneous route, a second device into the second vessel, wherein the second device comprises a sensor, wherein the sensor is capable of detecting a directional signal;c) generating a directional signal and aligning the first and second devices relative to each other such that penetrating element is advanced radially from the first vessel towards the second vessel, thereby forming a channel enabling fluid communication between the first and second vessels; andd) enlarging the channel to form a fistula.2. The method of claim 1 , wherein the first vessel is an artery and the second vessel is a vein.3. The method of claim 1 , wherein the first vessel is a vein and the second vessel is an artery.4. The method of claim 1 , wherein the fistula is an arterio-venous fistula (AVF).5. The method of claim 1 , wherein the first and second vessels are located in a limb of the body.6. The method of claim 5 , wherein limb is an arm.7. The method of claim 5 , ...

Anastomotic devices and methods

Exemplary embodiments comprise AV fistulas and other anastomotic devices for creating new or reinforcing existing side-branch vessels, and/or bridging neighboring vessels together. An exemplary embodiment may comprise a sidewall port, such as a flanged sidewall port, and/or flow frame design, such as a partially bare, flexible stent or a whisk, for purposes of creating a transmural flow. Another exemplary embodiment may comprise a compliant vessel support to aid in the transition from device to vessel and/or vessel to device, and to promote vessel dilation.

Vascular access device

A vascular access device that prevents needle infiltration, provides a repeatable same-site access, and simplifies cannulation all while being minimally invasive and allows patients to self-cannulate.

METHOD AND APPARATUS FOR TREATING AN ARTERIAL LESION

One disclosed embodiment comprises a method for treating lesions in the carotid artery of a mammalian body. The method comprises transcervical access and blocking of blood flow through the common carotid artery (with or without blocking of blood flow through the external carotid artery), shunting blood from the internal carotid artery and treating the lesion in the carotid artery. 1. A method of treating a lesion in a patient , comprising:inserting an arterial access device into an artery through an arterial access location;positioning at least a portion of the arterial access device into a common carotid artery;occluding blood flow in at least a portion of the common carotid artery to form a pressure gradient that establishes retrograde blood flow through the common carotid artery such that blood flows into a lumen of the arterial access device;in addition to establishing retrograde blood flow, actively pumping blood from the common carotid artery to a return location via the arterial access device and a shunt connected to the arterial access device, wherein the arterial access device comprises an elongate member defining an internal lumen that extends from a distal opening at a distal region of the arterial access device to a proximal opening at a proximal region of the arterial access device, wherein the internal lumen receives blood flow through the distal opening from the common carotid artery, and wherein the shunt comprises a sidearm connected to the arterial access device at a location between the distal and proximal openings of the arterial access device, and wherein the shunt provides a pathway for blood to flow out of the internal lumen of the arterial access device at a location between the distal and proximal openings of the arterial access device; andtreating the lesion by deploying a stent on the lesion.2. The method of claim 1 , wherein actively pumping blood comprises using a syringe fluidically connected to the arterial access device to aspirate ...

METHOD AND DEVICE FOR ENHANCED TRANSDERMAL VISUALIZATION OF MEDICAL DEVICES

Implantable and/or insertable devices having a near-IR fluorescing material that allows the device to be visualized through a patient's skin. Also described herein are apparatuses for imaging devices having a near-IR fluorescing material, and methods of imaging devices having a near-IR fluorescing material from within the body, including methods of modifying an implanted device having near-IR fluorescing material. 1. An arteriovenous shunt (AV shunt) implant device that is configured to be visible through the patient's skin using near-infrared (near-IR) illumination , the device comprising:an elongated tubular body the body comprising polytetrafluoroethylene (PTFE) and having an inner lumen forming an inner layer;a first middle layer extending at least partially over the inner layer, the first middle layer comprising a first substrate and a near-IR dye, wherein the near-IR dye is at a concentration of between 0.0001% to 0.5% w/w and comprises one or more of: 1,1′,3,3,3′,3′-Hexamethylindotricarbocyanine iodide (HITCI), and a rylene dye; anda first outer layer extending over the first middle layer and sealing the first middle layer between the first outer layer and the inner layer.2. The device of claim 1 , wherein the near-IR dye is at a concentration of between 0.001% w/w and 0.1% w/w.3. The device of claim 1 , wherein the tubular body comprises a second middle layer separate from the first middle layer claim 1 , wherein the second middle layer comprises a second substrate and a second near-IR dye.4. The device of claim 3 , wherein the second middle layer is covered by the first outer layer or a second outer layer extending over the second middle layer and sealing the second middle layer between the second outer layer and the inner layer.5. The device of claim 3 , wherein the second near-IR dye is the same as the first near-IR dye and the second substrate is the same as the first substrate.6. The device of claim 1 , wherein the first substrate comprises silicone.7. ...

ARTERIOVENOUS GRAFT FOR HEMODIALYSIS WITH PUNCTURE-RESISTANT POSTERIOR AND SIDE WALLS

An arteriovenous dialysis access graft configured to be implanted in a subject includes: at least one flexible conduit having first and second end portions, wherein the first end portion is configured to connect to an artery of the subject and the second end portion is configured to connect to a vein of the subject such that blood flows through the at least one conduit; and at least one cannulation chamber positioned between the first end portion and the second end portion of the at least one conduit. The chamber includes: an elongated housing having an inlet and an outlet, a posterior wall, a pair of sidewalls, and an open anterior portion defining a cannulation port; and a self-sealing material extending across the cannulation port. The posterior wall and the sidewalls of the housing are formed of a substantially rigid material. 1. An arteriovenous dialysis access graft configured to be implanted in a subject , comprising:at least one flexible conduit having first and second end portions, wherein the first end portion is configured to connect to an artery of the subject and the second end portion is configured to connect to a vein of the subject such that blood flows through the at least one conduit from the first end portion to the second end portion; and an elongated housing having an inlet at a first end thereof and an outlet at a second, opposed end thereof, a posterior wall, a pair of sidewalls, and an open anterior portion defining a cannulation port, wherein the cannulation port has a length that spans at least a major portion of a length of the housing;', 'a self-sealing material extending across the cannulation port; and', 'a longitudinal passageway defined by the housing and the self-sealing material that extends from the inlet to the outlet of the housing;, 'at least one cannulation chamber positioned between the first end portion and the second end portion of the at least one conduit, the chamber comprisingwherein the posterior wall and the sidewalls ...

METHODS AND SYSTEMS FOR ESTABLISHING RETROGRADE CAROTID ARTERIAL BLOOD FLOW

Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. The flow control assembly includes one or more components that interact with the blood flow through the shunt. 1. A system for use in accessing and treating a target artery , said system comprising:an arterial access device adapted to be introduced into a common carotid artery and receive blood flow from the target artery;a shunt fluidly connected to the arterial access device, wherein the shunt provides a pathway for blood to flow from the arterial access device to a return site; anda flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state, wherein the flow control assembly includes one or more components that interact with the blood flow through the shunt, wherein the flow control assembly comprises two or more parallel flow paths and a valve to open or close one or more of the flow paths to adjust the state of flow by selectively directing blood flow through one or more of the flow paths.2. A system as in claim 1 , further comprising a port fluidly communicating with the shunt claim 1 , wherein the port may be used to connect an aspiration device to the shunt.3. A system as in claim 2 , further comprising a second valve which controls fluid communication between the shunt and the port.4. A system as in claim 3 , wherein the second valve automatically opens with attachment of an aspiration or injection device ...

SYSTEMS AND METHODS FOR TREATING PULMONARY EDEMA

Systems, methods, and devices are provided for the treatment of edema. In one aspect a method for implanting an indwelling catheter within a vein of a patient is provided. The catheter can extend from a position upstream of at least one outflow port of a duct of the lymph system to a terminal position downstream of the at least one outflow port. In use, a first restriction can be created within the vein proximal to a distal region of the catheter. The first restriction can define a localized low pressure zone distal of the restriction and within a portion of the vein housing the catheter. The low pressure zone can be adjacent to the at least one outflow port to enable fluid to pass from the at least one lymph duct outflow port into the vein. 118-. (canceled)19. A catheter comprising:an elongate shaft comprising a proximal portion and distal portion; anda restrictor comprising a wire frame coupled to a distal portion of the elongate shaft and a covering material that at least partially covers the wire frame, wherein the restrictor is configured to move from a retracted configuration to an expanded configuration, wherein in the expanded configuration, the restrictor at least partially occludes flow through a vessel.20. The catheter of claim 19 , wherein the wire frame is comprised of nitinol.21. The catheter of claim 20 , wherein the wire frame comprises a portion that includes braided wires.22. The catheter of claim 19 , wherein the covering material is a membrane.23. The catheter of claim 19 , wherein the covering material is comprised of a polymeric material.24. The catheter of claim 23 , wherein the polymeric material is polyurethane.25. The catheter of claim 19 , wherein the catheter further comprises a pressure sensor.26. A method for treating heart failure in a patient claim 19 , the method comprising:providing a catheter comprising an elongate shaft comprising a proximal portion and distal portion; and a restrictor comprising a wire frame coupled to a distal ...

METHODS AND SYSTEMS FOR COUPLING CONDUITS

Medical devices including vascular access kits and related methods are disclosed. In some embodiments, a vascular access system may include a first conduit, a second conduit, and a connector that is reversibly or irreversibly coupled to both the first and second conduits such that there is a continuous lumen from the first conduit and the second conduit. In some embodiments the vascular access system may include a connector where the inside geometry of the connector enhances laminar flow. The vascular access system, when implanted and assembled, may be a fully subcutaneous surgical implant. 1. A vascular access system , comprising:a first conduit;a second conduit;a connector comprising an inside luminal wall, a first end, a second end, a first connecting member on the first end, and a second connecting member on the second end,the connector being configured to couple to an end of the first conduit and to an end of the second conduit such that there is a continuous lumen from the first conduit to the second conduit; andwherein the connector is configured to decouple from at least one of the first conduit and the second conduit.2. The vascular access system of claim 1 , wherein the first and the second connecting members further comprise securing devices to couple to the first and/or second conduits;wherein a connection between the connector and the first and/or second conduits is fluid tight.3. The vascular access system of claim 2 , wherein the securing devices are configured to compressibly couple the connector to the first and/or second conduits.4. The vascular access system of claim 1 , wherein there is a continuous inside diameter along the connector; andwherein the continuous lumen extends from an artery, a vein, or an arteriovenous graft to a heart of a mammal.5. The vascular access system of claim 1 , wherein the first and/or second conduits are configured with an impermeable wall segment in a portion nearest to the connector.6. The vascular access system of ...

VASCULAR ACCESS SYSTEM WITH CONNECTOR

A connector for fluidly coupling proximal and distal tubular segments of a fluid conduit is provided. In one embodiment, a system is provided for providing continuous flow of blood between two locations in a patient's cardiovascular system. A first blood conduit is provided that has a distal portion and a proximal portion. The distal portion is adapted to be inserted into a blood vessel at an insertion site and to be advanced therethrough to a location spaced apart from the insertion site. The system is provided with a connector that has a distal portion adapted to be engaged with the proximal portion of the first blood conduit and a tubular body extending proximally of the distal portion. The tubular body is adapted to be inserted into and/or attached to an end of a second blood conduit, such as a vascular graft or the like. 1. A system for providing continuous flow of blood between two locations in a cardiovascular system of a patient , the system comprising:a blood conduit having a distal portion and a proximal portion, the distal portion configured to be inserted into a blood vessel at an insertion site and to be advanced therethrough to a location spaced apart from the insertion site; anda connector comprising a distal portion configured to be engaged with the proximal portion of the blood conduit, whereby continuous flow can be provided through the connector and into the blood conduit, wherein the connector comprises one or more engagement features disposed about at least a portion of an outer surface of the distal portion of the connector, wherein the one or more engagement features comprise one or more textured surfaces disposed about all or part of the outer surface of the distal portion of the connector.2. The system of claim 1 , wherein the one or more textured surfaces comprise a pattern disposed about all or part of the outer surface of the distal portion of the connector.3. The system of claim 1 , wherein the one or more engagement features further ...

Method And Apparatus For Treating A Carotid Artery

One disclosed embodiment comprises a method for treating lesions in the carotid artery of a mammalian body. The method comprises transcervical access and blocking of blood flow through the common carotid artery (with or without blocking of blood flow through the external carotid artery), shunting blood from the internal carotid artery and treating the lesion in the carotid artery.

BLOOD PUMP SYSTEMS AND METHODS

A blood pump system for persistently increasing the overall diameter and lumen diameter of peripheral veins and arteries by persistently increasing the speed of blood and the wall shear stress in a peripheral vein or artery for a period of time sufficient to result in a persistent increase in the overall diameter and lumen diameter of the vessel is provided. The blood pump system includes a blood pump, blood conduit(s), a control system with optional sensors, and a power source. The pump system is configured to connect to the vascular system in a patient and pump blood at a desired rate and pulsatility. The pumping of blood is monitored and adjusted, as necessary, to maintain the desired elevated blood speed, wall shear stress, and desired pulsatility in the target vessel to optimize the rate and extent of persistent increase in the overall diameter and lumen diameter of the target vessel. 1. A pump system for pumping blood , the system comprising:a blood pump comprising:an inlet;an outlet;an impeller located fluidly between the inlet and outlet; and,an impeller drive; and,a control system comprising:an outflow pressure sensor located to read a pressure of blood flowing downstream of the impeller;an inflow pressure sensor located to read a pressure of blood flowing upstream of the impeller;a processor in communication with the outflow pressure sensor and inflow pressure; and,a memory with at least one stored target pressure difference, wherein the processor reads both a pressure reading from the outflow pressure sensor and a pressure reading from the inflow pressure sensor and calculates a pressure difference; and,wherein the processor causes the pump impeller drive to operate so the calculated pressure difference is within an acceptable range of the at least one stored target pressure difference.2. The pump system of claim 1 , wherein the system further comprises an outflow conduit operably coupled to the outlet claim 1 , and the outflow pressure sensor is located ...

Methods of Amelioration of Cerebrospinal Fluid and Devices and Systems Therefor

Cerebrospinal fluid (CSF) and other fluid amelioration systems completely or partially implantable within a mammalian subject and associated methods include a substrate and an agent for amelioration of a toxic biomolecule present in the CSF or fluid, wherein the agent is disposed on or within the substrate. 1. A method for treating a mammalian subject suffering from at least one of a pathology , trauma , a neurological disease , a non-neurological disease , or a deficiency characterized by presence of toxic biomolecules in a cerebrospinal fluid (CSF) by amelioration of the toxic biomolecules in the CSF using an ameliorating agent , an amelioration technique , or combinations thereof , the method comprising:selecting a patient having at least one of a risk, a diagnosis, a prognosis, or at least one symptom of a condition selected from the group consisting of pathology, trauma, neurological disease, non-neurological disease, or deficiency;removing a volume of CSF from a first location of the patient;treating the removed volume of CSF with a protease within a cartridge; andreturning the treated volume of CSF to the patient at a second location.2. The method of claim 1 , further comprising flowing the CSF through the cartridge sequentially or reversibly.3. The method of claim 1 , wherein the cartridge comprises a gamma radiation sterilized cartridge.4. The method of claim 1 , wherein the cartridge comprises at least one of a protease disposed in the cartridge or a protease decorated on an interior surface of the cartridge.5. The system of claim 1 , wherein the protease modifies or degrades a biomolecule present in the CSF by protease digestion.6. The method of claim 1 , wherein the protease comprises a serine protease.7. The method of claim 1 , wherein the protease comprises a threonine or proline protease.8. The method of wherein the protease is selected from the group consisting of a trypsin; an elastase; a proteinase K; clostripain; a rhinovirus protease 3C; a ...

SYSTEM AND METHOD TO INCREASE THE OVERALL DIAMETER OF VEINS

A system and method for increasing the speed of blood and wall shear stress (WSS) in a peripheral vein for a sufficient period of time to result in a persistent increase in the overall diameter and lumen diameter of the vein is provided. The method includes pumping blood at a desired rate and pulsatility. The pumping is monitored and adjusted, as necessary, to maintain the desired blood speed, WSS and pulsatility in the peripheral vein in order to optimize the rate and extent of dilation of the peripheral vein. 1. A method for creating an arteriovenous fistula or an arteriovenous graft in a human patient , the method comprising:fluidly connecting one end of a pump-conduit assembly to a donating vein;fluidly connecting another end of the pump-conduit assembly to an accepting vein;pumping deoxygenated blood from the donating vein into the accepting veinpumping deoxygenated blood from the donating vein into the accepting vein for a period of time sufficient to result in a persistent increase in the overall diameter of the accepting vein, wherein a mean pulse pressure in the conduit fluidly connected to the accepting vein is less than 20 mmHg; and,creating the arteriovenous fistula or arteriovenous graft in the patient using at least a portion of the accepting vein with the persistently-increased overall diameter.2. The method of claim 1 , wherein the patient is in need of an arteriovenous fistula or arteriovenous graft for hemodialysis.3. The method of claim 1 , wherein the pump-conduit assembly pumps blood at a rate between 50 ml/min and 1500 ml/min.4. The method of claim 1 , wherein the pump-conduit assembly pumps blood at a rate between 100 ml/min and 1000 ml/min.5. The method of claim 1 , wherein a wall shear stress in the accepting vein is greater than or equal to 0.76 Pa when the pump-conduit assembly is in operation.6. The method of claim 1 , wherein a wall shear stress in the accepting vein is between 0.76 Pa and 23 Pa when the pump-conduit assembly is in ...

SYSTEM AND METHOD TO INCREASE THE OVERALL DIAMETER OF VEINS

A system and method for increasing the speed of blood and wall shear stress (WSS) in a peripheral vein for a sufficient period of time to result in a persistent increase in the overall diameter and lumen diameter of the vein is provided. The method includes pumping blood at a desired rate and pulsatility. The pumping is monitored and adjusted, as necessary, to maintain the desired blood speed, WSS and pulsatility in the peripheral vein in order to optimize the rate and extent of dilation of the peripheral vein. 1. A system for increasing an overall diameter and a lumen diameter of a peripheral vein prior to creation of an arteriovenous fistula or an arteriovenous graft in a patient comprising: a pump configured to pump blood, having a pump inlet and a pump outlet;', 'a first conduit configured to carry blood having an inlet configured to fluidly connect to a donating vein or right atrium to remove the deoxygenated blood from the donating vein or to the right atrium, such first conduit comprising a catheter configured for insertion into a vein and advancement within the lumen of the vein, including into the right atrium; and an outlet fluidly connected to the pump inlet;', 'a second conduit configured to carry blood having an inlet fluidly connected to the pump outlet and an outlet to fluidly connect to a peripheral vein, such conduit comprising a first segment comprising a catheter and configured to connect to the pump outlet and a second segment configured to enable the creation of a surgical anastomosis between an end of the second segment and the peripheral vein using the end of the second segment to attach to the side of the peripheral vein; and, 'a pump-conduit assembly to remove deoxygenated blood from a donating vein or the right atrium and pump blood into the peripheral vein, the pump-conduit assembly includinga control unit to control the pump and pump deoxygenated blood into the peripheral vein at a rate to maintain a mean wall shear stress in the ...

SYSTEMS AND METHODS FOR TREATING PULMONARY EDEMA

Systems, methods, and devices are provided for the treatment of edema. In one aspect a method for implanting an indwelling catheter within a vein of a patient is provided. The catheter can extend from a position upstream of at least one outflow port of a duct of the lymph system to a terminal position downstream of the at least one outflow port. In use, a first restriction can be created within the vein proximal to a distal region of the catheter. The first restriction can define a localized low pressure zone distal of the restriction and within a portion of the vein housing the catheter. The low pressure zone can be adjacent to the at least one outflow port to enable fluid to pass from the at least one lymph duct outflow port into the vein. 118-. (canceled)19. A method for treating heart failure in a patient , the method comprising:providing a system comprising: a catheter apparatus comprising one or more restrictors and one or more sensors; and a control module operable coupled to the catheter apparatus, wherein the control module receives feedback from the one or more sensors and controls the one or more restrictors based on the feedback from the one or more sensors;advancing the catheter apparatus into a superior vena cava of a patient; andoperating the catheter apparatus to regulate venous blood return through the superior vena cava, wherein operating at least comprises activating the one or more restrictors within the superior vena cava to at least partially occlude flow through the superior vena cava and adjusting the one or more restrictors based on feedback from the one or more sensors, thereby treating heart failure in the patient.20. The method of claim 19 , wherein the one or more restrictors fully restrict flow through the superior vena cava.21. The method of claim 19 , wherein the catheter apparatus is advanced through a subclavian or jugular vein.22. The method of claim 19 , wherein the one or more sensors are one or more pressure sensors.23. The ...

SYSTEMS AND METHODS FOR TREATING PULMONARY EDEMA

Systems, methods, and devices are provided for the treatment of edema. In one aspect a method for implanting an indwelling catheter within a vein of a patient is provided. The catheter can extend from a position upstream of at least one outflow port of a duct of the lymph system to a terminal position downstream of the at least one outflow port. In use, a first restriction can be created within the vein proximal to a distal region of the catheter. The first restriction can define a localized low pressure zone distal of the restriction and within a portion of the vein housing the catheter. The low pressure zone can be adjacent to the at least one outflow port to enable fluid to pass from the at least one lymph duct outflow port into the vein. 118-. (canceled)19. A method for treating heart failure in a patient , the method comprising:advancing a catheter apparatus comprising one or more restrictors through a subclavian or jugular vein and into a superior vena cava of a patient; andoperating the catheter apparatus to regulate venous blood return through the superior vena cava, wherein operating at least comprises activating the one or more restrictors within the superior vena cava to at least partially occlude flow through the superior vena cava while maintaining intravascular pressure, thereby treating heart failure in the patient.20. The method of claim 19 , wherein the one or more restrictors fully restrict flow through the superior vena cava.21. The method of claim 19 , wherein the catheter apparatus further comprises one or more pressure sensors.22. The method of claim 21 , wherein the one or more restrictors are adjusted based on feedback from the one or more pressure sensors.23. The method of claim 19 , wherein the catheter apparatus is operably coupled to a control module.24. The method of claim 23 , wherein the control module receives feedback from one or more sensors of the catheter apparatus and controls the one or more restrictors based on the feedback ...

VASCULAR ACCESS IMPLANT AND ACCESS IMPLANT SYSTEM

A vascular access implant and system for connecting an intracorporeal blood circulation to an extracorporeal blood circulation includes an arterial fluid line for connection to a patient's artery and a venous fluid line for connection to a patient's vein. A controllable artery-vein-connection between the arterial fluid line and venous fluid line controls fluid flow between the arterial fluid line and venous fluid line. An arterial port is in fixed fluid connection with the arterial fluid line for coupling to and decoupling from a first hose of the extracorporeal blood circulation. A venous port is in fixed fluid connection with the venous fluid line for coupling to and decoupling from a second hose of the extracorporeal blood circulation. 1. A vascular access implant for connecting an intracorporeal blood circulation to an extracorporeal blood circulation , the vascular access implant comprising:an arterial fluid line adapted to be permanently connected to an artery of a patient;a venous fluid line adapted to be permanently connected to a vein of the patient;a controllable artery-vein-connection between the arterial fluid line and the venous fluid line that controls a fluid flow between the arterial fluid line and the venous fluid line;an arterial port which is in fixed fluid connection with the arterial fluid line and is adapted, as an arterial access, for coupling to and decoupling from a first hose of the extracorporeal blood circulation; anda venous port which is in fixed fluid connection with the venous fluid line and is adapted, as a venous access, for coupling to and decoupling from a second hose of the extracorporeal blood circulation.2. The vascular access implant according to claim 1 , wherein:the arterial port comprises an arterial connecting lock that firmly connects to the first hose by a positive fit and/or frictional fit, and/orthe venous port comprises a venous connecting lock that firmly connects to the second hose by a positive fit and/or ...

Magnetically Activated Arteriovenous Access Valve System and Related Methods

In one aspect, an arteriovenous access valve system may generally include a first valve configured to be positioned at or adjacent to an end of arteriovenous graft and a second valve configured to be positioned at or adjacent to an opposite end of the arteriovenous graft. In addition, the system may include an actuator assembly in fluid communication with the first and second valves. The actuator assembly may include a housing, a driver assembly positioned within the housing and a drive magnet positioned within the housing. The drive magnet may be rotatably coupled to the driver assembly such that, when the drive magnet is rotated, the driver assembly is configured to be rotatably driven so as to supply fluid to the first and second valves or to draw fluid out of the first and second valves depending on a rotational direction of the driver assembly.

Devices and Methods for Vascular Hyperperfusion of Extravascular Space

A method of delivering a therapeutic substance for treatment to a region of the body through vascular isolation and manipulation of fluid flux into and from the region of the body including the steps of: restricting vascular inflow to the region of the body; washing out oncotically active plasma proteins from the region of the body by increasing the outward oncotic pressure gradient from the region of the body; inducing ischemia in the region of the body; controlling the pressure and fluid flow of the main blood vessels to and from the region of the body; providing the therapeutic substance to the region of the body when the fluid flow to the region of the body is controlled. 140-. (canceled)41. A method of delivering a therapeutic substance for treatment to a region of the body through vascular isolation and manipulation of fluid flux into and from the region of the body comprising the steps of:restricting vascular inflow to the region of the body;washing out oncotically active plasma proteins from the region of the body into the systemic circulation of the body by increasing the outward oncotic pressure gradient from the region of the body;inducing ischemia in the region of the body;controlling the pressure and fluid flow of the main blood vessels to and from the region of the body; andhyperperfusing the therapeutic substance to the region of the body when the fluid flow to the region of the body is controlled.42. The method as claimed in claim 41 , wherein the region of the body is an organ.43. The method as claimed in claim 41 , wherein pressure through the vascular inflow is controlled to be less than or equal to 20 mmHg.44. The method as claimed in claim 43 , wherein the pressure through the vascular inflow is controlled to induce critical capillary closure.45. The method as claimed in claim 41 , wherein the oncotically active plasma proteins are washed out to create a reduced intravascular oncotic pressure.46. The method as claimed in claim 41 , wherein ...

Systems and methods for a fluid carrying conduit of a vascular access system

Systems and methods for a blood conduit for fluidly coupling a first vascular segment to a second vascular segment are disclosed herein. In one embodiment, a system for fluidly coupling proximal and distal tubular segments of a fluid conduit in a cardiovascular system is provided. The system may include a first engagement feature disposed on a distal end of the proximal tubular segment. The system also may include a second engagement feature disposed on a proximal end of the distal tubular segment. The first engagement feature may be configured to mate with the second engagement feature. In this manner, continuous flow may be provided between the proximal and distal tubular segments of the fluid conduit. In another embodiment, the proximal and distal tubular segments of the fluid conduit may collectively form a single unitary lumen without a connection device interposed between the segments.

DIALYSIS VALVE AND METHOD

A dialysis valve includes a tube attached between an artery and a vein which, when elongated, simultaneously narrows in diameter at at least one location. The narrowed portion of the tube decreases the volume and velocity between the arterial and venous side of the patient to prevent damage or intimal hyperplasia on the venous side between dialysis treatments. When the valve is opened for dialysis, an unrestricted blood flow exists between the arterial and venous side, permitting a controlled, open blood flow during dialysis. 1. (canceled)2. An implantable dialysis valve device for fluid connection with a blood vessel , comprising:an implantable valve actuation device sized to fit in a body limb proximate to a vein;a blood input graft connected with the implantable valve actuation device to attach with a blood vessel for receiving blood when the implantable valve actuation device is implanted;a blood output graft connected with the implantable valve actuation device to attach with a blood vessel for outputting blood when the implantable valve actuation device is implanted;a flexible implantable tube coupled to the implantable valve actuation device to convey blood received from the blood input graft, the flexible implantable tube extending for a longitudinal length and comprising a flexible polymer material; andthe implantable valve actuation device comprising: a self-sealing membrane configured to be repeatedly punctured by an infusion needle when the self-sealing membrane is implanted adjacent to an underside of a skin region, a hydraulic port adjacent to the self-sealing membrane such that the self-sealing membrane is positioned between the hydraulic port and the skin region when the self-sealing membrane is implanted adjacent to the underside of the skin region, and a hydraulic line extending between the hydraulic port and a controllable valve actuation member, wherein the controllable valve actuation member is configured to selectively adjust blood flow through ...

METHOD FOR CONFIGURING AN ARTERIOVENOUS FISTULA

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. 1. 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 having an end connected to a coupler, the coupler comprising a mount configured to be seated on a second blood vessel, so that an open end of the first blood vessel segment protrudes from the sleeve end and the mount;suturing edges of an incision made in a second blood vessel to the open end of the first blood vessel segment to create an anastomosis; andsliding the sleeve and coupler along the first blood vessel to seat the mount onto the second blood vessel at the anastomosis.2. The method according to claim 1 , wherein seating the mount further comprises one or a combination of:closing a brace incorporated in the mount around the second blood vessel; andsuturing or bonding the coupler to the second blood vessel.3. The method according to further comprising:configuring the sleeve from a longitudinally compressed state having a first diameter greater than that of the first blood vessel to a longitudinally expanded state having a diameter smaller than the that of the first blood vessel in order to enclose the portion of the first blood vessel firmly in the lumen of the sleeve.4. The method according to claim 1 , wherein the coupler is configured to deform the second blood vessel to have a non-circular cross section.5. The method according to claim 1 , wherein the coupler is configured to hold the sleeve claim 1 , relative to ...

INTRAVASCULAR SHUNT FOR TRAUMATIZED ARTERIES

The present invention relates to a catheter assembly including a catheter body, a first and a second set of a plurality of fenestrations, a first and a second inflatable device, a first and a second pleat, at least one obstructing stop near each end portion of the catheter body, and a first and a second flexible tube connected to the first and the second inflatable device. The catheter assembly further includes a pumping device in communication with the first and the second inflatable device via the first and the second flexible tube. The catheter assembly is used to restore blood flow to a traumatized blood vessel. 1. A catheter assembly for restoring blood flow to a traumatized blood vessel , comprising:a catheter body, in a tubular shape, comprising: a first and a second tip, each configured to permit insertion into a blood vessel without damaging an inner wall of a blood vessel lumen;a first and a second set of a plurality of fenestrations, disposed proximate to each tip extending a length of the catheter body away from each tip towards a center portion of the tubular catheter body;a first and a second inflatable device, placed circumferentially and longitudinally about the catheter body, configured such that when uninflated each is capable of sliding over a section of the catheter body, and when inflated an inner annulus of each presses against an outer perimeter of the catheter body;a first and a second pleat, spaced apart by a midsection, located in the center portion of the catheter body between the first and the second inflatable device;at least one obstructing stop, located on the outer perimeter of the catheter body in a section longitudinally adjacent to each of the first and the second set of the plurality of fenestrations towards the center portion, to obstruct the first or the second inflatable device from sliding over the first or second set of a plurality of fenestrations proximate to the first or the second tip of the catheter body, anda first and ...

PERCUTANEOUS ACCESS DEVICE

A percutaneous access device comprises a frame, a hatch and a hinge that couples the frame to the hatch. The frame has a passageway that extends therethrough. When the percutaneous access device is implanted in a patient, the frame is positioned beneath a layer of skin of the patient against a bodily vessel. Moreover, the hinge biases the hatch closed against the frame in a normally closed position such that liquid flowing through a lumen of the vessel cannot escape through the percutaneous access device. However, the application of force against the hatch from an object (such as a needle) that extends through the passageway causes the hatch to open outwardly from the frame and into the lumen of the vessel. Correspondingly, the hinge biases the hatch back to the normally closed position upon removal of the object. 2. The percutaneous access device according to claim 1 , wherein: a base member having a first major surface; and', 'an extension that projects from the first major surface;', 'the passageway extends through the base member and the extension;', 'wherein], 'the frame further comprises the base member is positioned beneath a layer of skin of the patient;', 'the first major surface of the base member faces the vessel; and', 'the extension passes through a wall of the vessel., 'wherein3. The percutaneous access device according to claim 1 , wherein the frame claim 1 , hatch and hinge include at least one of a titanium material or a stainless steel material.4. The percutaneous access device according to claim 1 , wherein:the hinge includes a spring that biases the hatch into the normally closed position.5. The percutaneous access device according to further comprising:a self-healing material secured within the passageway such that when the object, implemented as a needle, is inserted through the passageway, the needle penetrates the self-healing material to open the hatch and access the lumen of the vessel, and retraction of the needle causes the self-healing ...

SIMULTANEOUS ECMO AND CRRT

A controller for controlling an apparatus comprising a blood pump, oxygenator, and blood filtering system connected together by blood flow tubing and to a patient to circulate blood from the patient through the apparatus and back to the patient, to oxygenate and filter the blood, the controller comprising at least one communication interface operable to receive signals generated responsive to monitored parameters characterizing blood flow and/or quality of blood from the patient circulating through the apparatus and configured to: determine values for the monitored parameters based on the monitoring signals; determine whether or not a value determined for a given monitored parameter for blood circulating through the apparatus is within a normative range for the parameter; and generate an alarm to alert an operator of the system if the value is not within the normative range. 1. A controller for controlling an apparatus comprising a blood pump , oxygenator , and blood filtering system connected together by blood flow tubing configured to circulate blood from a patient through the apparatus and back to the patient , to oxygenate and filter the blood , the controller comprising:at least one communication interface operable to receive wireless and/or wire monitoring signals generated responsive to monitored parameters characterizing blood flow and/or quality of blood from the patient circulating through the apparatus at locations in and outside of the blood filtering system;a memory comprising a database having data that defines normative ranges for values of the monitored parameters; anda processor comprising computer executable instructions executable to:determine values for the monitored parameters based on the monitoring signals;determine whether or not a value determined for a given monitored parameter for blood circulating through the apparatus is within the normative range for the parameter; andgenerate an alarm if the value is not within the normative range.2. ...

ONE PIECE ANASTOMOTIC CONNECTOR

A one piece anastomotic connector is provided. The one piece anastomotic connector is substantially T-shaped in cross-section and has an arterial portion and a venous portion, the arterial portion is implantable into an arterial passageway and the venous portion implantable into a venous passageway. The venous portion and the arterial portion are integrally formed. The arterial portion allows for undisturbed, full flow of blood into extremities of a patient downstream the anastomotic connector. 1. An anastomotic connector comprising:a one piece anastomotic connector having an arterial portion having a first open end and a second open end and implantable into an arterial passageway, a venous portion having a single open end implantable into a venous passageway, the arterial portion and venous portion coupled by an integrally formed tubular body portion, said one piece anastomotic connector being T-shaped in cross section,wherein an outer diameter of the venous portion is greater than an outer diameter of the arterial portion and the first and second openings of the arterial portion allow for undisturbed, full flow of blood into extremities of a patient downstream the anastomotic connector.2. The anastomotic connector of wherein the tubular body portion extends radially outward from a mid-portion of the arterial portion.3. The anastomotic connector of wherein said venous portion includes an anchoring device on the open end that extends radially outwardly at an acute angle from a longitudinal axis of the venous connector.4. The anastomotic connector of wherein said anchoring device is configured to lie adjacent a venous vessel wall.5. The anastomotic connector of wherein said anchoring device is configured to penetrate a venous vessel wall to seat said venous portion in a venous passageway.6. The anastomotic connector of wherein said anastomotic connector is coated with a fluid impermeable material.7. The anastomotic connector of wherein said anastomotic connector is ...

PERIPHERAL ARTERIALIZATION DEVICES AND METHODS OF USING THE SAME

Peripheral arterialization devices and methods of using the same. In an exemplary embodiment of a catheter for facilitating venous arterialization of the present disclosure, the catheter comprises an elongated body extending from a proximal end to a distal end and having a lumen defined therethrough along a longitudinal length of the elongated body, the elongated body configured to attach to a graft at or near the proximal end of the elongated body and further configured to permit fluid to flow through the graft, through the lumen, and out of one or more apertures defined within the elongated body at or near the distal end to facilitate venous arterialization upon at least partial implantation of the catheter into a vein of a patient. 1. A catheter for facilitating venous arterialization , comprising:an elongated body extending from a proximal end to a distal end and having a lumen defined therethrough along a longitudinal length of the elongated body, the elongated body configured to attach to a graft at or near the proximal end of the elongated body and further configured to permit fluid to flow through the graft, through the lumen, and out of one or more apertures defined within the elongated body at or near the distal end to facilitate venous arterialization upon at least partial implantation of the catheter into a vein of a patient.2. The catheter of claim 1 , wherein the elongated body further comprises a balloon coupled thereto claim 1 , the balloon operable to inflate and deflate within a vein and further configured to occlude the vein upon inflation.3. The catheter of claim 1 , wherein when at least part of the catheter is implanted into the patient claim 1 , oxygenated arterial blood is permitted to flow through the graft claim 1 , through the lumen claim 1 , and out of the one or more apertures to facilitate peripheral vein arterialization.4. The catheter of claim 1 , wherein when the lumen has first cross-sectional area claim 1 , pressure of the fluid ...

Endovascular anastomotic connector device, delivery system, and methods of delivery and use

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.

ENDOVASCULAR DEVICE FOR DYSFUNCTIONAL FISTULAS

The endovascular device () according to the invention comprises a first tubular sheath in turn comprising a fibrous layer () made of a fibrous material containing a coherent assembly of fibers. The ends of the device () form two expansion sections (A, B) each of which in turn comprises an expander device () arranged to radially expand the endovascular device () at least in correspondence with the respective expansion section (A,B). The fibrous layer (), in particular in correspondence with the intermediate section () is, on the other hand, prickable and capable of quickly closing and resealing the holes produced by the needles for dialysis, transfusions or injections. This feature allows () compared to current devices, to treat malfunctioning dialysis fistulas and to avoid the exclusion of a part of the superficial venous circuit potentially usable for the hemodialysis session, so that the device being a maintenance device for fistulas from dialysis. 11577701771) Endovascular device () for dysfunctional dialysis surgical fistulas comprising a first tubular sheath comprising a fibrous layer () made of a fibrous material containing a coherent set of fibers , characterized in that that said endovascular device comprises at least two expansion sections (A , B) wherein each of them comprises an expander device () arranged to radially expand the endovascular device () at least in correspondence with the respective expansion sections (A , B) , said device () being a device for the treatment of dysfunctional surgical fistulas , adapted to be inserted inside the surgical fistula , when it begins to shrink or occlude after a certain number of punctures , to keep it pervious , increasing the survival of the dialysis fistulas.211771) Endovascular device () according to claim 1 , wherein the endovascular device () forms two ends and each expansion section (A claim 1 , B) is placed at or near a respective end of the endovascular device () itself.311117011) Endovascular device () ...

PERIPHERAL ARTERIALIZATION DEVICES AND METHODS OF USING THE SAME

Peripheral arterialization devices and methods of using the same. In an exemplary embodiment of a catheter for facilitating venous arterialization of the present disclosure, the catheter comprises an elongated body extending from a proximal end to a distal end and having a lumen defined therethrough along a longitudinal length of the elongated body, the elongated body configured to attach to a graft at or near the proximal end of the elongated body and further configured to permit fluid to flow through the graft, through the lumen, and out of one or more apertures defined within the elongated body at or near the distal end to facilitate venous arterialization upon at least partial implantation of the catheter into a vein of a patient. 1. A device for facilitating venous arterialization , comprising:a catheter comprising an elongated body extending from a proximal end to a distal end and having a lumen defined therethrough along a longitudinal length of the elongated body; anda graft, wherein the elongated body is configured to attach to the graft at or near the proximal end of the elongated body;wherein the device is configured to permit fluid to flow through the graft, through the lumen, and out of one or more apertures defined within the elongated body at or near the distal end to facilitate venous arterialization upon at least partial implantation of the device into a vein of a patient.2. The device of claim 1 , wherein the elongated body further comprises a balloon coupled thereto claim 1 , the balloon operable to inflate and deflate within a vein and further configured to occlude the vein upon inflation.3. The device of claim 1 , wherein when at least part of the catheter is implanted into the patient claim 1 , oxygenated arterial blood is permitted to flow through the graft claim 1 , through the lumen claim 1 , and out of the one or more apertures to facilitate peripheral vein arterialization.4. The device of claim 1 , wherein when the lumen has first cross- ...

IN-BODY PERFUSION SYSTEM

An implantable perfusion device () comprises a tubular transmission line () with an inlet end (), an outlet end () and a flow restriction element () located therebetween, whereby an inlet section () of the transmission line is defined between the inlet end and the flow restriction element and whereby an outlet section () of the transmission line is defined between the flow restriction element and the outlet end. Moreover, the device comprises a perfusion chamber () containing a load of biologically active cells and is provided with a fluid entrance (), a fluid exit () and a chamber volume () formed therebetween. The fluid entrance comprises at least one first microchannel platelet () and the fluid exit comprises at least one second microchannel platelet (), each one of the microchannel platelets comprising at least one array of microchannels () defining a fluid passage between respective external and internal platelet faces, the microchannels having an opening of 0.2 to 10 μm. The fluid entrance () of the perfusion chamber is in fluid communication with the inlet section () of the transmission line; and the flow restriction element () is configured to establish a predetermined pressure excess in the inlet section () versus the outlet section (). 1. An implantable perfusion device , comprising: an inlet end,', 'an outlet end and', 'a flow restriction element located therebetween,, 'a tubular transmission line with'}wherein an inlet section of the transmission line is defined between the inlet end and the flow restriction element andwherein an outlet section of the transmission line is defined between the flow restriction element and the outlet end, a fluid entrance,', 'a fluid exit and', 'a chamber volume formed therebetween;, 'a perfusion chamber comprising [ at least one first microchannel platelet and the fluid exit comprising', 'at least one second microchannel platelet,', 'each one of the microchannel platelets comprising at least one array of microchannels ...

VASCULAR ACCESS DEVICE AND METHOD

A vascular access device is disclosed including a needle insertion guide having a proximal end and a distal end a the guide including a needle insertion guide having a proximal end and a distal end and a vessel interface configured for attaching the distal end of the guide to a target on an unbroken outer wall of a blood vessel of a living subject and a skin interface configured for attaching the proximal end of the guide to a skin of the living subject. Optionally the vessel interface is connected to the guide by a flexible joint configured. Optionally two vascular access devices are connected by an electrically conductive connection. Optionally the vascular access device includes a sensor to determine when a needle enters the blood vessel. Optionally the vascular access device serves as a marker for a sensor determining a status of the blood vessel. 1. An implantable device for vascular access , comprising:{'sup': '2', 'a guide including a lumen shaped and sized to fit a hemodialysis needle constraining the needle to an angle of less than 5 degrees with respect to the lumen and constraining a position of a distal tip of the needle to a target of less than 90 mmat a distal end of said lumen on a front wall of a blood vessel;'}a sensor attached to said guide, said sensor configured to send a signal when a tip of said needle passes a predetermined position within 4 mm of and proximal of said distal end of said lumen; andan indicator responsive to said signal and to produce a signal visible to a practitioner through a skin of a subject.2. The device of claim 1 , wherein a length of the lumen is between 7 mm and 70 mm.3. The device of claim 1 , wherein a length of the lumen is between 7 mm and 35 mm.4. The device of claim 1 , wherein the lumen has an average inner width of between 2 mm and 7 mm.5. The device of claim 1 , wherein said indicator is mounted on said guide.6. The device of claim 5 , wherein said indicator is configured to be visible from outside through ...

METHOD AND APPARATUS FOR DETECTING THE BODY TEMPERATURE OF A PATIENT

The present invention relates to a method for detecting the body temperature of a patient, wherein the patient has a fistula for draining blood into an extracorporeal circuit and/or for supplying blood from an extracorporeal circuit, wherein a thermal image recording of the fistula or of a part of the fistula is produced by means of an infrared camera for the purpose of detecting the body temperature of the patient. The present invention further relates to a dialysis machine. 1. A method for detecting the body temperature of a patient , wherein the patient has a fistula for draining blood into an extracorporeal circuit and/or for supplying blood from an extracorporeal circuit , characterized in that a thermal image recording of the fistula or of a part of the fistula is produced by means of an infrared camera for the purpose of detecting the body temperature of the patient.2. A method in accordance with claim 1 , characterized in that the temperature of the skin of the patient is detected by means of the thermal image recording; and/or in that a conclusion is drawn from this detected temperature value of the skin on the blood temperature in the fistula and/or on the core body temperature.3. A method in accordance with claim 1 , characterized in that the body temperature is measured before and/or during and/or after a dialysis treatment.4. A method in accordance with claim 1 , characterized in that the thermal image recording is made continuously or intermittently.5. A method in accordance with claim 1 , characterized in that the measurement of the body temperature is carried out continuously or intermittently on the basis of the thermal image recording.6. A method in accordance with claim 1 , characterized in that an actual value of a parameter of the thermal image recording or an actual value of a parameter derived therefrom is compared with a desired value or a desired value range; and in that a regulation of the actual value is carried out so that the latter ...

DIAMETRICALLY ADJUSTABLE ENDOPROSTHESES AND ASSOCIATED SYSTEMS AND METHODS

A diametrically adjustable endoprosthesis includes a controlled expansion element extending along at least a portion of a graft and is supported by a stent. The controlled expansion element diametrically constrains and limits expansion of the endoprosthesis. Upon deployment from a smaller, delivery configuration, the endoprosthesis can expand to the initial diameter set by the controlled expansion element. Thereafter, the endoprosthesis can be further diametrically expanded (e.g., using balloon dilation) by mechanically altering the controlled expansion element. 1. A diametrically adjustable endoprosthesis comprising:a stent-graft including a stent and a base graft secured to the stent, the base graft having a first end and a second end and the stent-graft being self-expanding and exhibiting a self-expansion force, the stent-graft having a maximum diametric expansion limit; anda controlled expansion element having a continuous wall, the controlled expansion element having an initial diametric expansion limit and being adjustable to an adjusted diameter in a range of diameters between the initial diametric expansion limit and the maximum diametric expansion limit when placed under an expansion force in addition to the self-expansion force of the stent-graft, the controlled expansion element being configured to maintain the adjusted diameter under physiological conditions following removal of the expansion force and the stent-graft being configured to limit the range of diameters for the adjusted diameter to the maximum diametric expansion limit.2. The endoprosthesis of claim 1 , wherein the controlled expansion element defines a sliding interface with the stent-graft such that during diametric expansion of the endoprosthesis claim 1 , the sliding interface between the controlled expansion element and the stent-graft permits at least a portion of the controlled expansion element to change in longitudinal dimension at a different rate than the stent-graft at the ...

DIALYSIS VALVE AND METHOD

A dialysis valve includes a tube attached between an artery and a vein which, when elongated, simultaneously narrows in diameter at at least one location. The narrowed portion of the tube decreases the volume and velocity between the arterial and venous side of the patient to prevent damage or intimal hyperplasia on the venous side between dialysis treatments. When the valve is opened for dialysis, an unrestricted blood flow exists between the arterial and venous side, permitting a controlled, open blood flow during dialysis. 1a. implanting a tube between a patient's vein and an artery, the tube capable of containing fluids and defining a longitudinal dimension, a diameter and an inner surface;b. narrowing the diameter of the tube in an adjustable manner between dialysis treatments at at least one location along the longitudinal dimension; andc. opening the diameter of the tube during dialysis.. A method of controlling blood flow between and during dialysis treatments, comprising: This application is a continuation application of U.S. application Ser. No. 16/050,414, filed on Jul. 31, 2018, which is a continuation of U.S. application Ser. No. 15/046,070 filed Feb. 17, 2016 (now U.S. Pat. No. 10,046,103), which is a continuation of U.S. application Ser. No. 14/153,563 filed Jan. 13, 2014 (now U.S. Pat. No. 9,295,774), which is a continuation of U.S. application Ser. No. 13/204,445, filed on Aug. 5, 2011 (now U.S. Pat. No. 8,628,502) by Timothy Claude et al., entitled “Dialysis Valve and Method,” which is a continuation application of U.S. application Ser. No. 12/877,806, filed on Sep. 8, 2010 (now U.S. Pat. No. 8,012,134) by Timothy Claude et al., entitled “Dialysis Valve and Method,” which is a continuation of U.S. application Ser. No. 12/431,101, filed on Apr. 28, 2009 (now U.S. Pat. No. 7,811,264) by Timothy Claude et al., entitled “Dialysis Valve and Method,” which is a continuation of U.S. application Ser. No. 10/497,137, filed on Aug. 18, 2004 (now U.S. Pat. No ...

MAGNETICALLY-LOCALIZABLE, IMPLANTABLE ARTERIO-VENOUS GRAFT DEVICES

Disclosed are vascular access devices, implantable dialysis grafts, and systems that include them useful in facilitating easy, accurate and reproducible cannulation or needle entry into an implantable device such as a hemodialysis graft, by localizing a portion of the implanted graft that contains one or more paramagnetic materials that operably define the physical boundaries of the target cannulation site/entry port by passage of an external magnetic detector wand over that portion of the patient's body into which the device has been implanted. 1. A biocompatible arterio-venous graft device adapted and configured to connect an artery to a vein in a mammal , the device comprising: (a) a first lumen that is adapted and configured to conduct fluid through the length of the conduit between its first and its second ends, and', '(b) a plurality of localizing rings, each comprised of a substantially ferromagnetic material and extending circumferentially around a distinct portion of the conduit along its longitudinal axis; and each member of the plurality spaced substantially consistently along the length of the conduit, wherein at least two adjacent localizing rings of the plurality define a selected site for cannulation into the conduit; and', 'wherein the first end of the substantially tubular conduit is anastomosed in an “end-to-end”fashion to the artery, and wherein the second end of the substantially tubular conduit is anastomosed in an “end-to-end”fashion to the vein, and wherein the selected cannulation site is capable of being penetrated by a single needle or cannula, or, simultaneously by two or more needles or cannulae, or a combination thereof., 'a substantially tubular conduit of a selected length, and comprised of a biocompatible material, the conduit having2. The biocompatible arterio-venous graft device of claim 1 , wherein the plurality of localizing rings comprises at least three members claim 1 , each positioned circumferentially along the longitudinal ...

BUTTONHOLE TOOL

Some implementations provide a tool that includes a gripping portion that includes a first substantially flat surface and a second substantially flat surface arranged substantially parallel to the first surface and coupled to the first surface by at least one side surface, wherein the gripping portion is shaped and sized such that a user can hold the gripping portion between a thumb and forefinger of the user; and a prying portion that includes a first end portion, a second end portion, and a shaft portion connecting the first end portion and the second end portion, wherein the first end portion is shaped and sized for the user holding the gripping portion to pry scab tissue away from a patient's skin and the second end portion is coupled to the gripping portion at the at least one side surface. 1. A tool comprising:a gripping portion comprising a first substantially flat base surface having a shape entirely bounded by at least three line segments and a second substantially flat base surface having the same shape as the first substantially flat base surface and entirely bounded by at least three corresponding line segments, wherein:the second base surface is arranged substantially parallel to the first base surface and coupled to the first base surface by multiple non-base substantially flat side surfaces, each of the multiple non-base substantially flat side surfaces directly connecting one of the three line segments of the first base surface to the corresponding one of the three line segments of the second base surface, andthe gripping portion is shaped and sized such that a user can hold the gripping portion by pinching the first substantially flat base surface and the second substantially flat base surface between a thumb and a forefinger of the user; anda prying portion comprising a first end portion, a second end portion, and a shaft portion connecting the first end portion and the second end portion, the prying portion configured to have a longitudinal axis ...

VASCULAR ACCESS SYSTEM WITH CONNECTOR

A connector for fluidly coupling proximal and distal tubular segments of a fluid conduit is provided. In one embodiment, a system is provided for providing continuous flow of blood between two locations in a patient's cardiovascular system. A first blood conduit is provided that has a distal portion and a proximal portion. The distal portion is adapted to be inserted into a blood vessel at an insertion site and to be advanced therethrough to a location spaced apart from the insertion site. The system is provided with a connector that has a distal portion adapted to be engaged with the proximal portion of the first blood conduit and a tubular body extending proximally of the distal portion. The tubular body is adapted to be inserted into and/or attached to an end of a second blood conduit, such as a vascular graft or the like. 1. A vascular access system , the system comprising:a first conduit defining a first conduit lumen;a second conduit defining a second conduit lumen; a proximal portion,', 'a distal portion,', 'an outer abluminal surface, and', 'an inner luminal surface;', 'wherein the outer abluminal surface further comprises an engagement feature comprising a textured surface., 'a connector configured to fluidly connect the first conduit lumen to the second conduit lumen, the connector comprising2. The vascular access system of claim 1 , wherein the textured surface is in a design and/or pattern.3. The vascular access system of claim 2 , wherein the design and/or pattern is cross-hatches.4. The vascular access system of claim 1 , wherein the textured surface is a random roughened feature.5. The vascular access system of claim 1 , wherein the first or second conduit lumen comprises a textured inner surface.6. The vascular access system of claim 1 , wherein the textured surface is chemically etched nano texture.7. The vascular access system of claim 1 , wherein the textured surface is formed by knurling.8. The vascular access system of claim 1 , wherein the ...

SHEATH

The present application includes a sheath that is suitable for use in a variety of medical procedures. In one or more implementations, the sheath includes a shunt member, and a curvable portion. The curvable portion may be configured in various orientations to facilitate an intervention, such as a hemodialysis intervention, or the like, by an operator. The curvable portion may be configured to bend between a substantially straight configuration and a curved configuration. In implementations, the sheath may be configured to have detachable and/or interchangeable components (e.g., shunt member, curvable portion, etc.). 1. A sheath comprising:a detachable shunt member configured to extend through a perforation in a side wall of an internal patient conduit source and into an anatomical conduit;a detachable junction configured to receive an interventional tool;a detachable curvable portion having a first end configured to be coupled to the shunt member and a second end configured to be coupled to the detachable junction, the curvable portion configured to bend between a curved configuration and a substantially straight configuration where the first end is linearly distal to the second end.2. The sheath as recited in claim 1 , wherein the curvable portion is configured to form up to an 180° curve when the curvable portion is in the curved configuration.3. The sheath as recited in claim 1 , wherein the curvable portion is comprised of a semi-rigid material and is configured to retain a desired curved configuration.4. The sheath as recited in claim 1 , further comprising:a clasp configured to hold the curvable portion in the curved configuration.5. The sheath as recited in claim 4 , wherein the clasp is coupled to at least one of the first end of the curvable portion or the second end of the curvable portion and to be selectively coupled at a position proximate to the other of the first end of the curvable portion and the second end of the curvable portion.6. The sheath as ...

DEVICES FOR FLUID FLOW THROUGH BODY PASSAGES

A device includes a first end portion, a second end portion, an intermediate portion between the first end portion and the second end portion, and a graft material coupled to at least the intermediate portion. The first end portion has a first end diameter. The second end portion has a second end diameter larger than the first end diameter. The intermediate portion tapers between the first end portion and the second end portion. A method of diverting fluid flow from a first passage to a second passage comprising deploying the device in a third passage between the first passage and the second passage, expanding the first end portion against sidewalls of the first passage, and expanding the second end portion against sidewalls of the second passage. 1. (canceled)2. A method of diverting fluid flow from a first vessel to a second vessel in a limb , the method comprising:inserting a first catheter in the first vessel;inserting a second catheter in the second vessel;deploying a needle from the first catheter, through tissue between the first vessel and the second vessel, and into the second vessel; and a first end portion having a first end diameter sized to correspond to a diameter of the first vessel,', 'a second end portion having a second end diameter sized to correspond to a diameter of the second vessel, and', 'an intermediate portion between the first end portion and the second end portion,, 'deploying a device in the first vessel, the second vessel, and the tissue between the first vessel and the second vessel, the device comprising expanding the first end portion coaxial with and against sidewalls of the first vessel, wherein expanding the first end portion comprises self-expanding the first end portion,', 'expanding the intermediate portion, wherein expanding the intermediate portion comprises self-expanding the intermediate portion, and', 'expanding the second end portion coaxial with and against sidewalls of the second vessel, wherein expanding the second end ...

Arteriovenous Access Valve System and Process

An arteriovenous graft system is described. The arteriovenous graft system includes an arteriovenous graft that is suited for use during hemodialysis. In order to minimize or prevent arterial steal, at least one valve device is positioned at the arterial end of the arteriovenous graft. In one embodiment, for instance, the arteriovenous graft systems includes a first valve device positioned at the arterial end and a second valve device positioned at the venous end. In one embodiment, the valve devices may include an inflatable balloon that, when inflated, constricts and closes off the arteriovenous graft. If desired, a single actuator can be used to open and close both valve devices. 120-. (canceled)21. A subcutaneous arteriovenous graft system , comprising:an arteriovenous graft including an arterial end and an opposite venous end;a valve device positioned at or adjacent to the arterial end or the venous end of the arteriovenous graft, the valve device including a valve member provided in operative association with a fluid conduit; andan actuator configured to actuate the valve member between an opened state, at which the valve member is configured to allow a flow of blood through the fluid conduit, and a closed state, at which the valve member is configured to prevent the flow of blood through the fluid conduit;wherein, when the valve member is transitioned to the opened state, a substantially continuous flow boundary is defined for the blood flowing through the conduit at an interface between an inner surface of the fluid conduit and the valve member.22. The subcutaneous arteriovenous graft system of claim 21 , wherein claim 21 , when the valve member is transitioned to the opened state claim 21 , the valve member is substantially radially aligned with the inner surface of the fluid conduit.23. The subcutaneous arteriovenous graft system of claim 21 , wherein the valve member comprises a thinner wall than the fluid conduit.24. The subcutaneous arteriovenous graft ...

SYSTEMS AND METHODS FOR TREATING PULMONARY EDEMA

Various systems and methods are provided for treating pulmonary edema. In general, a pump can be configured to be implanted within a patient at risk of developing edema. The pump can be configured to pump fluid out of the patient's lungs, e.g., out of the patient's interstitial and alveolar spaces. The pump can be configured to be fully implanted within the patient's body. The pump can be configured to continuously pump fluid, or the pump can be configured to be selectively actuatable in response to a trigger event. In an exemplary embodiment, the pump can include an inflow port coupled to an inflow tube in fluid communication with a lymphatic vessel of the patient, and can include an outflow port coupled to an outflow tube in fluid communication with a vein of the patient. 122-. (canceled)23. A system for treating edema , the system comprising:a pump comprising an inlet and an outlet;an inflow tube operably coupled to the inlet;an outflow tube operably coupled to the outlet;a pressure sensor; anda controller operably coupled to the pressure sensor and the pump and configured to receive a pressure measurement from the pressure sensor and trigger activation of the pump if the pressure measurement received from the pressure sensor indicates a pressure of at least 2 mm Hg at a junction of a subclavian vein and an internal jugular vein.24. The system of claim 23 , wherein the controller is configured to control a speed of operation of the pump depending on a pressure measured by the pressure sensor.25. The system of claim 23 , wherein the pump is configured to continuously pump the fluid from the lymphatic duct to the vein when the pressure measured by the pressure sensor is above 6 mm Hg.26. The system of claim 23 , further comprising a power source configured to be implanted in the body of the patient and configured to provide power to the pump.27. The system of claim 23 , further comprising a charging coil configured to inductively couple to a power source external ...

SYSTEMS AND METHODS FOR CREATING ARTERIOVENOUS (AV) FISTULAS

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. 1. A device for creating an arteriovenous (AV) fistula , comprising:a first member comprising a main body having a primary lumen and a secondary lumen;a second member comprising a piercing member disposed in said secondary lumen, and configured to be moved distally out of said secondary lumen, and to cut through tissue while being distally moved; anda third member extending from a distal end of the piercing member and being actuatable to move adjacent first and second blood vessels toward one another and to create an elongated communicating aperture in opposing sides of each of the first vessel and the second vessel, the third member comprising a needle which is extendable from a distal end of the piercing member into a distal end of the primary lumen of the main body.26-. (canceled)7. The device as recited in claim 1 , and further comprising apparatus disposed in said primary lumen for retracting in a proximal direction said needle.8. A method of creating an AV fistula between adjacent first and second blood vessels claim 1 , comprising:positioning a first member comprising a main body of a device within the first vessel;extending a second or piercing member distally ...

VARIABLE ORIFICE FISTULA GRAFT

A medical implant includes a primary tubular member having a first end and a second end and defining a primary longitudinal axis and a primary lumen. The primary tubular member is disposed in an arterial-venous connection. The medical implant also includes a baffle disposed transversely to the primary longitudinal axis within the primary lumen. The baffle defines at least one aperture therethrough.

Delivery system for implantable flow connector

A delivery system for delivering an implant to a first space within a body of a patient including an elongate delivery member having a proximal portion, a distal portion, a lumen and a receiving area, the receiving area dimensioned for receipt of the implant. A deforming member is movable with respect to the delivery member from a first position to a second position to apply a force to the implant to deform the implant positioned in the receiving area of the delivery member.

Implantable flow connector

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.

ALTERNATING CIRCUMFERENTIAL BRIDGE STENT DESIGN AND METHODS FOR USE THEREOF

A stent includes a first section and a second section. The second section is aligned with the first section along a longitudinal axis of the stent. Each section includes a plurality of expandable modules and a plurality of bridging modules. Each expandable module includes a plurality of strut elements that join together at a plurality of apices. Each bridging module includes bridging elements that connect an apex of a first module with an apex of a second module. The plurality of expandable modules or the plurality of bridging modules in the first section are more radially stiff than the plurality of expandable modules or the plurality of bridging modules in the second section such that at least a portion of the first section is configured to be placed in a region of a vein subjected to physiologic compression. 1 a plurality of expandable modules, each expandable module including a plurality of strut elements that join together at a plurality of apices; and', 'a plurality of bridging modules, each bridging module including bridging elements that connect an apex of a first module with an apex of a second module;, 'a first section and a second section, the second section aligned with the first section along a longitudinal axis of the stent, each section includingwherein the plurality of expandable modules or the plurality of bridging modules in the first section are more radially stiff than the plurality of expandable modules or the plurality of bridging modules in the second section such that at least a portion of the first section is configured to be placed in a region of a vein subjected to physiologic compression.. A stent comprising: This application claims priority to and is a continuation of U.S. patent application Ser. No. 13/100,132, filed May 3, 2011, entitled “Alternating Circumferential Bridge Stent Design and Methods for Use Thereof,” now U.S. Pat. No. 9,649,211, which is a continuation-in-part of U.S. patent application Ser. No. 12/939,894, filed Nov. 4, ...

ENDOVASCULAR IMPLANTS AND DEVICES AND METHODS FOR ACCURATE PLACEMENT

Various systems, devices, and methods for endovascular implants and accurate placement thereof are disclosed. The disclosed implants include a proximal implant segment, a distal implant segment, connector struts connecting the proximal implant segment to the distal implant segment, and a side opening between the proximal implant segment and the distal implant segment. The disclosed implants can be used to create an arteriovenous fistula or connect one vessel of the body to another by placement of the proximal implant segment and the distal implant segment within the vessels to be connected. The disclosed implants can include one or more anchors for securing the implant in place with respect to the vessels of the body it is connecting. The disclosed implants can also include a continuous strut or ring at a distal edge of the proximal implant segment. Also disclosed are methods for accurate percutaneous placement of the implants disclosed, and a device for percutaneous delivery. 1. A system for creating an arteriovenous fistula in an arm of a patient , the system comprising:an endovascular delivery device configured for access into the arm of the patient, wherein the endovascular delivery device is configured to be advanced into a superficial vein, into a perforator vein, into a deep vein, and into an artery adjacent to the deep vein; and a proximal implant segment comprising a proximal end and a distal end, the proximal implant segment being releasable from the endovascular delivery device to transform from a radially compressed configuration to a radially expanded configuration in which the proximal implant segment extends through the perforator vein and the deep vein with the proximal end of the proximal implant segment positioned within the perforator vein; and', 'a distal implant segment connected to the proximal implant segment, the distal implant segment being releasable from the endovascular delivery device to transform from a radially compressed configuration ...

Implantable and removable customizable body conduit

An apparatus and method are provided to treat a stenosis. A delivery device is provided that has an elongate tubular member coupled therewith. The elongate tubular member has an outside surface that is configured to prevent adherence of in vivo matter. The tubular member has a proximal end and a distal end and is reinforced along its length to maintain open lumen under a transverse load. The tubular member is placed in the vasculature such that the distal end of the elongate tubular member is disposed distal of a stenosis. The proximal end of the elongate tubular member is disposed inside the vessel, preferably at a location proximal of the stenosis. Thereafter, after a therapeutic period, the elongate tubular member is removed intact.

SUBCUTANEOUS VASCULAR ACCESS ASSEMBLIES AND RELATED DEVICES AND METHODS

Vascular access devices, assemblies, kits, and related methods are disclosed. A vascular access assembly may include a first tubular conduit, a second tubular conduit, and an expandable stent graft that is coupled adjacent to a peripheral end of the second tubular conduit. When implanted into the patient, vascular access assemblies may form a flow path that extends from an artery or an arteriovenous graft to a heart of a patient. The vascular access assembly, when implanted and assembled, may be a fully subcutaneous surgical implant. 1. A vascular access assembly comprising:a first tubular conduit;a second tubular conduit; andan expandable stent graft that is coupled to the second tubular conduit adjacent a peripheral end of the second tubular conduit, wherein the expandable stent graft is configured to couple to an artery, vein or arteriovenous graft of a patient such that the artery, the vein, or the arteriovenous graft is in fluid communication with the second tubular conduit;wherein the first tubular conduit is configured to couple to a central end of the second tubular conduit to form a flow path that extends from the artery, the vein, or the arteriovenous graft to a heart of the patient.2. The vascular access assembly of claim 1 , wherein the expandable stent graft is a branched stent graft.3. The vascular access assembly of claim 1 , wherein the expandable stent graft is an unbranched stent graft.4. The vascular access assembly of claim 1 , wherein the second tubular conduit comprises a puncturable and self-sealing wall such that the wall may be punctured by insertion of a needle and then reseal upon withdrawal of the needle.5. The vascular access assembly of claim 1 , further comprising a connector for coupling the first tubular conduit to the second tubular conduit.6. The vascular access assembly of claim 1 , wherein the second tubular conduit is configured for delivery through a lumen of a deployment device.7. The vascular access assembly of claim 1 , ...

SHEATH

The present application includes a sheath that is suitable for use in a variety of medical procedures. In one or more implementations, the sheath includes a shunt member, and a curvable portion. The curvable portion may be configured in various orientations to facilitate an intervention, such as a hemodialysis intervention, or the like, by an operator. The curvable portion may be configured to bend between a substantially straight configuration and a curved configuration. In implementations, the sheath may be configured to have detachable and/or interchangeable components (e.g., shunt member, curvable portion, etc.). 120-. (canceled)21. A system of using a sheath device configured to receive an interventional tool , the system comprising:a detachable shunt member positionable through a perforation in a side wall of an anatomical vessel, the detachable shunt member including: a distal opening configured to reside in the anatomical vessel, and a connection member that resides external to the anatomical vessel and that includes a first septum configured to receive an interventional tool therethrough;a detachable curvable sheath tube matable to the connection member including the first septum of the shunt member, wherein the detachable curvable sheath tube includes: a distal end that is smaller in outer diameter than, and detachably mated with, a proximal end of the connection member of the shunt member, and a proximal end opposite from the distal end, and a tube wall configured to bend between a curved configuration and a substantially straight configuration, wherein the proximal end of the detachable curvable sheath tube is coupled with a septum hub configured to receive the interventional tool, the septum hub having an introducer portion at a proximal end of the septum hub and a secondary tube for injecting or suctioning fluids; andwherein an internal access path defined through the septum hub, the detachable curvable sheath tube, the shunt member, and the anatomical ...

DEVICES FOR FLUID FLOW THROUGH BODY PASSAGES

A device includes a first end portion, a second end portion, an intermediate portion between the first end portion and the second end portion, and a graft material coupled to at least the intermediate portion. The first end portion has a first end diameter. The second end portion has a second end diameter larger than the first end diameter. The intermediate portion tapers between the first end portion and the second end portion. A method of diverting fluid flow from a first passage to a second passage comprising deploying the device in a third passage between the first passage and the second passage, expanding the first end portion against sidewalls of the first passage, and expanding the second end portion against sidewalls of the second passage. 1. (canceled)2. A device comprising:a longitudinal axis;a first end portion having a terminal first end diameter, the first end portion having a first length along the longitudinal axis, the first end portion being self-expanding;a second end portion having a second end diameter smaller than the terminal first end diameter, the second end portion being substantially cylindrical, the second end portion having a second length along the longitudinal axis, the second end portion being self-expanding;an intermediate portion between the first end portion and the second end portion, the intermediate portion tapering between the first end portion and the second end portion, the intermediate portion having a third length along the longitudinal axis, the first end portion being frustoconical, the first end portion tapering between the terminal first end diameter and the intermediate portion; anda graft material coupled to at least the intermediate portion, the device configured to provide fluid flow between a first passage in which the first end portion is anchored and a second passage in which the second end portion is anchored.3. The device of claim 2 , wherein each of the first end portion claim 2 , the second end portion claim 2 ...

Devices, methods and systems for counterpulsation and blood flow conduit connection

A blood flow conduit includes a first conduit portion defining a first portion of a lumen and blood flow path, and a second conduit portion defining a second portion of a lumen and blood flow path. The first portion of the lumen has a smoother surface for contacting the blood flow than the second portion of the lumen. A discontinuity such as a tip portion is positioned between the first and second portions of the lumen.

DEVICES, SYSTEMS, AND METHODS FOR PERIPHERAL ARTERIOVENOUS FISTULA CREATION

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. 1. A method of treating hypertension in a patient comprising:identifying a patient suffering from hypertension;externally visualizing anatomical structures in a limb of the patient to determine a degree of calcification;selecting a first anatomical structure and a second anatomical structure in the limb based at least in part on the degree of calcification;creating a fistula in the limb between a first anatomical structure and a second anatomical structure at a location based at least in part on the degree of calcification;wherein the first anatomical structure contains blood at a first oxygen content level and the second anatomical structure contains blood at a second oxygen content level, said first oxygen content level greater than said second oxygen content level; andwherein the second anatomical structure provides blood to a lung of the patient and the fistula is located in is a limb of the patient.2. The method of claim 1 , wherein the fistula is created in a surgical procedure.3. The method of claim 1 , wherein the fistula is created in an interventional procedure.4. The method of claim 1 , wherein the performance of said method decreases systemic vascular resistance of the patient.5. The method ...

BONE BYPASS SHUNTS AND METHODS USING THEREOF

Bone bypass shunts and methods using thereof. Method for affecting a pathophysiological condition in a body of a live subject includes exemplary steps/procedures of: connecting an inlet port of a bone bypass shunt to a first bone portion adjacent a first bone marrow location such that inlet port lumen of inlet port facilitates fluid communication with blood accumulated or flowing at first blood marrow location; connecting outlet port of the bone bypass shunt to second bone portion adjacent second bone marrow location, such that outlet port lumen of outlet port facilitates fluid communication with bone marrow; a formed cavity, or/and bone marrow vasculature, located at second bone marrow location; via inlet port lumen, removing a chosen volume of blood from first bone marrow location; and via outlet port lumen, delivering chosen volume of blood to the second bone marrow location. 1. A method for affecting a pathophysiological condition in a body of a live subject , the method comprising:connecting an inlet port of a bone bypass shunt to a first bone portion adjacent a first bone marrow location such that an inlet port lumen of said inlet port facilitates fluid communication with blood accumulated or flowing at said first blood marrow location;connecting an outlet port of said bone bypass shunt to a second bone portion adjacent a second bone marrow location such that an outlet port lumen of said outlet port facilitates fluid communication with at least one of bone marrow, a formed cavity, and bone marrow vasculature, located at said second bone marrow location;via said inlet port lumen, removing a chosen volume of blood from said first bone marrow location; andvia said outlet port lumen, delivering at least part of said chosen volume of blood to said second bone marrow location.2. The method according to claim 1 , comprising choosing said first bone marrow location and said second bone marrow in a single bone.3. The method according to claim 1 , comprising choosing ...

METHODS, SYSTEMS AND DEVICES FOR TREATING HYPERTENSION

Provided is a method of treating arterial hypertension in a patient. The method comprises selecting a patient suffering from arterial hypertension and creating a flow pathway between a first vascular location and a second vascular location. The first vascular location comprises a source of arterial blood and the second vascular location comprises a source of venous blood. The method causes a reduction in diastolic pressure and a reduction in systolic pressure; and the reduction in diastolic pressure is to an extent at least approximating the reduction in systolic pressure. Systems and devices for creating a flow pathway are also provided. 1. A method for treating a disease or disorder in a patient , the method comprising:advancing a vessel-to-to vessel guidewire through a starting vessel to a target vessel with a needle delivery device;advancing a flow creation device over the advanced vessel-to-vessel guidewire to be positioned through vessel walls of the starting vessel and the target vessel; and (i) moving a control of a handle of the clip deployment catheter from a first ready to deploy position to a first deployed position, thereby causing the outer sheath of the clip deployment catheter to retract a first distance relative to a distal tip of the clip deployment catheter while the anastomotic clip is held stationary relative to the distal tip, allowing at least one distal arm of the anastomotic clip to deploy,', '(ii) moving the control from the first deployed position to a second ready to deploy position, and', '(iii) moving the control from the second ready to deploy position to a second deployed position, thereby causing the outer sheath of the clip deployment catheter to retract a second distance relative to the distal tip of the clip deployment catheter while the anastomotic clip is held stationary relative to the distal tip, allowing at least one proximal arm of the anastomotic clip to deploy., 'creating a flow path between the starting vessel and the ...

Methods And Systems For Establishing Retrograde Carotid Arterial Blood Flow

Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. The flow control assembly includes one or more components that interact with the blood flow through the shunt. 1. A method of treating a lesion in a carotid artery of a patient having an arterial blood system and a venous blood system , comprising:positioning an arterial access sheath into a common carotid artery via an insertion site in the patient's neck;blocking blood flow in at least a portion of the common carotid artery to establish retrograde blood flow through the common carotid artery such that blood flows into a lumen of the arterial access device;shunting blood from the common carotid artery to a femoral vein of the patient via the arterial access sheath; andtreating the lesion by deploying a stent on the lesion.2. The method of claim 1 , further comprising making an incision at the insertion site to expose a region of the common carotid artery.3. The method of claim 1 , further comprising deploying a filter in the arterial blood system at a location distal of the lesion.4. The method of claim 1 , wherein the arterial access device comprises a working length of 5 cm to 15 cm.5. The method of claim 2 , further comprising forming a penetration in a wall of a common carotid artery via the incision claim 2 , the penetration being located at distance of around 5 cm to 7 cm below a bifurcation location where the patient's common carotid artery bifurcates into an internal carotid artery and external carotid artery.6. The method of ...

VASCULAR STENT DEVICES AND METHODS

Described here are devices, systems, and methods for cannulating a vessel. Generally, the method may comprise advancing a stent into a first vessel and deploying the stent in the first vessel to hold open one or more valves. This may permit retrograde blood flow through the blood vessel in peripheral vasculature and aid in cannulation of the blood vessel. 1. A catheter system comprising:a stent comprising one or more apertures, the stent configured to hold open one or more venous valves and receive a needle through the one or more apertures;a first catheter comprising a fistula-forming element; anda stent detector comprising a sensor configured to noninvasively detect a location of the stent.2. The system of claim 1 , wherein the stent comprises first struts and second struts having different thicknesses.3. The system of claim 1 , further comprising a second catheter comprising a push wire configured to deploy one or more stents sequentially from a distal end of the second catheter.4. The system of claim 3 , wherein a distal end of the push wire pushes the one or more stents out of the second catheter.5. The system of claim 1 , wherein the fistula-forming element is an electrode.6. The system of claim 2 , wherein the first struts form a first set of diamonds claim 2 , and the second struts form a second set of diamonds within the first set of diamonds.7. The system of claim 1 , further comprising an output device communicatively coupled to the stent detector and configured to output a warning when the stent is not detected within a predetermined range.8. The system of claim 1 , further comprising an output device communicatively coupled to the stent detector and configured to output a signal when the stent detector is above the stent.9. The system of claim 8 , wherein the signal is a visual signal.10. The system of claim 1 , wherein the sensor of the stent detector is a metal detector.11. The system of claim 1 , wherein the stent detector emits a magnetic field.12. ...

METHODS TO INCREASE THE OVERALL DIAMETER OF DONATING VEINS AND ARTERIES

A system and method for increasing the speed of blood and the wall shear stress in a peripheral artery or peripheral vein to a sufficient level and for a sufficient period of time to result in a persistent increase in the overall diameter and lumen diameter of the donating artery or donating vein is provided. The method includes systems and methods to effect the movement of blood at the desired rate and in the desired direction. The movement of blood is monitored and adjusted, as necessary, to maintain the desired blood speed and wall shear stress in the peripheral artery or vein in order to optimize the rate and extent of persistent diameter increase of the peripheral artery or peripheral vein. 1. A method for creating an arteriovenous fistula or an arteriovenous graft in a human patient , the method comprising:fluidly connecting one end of a pump-conduit assembly to the donating vein or location; pumping venous blood from the donating vein or location into the accepting vein, wherein: the pumping of blood results in a mean wall shear stress in the accepting vein of greater than or equal to 0.76 Pa;', 'the pumping of blood results in a mean pulse pressure in the accepting vein of less than 40 mmHg; and', 'the pumping of blood results in an increase in the lumen diameter and overall diameter of the accepting vein which persists after pumping has ceased; and,, 'fluidly connecting another end of the pump-conduit assembly to an accepting vein; and,'}creating the arteriovenous fistula or arteriovenous graft in the patient using at least a portion of the accepting vein with the persistently-increased lumen diameter and overall diameter.2. The method of claim 1 , wherein the pump-conduit assembly pumps deoxygenated blood.3. The method of claim 1 , wherein the pump-conduit assembly pumps blood at a rate between 50 ml/min and 2500 ml/min claim 1 , 50 ml/min and 1000 ml/min claim 1 , 100 ml/min and 1000 ml/min claim 1 , 100 ml/min and 1500 ml/min claim 1 , 50 ml/min and 2500 ...

Alternating circumferential bridge stent design and methods for use thereof

A stent includes a first section and a second section. The first section and the second section each include a plurality of expandable modules and a plurality of bridging modules. Each expandable module includes a plurality of strut elements that join together at a plurality of apices, and each bridging module includes bridging elements that connect an apex of a first module with an apex of a second module. In some aspects, the first section is more flexible along the longitudinal axis of the stent than the second section and is configured to be placed in a specific region of a vessel that requires flexibility to accommodate surrounding anatomy. In some aspects, the first section is more radially stiff than the second section and is configured to be placed in a specific region of the vessel that requires radial stiffness to counteract crushing force caused by surrounding anatomy.

SELF-CLOSING DEVICES AND METHODS FOR MAKING AND USING THEM

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. 1. A method for implanting an access device into a patient's body , comprising:providing an access device defining a first end, a second end, a longitudinal axis extending therebetween, and a wall including inner and outer surfaces and defining opposite side edges extending between the first and second ends, the access device comprising elastomeric base material, a plurality of elongate elastic elements embedded in the base material, the elastic elements being disposed adjacent one another and unconnected to adjacent support elements, and fabric covering the base material and the elastic elements, the elastic elements separable laterally to accommodate creating an opening through the base material when an instrument is introduced through the base material, and biased to return laterally towards a relaxed state for self-closing the opening after removing the instrument;exposing a body structure within a patient's body;separating the side edges of the access device to open the access device;positioning the access device adjacent the outer surface of the body structure; andreleasing the side edges such that the inner surface of the access device wraps at least partially around the body structure. andattaching the access device to the body structure.2. The method of claim 1 , wherein the body ...

SYSTEM AND METHOD FOR DETECTING DIALYSIS NEEDLE DISLODGMENT

A system for detecting needle dislodgement includes a first sensor element, a second sensor element, and an alarm. The first sensor element attaches to an associated dialysis tubing having a needle connected at one end. The first sensor element also attaches to the associated dialysis tubing offset from the needle and a sterile field, which is an area on a leg or arm adjacent to where the needle is inserted, in a manner such that movement of the associated dialysis tubing results in movement of the first sensor element. The second sensor element secures to the arm or leg offset from the sterile field. The alarm is in communication with or includes at least one of the first sensor element and the second sensor element. The alarm generates a signal indicative of a position of the first sensor element with respect to the second sensor element. 1. A system for detecting needle dislodgement comprising:a first sensor element configured to attach to an associated dialysis tubing having a needle connected at one end, the first sensor element being configured to attach to the associated dialysis tubing offset from the needle and a sterile field, which is an area on a leg or arm adjacent to where the needle is inserted, in a manner such that movement of the associated dialysis tubing results in movement of the first sensor element;a second sensor element configured to secure to the arm or leg offset from the sterile field; andan alarm in communication with at least one of the first sensor element and the second sensor element, the alarm being configured to generate a signal indicative of a position of the first sensor element with respect to the second sensor element.2. The system of claim 1 , wherein the first sensor element is a magnet and the second sensor element is at least one of a Hall-effect sensor and a magnetometer.3. The system of claim 2 , further comprising a non-sterile mounting apparatus configured to secure to the arm or leg offset from the sterile field claim ...

Systems and methods for treatment of pulmonary edema

Systems, methods, and devices are provided for the treatment of edema. In one aspect a method for implanting an indwelling catheter within a vein of a patient is provided. The catheter can extend from a position upstream of at least one outflow port of a duct of the lymph system to a terminal position downstream of the at least one outflow port. In use, a first restriction can be created within the vein proximal to a distal region of the catheter. The first restriction can define a localized low pressure zone distal of the restriction and within a portion of the vein housing the catheter. The low pressure zone can be adjacent to the at least one outflow port to enable fluid to pass from the at least one lymph duct outflow port into the vein.

SYSTEMS AND METHODS FOR TREATMENT OF PULMONARY EDEMA

Systems, methods, and devices are provided for the treatment of edema. In one aspect a method for implanting an indwelling catheter within a vein of a patient is provided. The catheter can extend from a position upstream of at least one outflow port of a duct of the lymph system to a terminal position downstream of the at least one outflow port. In use, a first restriction can be created within the vein proximal to a distal region of the catheter. The first restriction can define a localized low pressure zone distal of the restriction and within a portion of the vein housing the catheter. The low pressure zone can be adjacent to the at least one outflow port to enable fluid to pass from the at least one lymph duct outflow port into the vein. 118-. (canceled)19. A device comprising:a conduit;a first restrictor operably associated with an exterior of the conduit, wherein the first restrictor comprises a retracted and deployed configuration and in the deployed configuration, the first restrictor comprises a diameter of an innominate vein; andand a pump configured to urge fluid through the conduit.20. The device of claim 19 , wherein the pump is disposed within the conduit.21. The device of claim 20 , wherein the pump is configured to advance fluid from a proximal end of the conduit toward a distal end of the conduit claim 20 , thereby advancing fluid within the innominate vein.22. The device of claim 20 , wherein the pump is an impeller.23. The device of claim 19 , further comprising one or more pressure sensors.24. The device of claim 19 , wherein the first restrictor comprises an expandable balloon.25. The device of claim 24 , wherein the expandable balloon is formed on an outer wall of the conduit.26. The device of claim 25 , further comprising an inflation lumen operably associated with the expandable balloon.27. The device of claim 19 , further comprising a second restrictor comprising a retracted and deployed configuration.28. The device of claim 19 , wherein the ...

Device and Method for Atraumatic and Percutaneous Formation of an Arteriovenous Fistula

Provided herein are novel devices for the formation of arteriovenous fistulas, which may aid subjects in need of hemodialysis. The novel devices are provided in a non-surgical procedure, greatly decreasing the cost and increasing the convenience of placing an arteriovenous fistula. The devices are atraumatic, and consist of a sutureless anastomosis device and conduit. Methods and tools for placing the devices in vivo are disclosed, including a magnetic-assisted method. 1. An implant for the creation of a fistula between a first and a second blood vessel , the implant having a longitudinal axis from a distal to a proximal end , the implant comprisinga sutureless anastomosis device comprising a first set of hands and a second set of hands;wherein each hand comprises a body extending at an angle from the longitudinal axis of the implant;wherein each hand comprises a resilient material such that the hand may be deflected under tension to a compact orientation substantially parallel to the longitudinal axis of the implant;wherein each of the first set of hands and the second set of hands is connected to and arranged around an annular structure such that the first set of hands forms a first flange and the second set of hand forms a second flange, wherein the flanges are separated by a space along the longitudinal axis of the implant;wherein the implant further comprises a conduit comprising a tubular structure comprising a lumen, connected at its distal end circumferentially around the proximal end of the annular structure, wherein the conduit comprises a scaffolding material enclosed in or surrounded by a covering of biocompatible material.2. The implant of claim 1 , whereinthe sutureless anastomosis device comprises 4-12 hands.3. The implant of claim 1 , whereinthe hands are substantially perpendicular to the longitudinal axis of the implant.4. The implant of claim 1 , whereinthe hands comprise a material selected from the group consisting of nitinol, stainless steel, ...

VASCULAR ACCESS SYSTEM WITH CONNECTOR

A connector for fluidly coupling proximal and distal tubular segments of a fluid conduit is provided. In one embodiment, the connector can include a connector body having an outer surface defining a first outer perimeter and an inner surface defining a lumen. The connector can also include a connecting device having an open configuration and a plurality of closed configurations. The connecting device can include first and second members configured to engage each other to secure the fluid conduit to the connector. The connecting device can also include a plurality of closed configurations for securing fluid conduits of different sizes. 1. A method for coupling tubular segments of a fluid conduit in a cardiovascular system , the method comprising:providing a connector having an outer surface defining a first outer perimeter and an inner surface defining a lumen and a connecting device positioned between a proximal and distal end of the connector, the connecting device having a disengaged configuration and a plurality of engaged configurations for securing tubular segments of different thicknesses;engaging an end of a fluid conduit with the connector such that the lumen of the connector is in fluid communication with the lumen of a fluid conduit; andactuating the connecting device from the disengaged configuration to one of the engaged configurations such that the fluid conduit is compressed by the connecting device.2. The method of claim 1 , wherein the actuating comprises moving two jaw members past each other to cause at least one tooth on a first jaw to engage with at least one tooth on a second jaw.3. The method of claim 1 , wherein actuating the connecting device into one of the engaged configurations further comprises pivoting free ends of first and second members of the connecting device disposed away from each other toward each other.4. The method of claim 1 , wherein actuating the connecting device into one of the engaged configurations further comprises ...

ARTERIOVENOUS ACCESS VALVE SYSTEM WITH SEPARATE VALVE TUBES

An arteriovenous access valve system may generally include a first valve tube extending lengthwise between an arterial end and a first joint end, with the first valve tube including a first valve device. The system may also include a separate second valve tube extending lengthwise between a venous end and a second joint end, with the second valve tube including a second valve device. In addition, the system may include at least one tube connector coupled between the first and second valve tubes. 1. An arteriovenous access valve system , the system comprising:a first valve tube extending lengthwise between an arterial end and a first joint end, the first valve tube including a first valve device and a first tube portion extending outwardly from the first valve device towards the first joint end;a separate second valve tube extending lengthwise between a venous end and a second joint end, the second valve tube including a second valve device and a second tube portion extending outwardly from the second valve device towards the second joint end; anda tube connector extending lengthwise between a first end and a second end, the first joint end of the first valve tube being configured to be coupled to the tube connector at or adjacent to the first end, the second joint end of the second valve tube being configured to be coupled to the tube connector at or adjacent to the second end.2. The system of claim 1 , wherein the first and second valve devices each correspond to balloon-actuated devices claim 1 , wherein claim 1 , when a fluid is supplied to the first and second valve devices claim 1 , each of the first and second valve devices is adjusted to a closed position and claim 1 , when the fluid is drawn out of the first and second valve devices claim 1 , each of the first and second valve devices is adjusted to an opened position.3. The system of claim 2 , wherein each of the first and second valve devices includes an inflatable balloon claim 2 , wherein claim 2 , when ...

Vascular corrective appliance and supporting method for anastomosis part

A vascular corrective appliance and a supporting method for an anastomosis part capable of reducing or preventing narrowing at an anastomosis part between vessels and/or narrowing in the vicinity of the anastomosis part wherein the vascular corrective appliance and the supporting method are configured to support a first vessel and a second vessel from their outer sides in such a manner that an angle formed between a blood flow direction of the first vessel and a blood flow direction of the second vessel at an anastomosis part where the first vessel is anastomosed in a branch pattern with the second vessel becomes an acute angle, and that the first vessel is curved on a downstream side from the anastomosis part to extend toward an upstream side of the second vessel from the anastomosis part.

AV Flow Restrictors

A shunt comprising a flexible tube having a first, and a second end, and a central opening, having a first diameter that extends from the first end to the second end. The shunt also includes one or more restrictor bands having a second diameter around the flexible tube. The one or more restrictor bands are located between the first end and the second end of the flexible tube and the second diameter is less than the first diameter such that the restrictor band forms a restriction. The restrictor band is expandable between a first position and a second position. The restrictor band may have fracturable sections configured to fracture in responds to pressure thereby increasing a diameter of the one or more restrictor bands to a diameter greater than the second diameter. The one or more restrictor bands may comprise restrictor bands of at least two different inner diameters. 1. A shunt comprising:a flexible tube having a first end and a second end, the flexible tube having a central opening having a first diameter, the opening extending from the first end to the second end; andone or more restrictor bands having a second diameter around the flexible tube, the one or more restrictor bands located between the first end and the second end of the flexible tube, wherein the second diameter is less than the first diameter.2. The shunt of claim 1 , wherein the shunt is an arterial venous shunt.3. The shunt of claim 1 , wherein the restrictor band is expandable between a first position and a second position.4. The shunt of claim 1 , wherein the restrictor band further comprises sections that are configured to fracture in responds to pressure thereby increasing a diameter of the one or more restrictor bands to a diameter greater than the second diameter.5. The shunt of claim 1 , wherein the one or more restrictor bands comprise restrictor bands of at least two different inner diameters.6. A stent with an expandable restriction comprising:a stent having an inlet end and an outlet ...

INTRAOSSEOUS INFUSION PORTS AND METHODS OF USE

Example embodiments are related to intraosseous infusion port (IOP) devices to provide access to bone marrow cavities. The IOP device according to example embodiments may comprise a proximal portion with a hollow chamber extending through the proximal portion, the hollow chamber having a proximal inlet for receiving an insertion device. The IOP device may also include an anchor portion positioned distally to the proximal portion, the anchor portion may be configured for anchoring the infusion port device in a bone, and an open-ended channel extending through the anchor portion, the channel being in fluid communication with the hollow chamber, such that, when the infusion port is implanted into a bone, the channel and the hollow chamber create a substantially straight pathway terminating at an opening at its distal end for insertion of the insertion device towards the bone marrow. 1. An infusion system comprising:a chamber having an inlet for receiving an insertion device;an anchor portion extending distally from the chamber, and configured for secured placement in a bone; andan open-ended channel extending through the anchor portion, the channel being in fluid communication with the chamber, and providing a substantially straight pathway that terminates at an opening at its distal end through which the insertion device can be directed towards the bone marrow.2. The infusion system of claim 1 , wherein the chamber further includes a septum for sealing off the inlet.3. The infusion system of claim 1 , wherein the chamber includes one of a substantially straight channel claim 1 , a reservoir shaped cavity and a concaved shaped channel with sloped walls.4. The infusion system of claim 1 , wherein the chamber is a reservoir for holding substances.5. The infusion system of claim 1 , wherein the anchor portion further includes a threaded surface for anchoring the infusion device into the bone.6. An infusion system comprising:a first port having a chamber from which blood ...

SHEATH

The present application includes a sheath that is suitable for use in a variety of medical procedures. In one or more implementations, the sheath includes a shunt member, and a curvable portion. The curvable portion may be configured in various orientations to facilitate an intervention, such as a hemodialysis intervention, or the like, by an operator. The curvable portion may be configured to bend between a substantially straight configuration and a curved configuration. In implementations, the sheath may be configured to have detachable and/or interchangeable components (e.g., shunt member, curvable portion, etc.). 120-. (canceled)21. A system configured to receive an interventional tool , the system comprising:a detachable shunt member positionable through a perforation in a side wall of an anatomical vessel, the detachable shunt member including: a distal opening configured to reside in the anatomical vessel, and a connection member that resides external to the anatomical vessel and configured to receive an interventional tool therethrough; anda detachable sheath tube matable to the connection member, the detachable sheath tube including: a distal end detachably mated with the connection member of the shunt member, and a proximal end opposite from the distal end, and a tube wall retainable in a curved configuration in which a proximal portion of the detachable sheath tube is transverse to the detachable shunt member when the detachable sheath tube is mated to the connection member of the detachable shunt member, the proximal end of the detachable sheath tube configured to receive the interventional tool;wherein an internal access path defined through the detachable sheath tube, the shunt member, and the anatomical vessel is configured to movably receive an interventional tool.22. The system of claim 21 , wherein the proximal end of the detachable sheath tube is coupled with a septum hub claim 21 , the septum hub configured to receive the interventional tool.23. ...

Interface Device For Performing Hemodialysis

Interface device between a hemodialysis machine and venous and arterial tubes, this interface device comprising: a first port adapted to be connected to an output port of the hemodialysis machine; a venous port to inject blood into the venous tube; said interface device comprises: a second port adapted to be connected to an input port of the hemodialysis machine; an arterial port for receiving blood from the patient from the arterial tube, the interface device being further adapted to selectively allow or prohibit the passage of blood between the first and second ports and the venous and arterial ports respectively. 1. Interface device between a hemodialysis machine and at least one venous tube intended to be connected to a patient's circulatory system for transferring blood from the hemodialysis machine to the circulatory system , this interface device comprising:a first port adapted to be connected to an output port of the hemodialysis machine;a venous port to inject blood into the venous tube;the interface device being adapted to selectively adopt a first configuration in which the passage of blood between the first port and the venous port is prohibited and a second configuration in which the first port is connected to the venous port to allow blood to pass from the first port to the venous porter), characterized in that the interface device is also adapted to form an interface between the hemodialysis machine and an arterial tube for connection to said patient's circulatory system to transfer blood from the circulatory system to the hemodialysis machine, said interface device also comprising:a second port adapted to be connected to an input port of the hemodialysis machine;an arterial port for receiving blood from the patient via the arterial tube, the interface de-vice being further adapted to prohibit the passage of blood between the second port and the arterial portwhen the device is in its first configuration and to allow the passage of blood between the ...

Hemofiltration Device and Methods of Use Thereof

Parallel plate devices for hemofiltration or hemodialysis are provided. A parallel plate device includes a parallel plate assembly having an aligned stack of stackable plate subunits, each stackable plate subunit having a through channel for blood, where the blood channels are opened up at opposite ends of the parallel plate assembly. The parallel plate assembly is configured to form filtrate/dialysate channels interleaved with the blood channels, adjacent channels being separated by a silicon nanoporous filtration membrane. A blood conduit adaptor is attached to the parallel plate assembly at each of the ends, and is configured to distribute blood to or collect blood from the blood channels. Also provided are systems and methods for using the parallel plate devices. 1. A stackable plate subunit of a parallel plate device , comprising a planar through channel bound by:a first side of a first silicon nanoporous membrane, anda first side of a second silicon nanoporous membrane, a length of a first strut of the stackable frame comprises a slot configured to form an opening at a first end of the through channel, and', 'a length of a second strut of the stackable frame opposite the first strut comprises a slot configured to form an opening at a second end of the through channel,, 'wherein the first silicon nanoporous membrane and the second silicon nanoporous membrane are positioned in a stackable frame such that the membranes are substantially parallel to each other and in a spaced apart configuration, wherein'} a second side of the first silicon nanoporous membrane opposite the first side, and', 'a second side of the second silicon nanoporous membrane opposite the first side when the stackable plate subunit is stacked., 'and wherein a planar channel is latently formed along each of'}2. The stackable plate subunit of claim 1 , wherein a third strut and a fourth strut of the stackable frame each comprise one or more through holes configured to provide fluidic ...

Catheter Assembly Including a Multi-Lumen Configuration

A catheter assembly for use in accessing a vasculature of a patient is disclosed. In one embodiment, the catheter assembly includes a catheter body that includes a flattened oval outer surface and defines first and second lumens. The catheter body defines a distal tip region that includes a venous lateral opening that is in fluid communication with the first lumen and includes a distal-facing portion. The distal tip region further includes an arterial lateral opening that is in fluid communication with the second lumen, includes a distal-facing portion, and is substantially un-staggered with respect to the venous lateral opening. A distal end opening is in fluid communication with a power injectable third lumen. In another embodiment, the first and second lumens each generally include a reniform cross-sectional shape. In yet another embodiment, a dual-lumen catheter includes first and second lumens that each define a modified ellipse cross-sectional shape. 1. A method for making an elongate catheter tube , the method comprising: an outer surface having a flattened oval cross-sectional shape with opposing flat sides;', 'a first lumen and a second lumen separated by a septum having an hourglass cross-sectional shape; and', 'a third lumen between the first lumen and the second lumen, the third lumen configured to withstand pressures associated with power injection of a fluid therethrough., 'extruding an extrusion material to define2. The method for making according to claim 1 , wherein the extruding further comprises defining the first lumen and the second lumen to each have a cross-sectional shape including:a minor arc portion adjacent the septum;a major arc portion adjacent an outer wall of the catheter tube; androunded first and second corners interposed between the minor arc portion and the major arc portion.3. The method for making according to claim 2 , wherein the extruding comprises defining the third lumen to be positioned adjacent the minor arc portion of ...

APPARATUS AND METHOD FOR CANNULATION OF VASCULAR ACCESS VESSEL

An apparatus is provided for rotatable selection of sites for cannulation with a needle along a subcutaneous vascular access vessel. The cannulation site selection apparatus comprises a template having an inner surface and an outer surface, and a plurality of visible markings on the outer surface of the template. The template is adapted to be disposed adjacent the subcutaneous vascular access vessel such that the markings align with the cannulation sites along the vascular access vessel for selecting a site for cannulation with a needle into the vascular access vessel. 2. The cannulation site selection apparatus as recited in claim 1 , wherein the vascular access vessel is an arteriovenous dialysis access graft subcutaneously implanted in a body of a patient.3. The cannulation site selection apparatus as recited in claim 1 , wherein the vascular access vessel is an arteriovenous fistula in a body of a patient.4. The cannulation site selection apparatus as recited in claim 1 , wherein the plurality of visible markings comprises an amount of cannulation site selection markings such that a user can cannulate the vascular access vessel at a different cannulation site selection marking for four weeks of treatment.5. (canceled)6. The cannulation site selection apparatus as recited in claim 1 , wherein the plurality of visible markings are on a first side and a second side of a longitudinal axis of the template.7. The cannulation site selection apparatus as recited in claim 1 , wherein the template is translucent.8. The cannulation site selection apparatus as recited in claim 1 , further comprising a key on the template claim 1 , the key facilitating alignment of the template for rotation of the cannulation site selection markings.9. The cannulation site selection apparatus as recited in claim 8 , wherein the key includes a reproduction of an image of a forearm and a wrist of a patient.10. The cannulation site selection apparatus as recited in claim 9 , wherein the key ...

CHARGED GRAFTS AND METHODS FOR USING THEM

A system for preventing thrombosis in an implantable medical device includes an implantable medical device sized for implantation at least partially within a patient's body. The device includes an at least partially electrically conductive portion that is disposed within a patient's body upon implantation, an electrode coupled to the electrically conductive portion of the device; and a power source coupled to the electrode. The power source provides a negative electric charge to the at least partially electrically conductive portion for an indefinite period of time. The device may be configured to resist thrombosis, infection, and/or undesired tissue growth via the charged conductive portion once implanted. Exemplary embodiments of the implantable medical device include a hemodialysis vasculature graft, a dialysis catheter, a coronary artery, and a heart valve. 1. A system for preventing at least one of infection , thrombosis , and undesired tissue growth in an implantable medical device , comprising:an implantable medical device sized for implantation at least partially within a patient's body, the device comprising an at least partially electrically conductive portion that is disposed within a patient's body upon implantation; anda power source coupled to the electrode for providing an electric charge to the at least partially electrically conductive portion.234-. (canceled)35. A method for preventing thrombosis on an implantable device in a body , the method comprising:implanting the device within a patient's body, the device comprising an at least partially electrically conductive portion, and a power source coupled to the at least partially electrically conductive portion; andapplying a negative electrical charge to the at least partially electrically conductive portion for an indefinite time to prevent thrombosis adjacent the at least partially electrically conductive portion.36. The method of claim 35 , wherein implanting the device comprises:implanting an ...

CANNULAS AND CANNULA ASSEMBLIES FOR HEMODIALYSIS

A cannula assembly comprises a cannula including a first portion, and a second portion extending from a distal end of the first portion, the second portion being more flexible than the first portion and configured to be inserted into a fistula vein of a patient. A needle is removably disposed in the cannula and configured to be displaced axially within the cannula. 1. A cannula assembly , comprising: a first portion, and', 'a second portion extending from a distal end of the first portion, the second portion being more flexible than the first portion and configured to be inserted into a fistula vein of a patient; and, 'a cannula comprisinga needle removably disposed in the cannula and configured to be displaced axially within the cannula.2. The cannula assembly of claim 1 , wherein a wall of the cannula has a first thickness at the first portion and a second thickness at the second portion claim 1 , the second thickness being less than the first thickness.3. The cannula assembly of claim 1 , wherein the first portion of the cannula is formed from a first material and the second portion of the cannula is formed from a second material claim 1 , the second material being more flexible than the first material.4. The cannula assembly of claim 1 , wherein one or more apertures extend radially through a wall of the second portion at a distal end of the second portion.5. The cannula assembly of claim 1 , further comprising:a hub coupled to a proximal end of the first portion of the cannula, the hub defining a fluid conduit configured to deliver a fluid into or receive a fluid from the cannula,wherein the needle extends through the hub and is axially displaceable through the hub.6. A cannula assembly comprising: a first channel,', 'a second channel disposed adjacent to the first channel and fluidly separated from the first channel by a wall, and', 'a tip portion located at a distal end of the first channel and/or the second channel and configured to be inserted into a ...

APPARATUS FOR CONFIGURING AN ARTERIOVENOUS FISTULA

An embodiment of the invention relates to an apparatus for supporting first and second blood vessels connected by an anastomosis at a fistula, the apparatus comprising: a coupler that seats on and couples to the first blood vessel; and a sleeve connected to the coupler that ensheathes a portion of the second blood vessel in the vicinity of the fistula. 1. Apparatus for configuring first and second blood vessels connected by an anastomosis at a fistula , the apparatus comprising: a mount having a saddle-like shape that seats on and couples to the first blood vessel;', 'an adapter having a substantially cylindrical shape that extends from the mount in the vicinity of the fistula; and', 'a brace extending from a side of the mount that can be closed to prevent the coupler from lifting off from the first blood vessel; and, 'a coupler comprisinga sleeve connected to the adapter that ensheathes and holds a portion of the second blood vessel in the vicinity of the fistula so that the first and second blood vessels are joined at an acute angle.2. Apparatus according to claim 1 , wherein the brace comprises two legs extending from the mount that are closable to from a ring-like shape.3. Apparatus according to wherein the acute angle formed between the first and second blood vessels at the fistula is greater than about 20° and is less than about 60°.4. Apparatus according to wherein the sleeve has a cross section that increases as a function of distance along the sleeve from the coupler for at least a first portion of the sleeve length.5. Apparatus according to wherein the cross section of the sleeve increases as a function of distance from the coupler along the sleeve beginning from the sleeve opening proximal to the fistula.6. Apparatus according to wherein the sleeve has a second portion that extends from an end of the first portion to an end of the sleeve and has a substantially same cross section at each point along its length.7. Apparatus according to claim 1 , wherein ...

Inhibition of Platelet Absorption

A cardiovascular graft is provided with highly reduced thrombogenicity. The cardiovascular graft is an electrospun non-woven mesh produced from supramolecular polymers with large diameter fibers. The cardiovascular graft can be implemented as a vascular graft into the human body to allow vascular bypass/reconstruction, or repeated venous access for dialysis treatment, as well as other disorders of small-diameter blood vessels. 1. A method of using a cardiovascular graft to reduce thrombogenic effects , comprising:having a cardiovascular graft designed as a tubular structure with an inner wall made out of a fibrous network of supramolecular compounds having hard-blocks covalently bonded with soft-blocks, wherein the hard-blocks comprise 2-ureido-4[1H]-pyrimidinone (UPy) compounds, wherein the fibrous network is a bioresorbable electrospun non-woven fibrous network with fibers having an average fiber diameter of 1-10 microns, and wherein the tubular structure has an inner diameter between 2-8 mm, and an inner wall thickness of 20-900 micrometers; andusing the cardiovascular graft to reduce thrombogenic effects upon implantation of the cardiovascular graft in a human body.2. The method as set forth in claim 1 , further comprises administering an an αβinhibitor in combination with the implantation of the cardiovascular graft.3. The method as set forth in claim 1 , wherein the inner wall has a thickness of at least 200 micrometers and has pores with an average pore size between 5 and 10 micrometers.4. The method as set forth in claim 1 , wherein the inner wall has pores with an average pore size between 5 and 8 micrometers and an average porosity ranging from 50 to 80%.5. The method as set forth in claim 1 , wherein the tubular structure has an inner diameter between 3-6 mm and a wall thickness of 200-800 microns.6. The method as set forth in claim 1 , wherein the tubular structure has an inner diameter between 4-8 mm and an inner wall thickness of 300-900 microns.7. The ...

PUNCTURE NEEDLE

The success rate of the insertion of a dull needle into a puncture hole is improved. A puncture needle is provided which is inserted into a puncture route that is formed to cover from a skin surface to a shunt vessel surface so as to expand an incision of a puncture hole formed in the shunt vessel surface. The puncture needle has an inclined end face that is inclined toward a front end of the needle, and a front end part of the inclined end face has an edge having no sharpness. Right and left side parts of the inclined end face which are contiguous with the front end part are respectively inclined outward, and side edges of the side parts are provided with cutting lines. 1. A puncture needle that is inserted into a puncture route formed to cover from a skin surface to a shunt vessel surface so as to expand an incision forming a puncture hole that is made in the shunt vessel surface , the puncture needle comprising:an inclined end face that is inclined toward a front end of the needle,wherein a front end part of the inclined end face constitutes an edge having no sharpness, andwherein right and left side edges of the inclined end face which are contiguous with the front end part are provided with cutting lines each having an edge angle from 5 degrees to 85 degrees.2. The puncture needle according to claim 1 , wherein right and left side parts of the inclined end face which are contiguous with the front end part are respectively inclined claim 1 , and side edges of the side parts are provided with the cutting lines.3. The puncture needle according to claim 2 , wherein the side parts are inclined so as to become lower in an outward direction.4. The puncture needle according to any of to claim 2 , wherein the edge angle of the cutting lines is from 15 degrees to 65 degrees.5. The puncture needle according to any of to claim 2 , wherein the front end part of the inclined end face is formed into an arc shape.6. The puncture needle according to claim 5 , wherein the front ...

VISCOELASTIC ANALYSIS IN PATIENTS WITH DISEASE ASSOCIATED WITH CARDIOVASCULAR SYSTEM

In some embodiments, the invention provides a method for identifying a patient suffering from or suspected of suffering in from a disease associated with the cardiovascular system that is having a subnormal response to the treatment for the disease comprising: subjecting a blood sample from a patient being treated for a disease to a viscoelastic analysis in the presence of a known amount of a thrombolytic agent, to obtain a coagulation characteristic value of the patient; and comparing the coagulation characteristic value of the patient to a coagulation characteristic value of a healthy individual, wherein a difference in the coagulation characteristic value of the patient as compared to the coagulation characteristic value of the healthy individual identifies the patient as a patient having a subnormal response to treatment. 1. A method for identifying a patient suffering from or suspected of suffering from a disease associated with the cardiovascular system who has a subnormal response to treatment for said disease comprising:(a) subjecting a blood sample from a patient receiving treatment for a disease associated with the cardiovascular system to a viscoelastic analysis or other physical measurement (such as, but not limited to, mechanical, acoustic, optical, magnetic, radiologic, or image processing methods) of clot strength or integrity or fibrin strength or integrity, in the presence of a known amount of a thrombolytic agent, to obtain a coagulation characteristic value of the patient;(b) subjecting a blood sample from one or more healthy individuals not receiving treatment for a disease associated with the cardiovascular system to a viscoelastic analysis or other physical measurement (such as, but not limited to, mechanical, acoustic, optical, magnetic, radiologic, or image processing methods) of clot strength or integrity or fibrin strength or integrity, in the presence of a known amount of a thrombolytic agent, to obtain a coagulation characteristic value ...

ARTERIOVENOUS ACCESS VALVE SYSTEM AND PROCESS

In accordance with certain aspects of the present disclosure, a subcutaneous arteriovenous graft system is described. The system includes an arteriovenous graft having an arterial end and an opposite venous end, at least one of the arterial end and venous end including a support frame. The system further includes a first valve device positioned at the arterial end of the arteriovenous graft and a second valve device positioned at the venous end of the arteriovenous graft and an actuator in communication with both the first valve device and the second valve device, the actuator being configured to cause each valve device to open or close simultaneously. 1. A subcutaneous arteriovenous graft system comprising:an arteriovenous graft having an arterial end and an opposite venous end, at least one of the arterial end and venous end comprising a support frame;a first valve device positioned at the arterial end of the arteriovenous graft and a second valve device positioned at the venous end of the arteriovenous graft; andan actuator in communication with both the first valve device and the second valve device, the actuator being configured to cause each valve device to open or close simultaneously.2. A graft system as in claim 1 , wherein both the arterial end and the venous end each comprise a support device.3. A graft system as in claim 1 , wherein the support frame comprises a stent.4. A graft system as in claim 1 , wherein the support frame is encapsulated within the graft.5. A graft system as in claim 1 , wherein each valve device is configured to exert a pressure of between about 20 psi and about 40 psi against the support frame.6. A graft system as in claim 1 , further comprising a coupling insert claim 1 , the coupling insert joining the arteriovenous graft to the support frame.7. A graft system as in claim 6 , wherein the arteriovenous graft and the support frame define a flow path claim 6 , the coupling insert being positioned within the flow path.8. A graft ...

DIALYSIS VALVE AND METHOD

A dialysis valve includes a tube attached between an artery and a vein which, when elongated, simultaneously narrows in diameter at at least one location. The narrowed portion of the tube decreases the volume and velocity between the arterial and venous side of the patient to prevent damage or intimal hyperplasia on the venous side between dialysis treatments. When the valve is opened for dialysis, an unrestricted blood flow exists between the arterial and venous side, permitting a controlled, open blood flow during dialysis. 1. (canceled)2. An implantable dialysis valve device , comprising:an implantable valve actuation apparatus sized to fit in a body limb;a flexible implantable tube portion coupled to the implantable valve actuation apparatus and configured to convey blood, the flexible implantable tube portion comprising a flexible polymer material and a nitinol structure;a blood input graft portion in fluid communication with the flexible implantable tube portion and being configured to attach with a blood vessel for receiving blood;a blood output graft portion in fluid communication with the flexible implantable tube portion and being configured to attach with another blood vessel for outputting blood; andthe implantable valve actuation apparatus comprising: a self-sealing membrane configured to be repeatedly punctured when the self-sealing membrane is implanted adjacent to an underside of a skin region, a hydraulic port proximate to the self-sealing membrane such that the self-sealing membrane is positioned between the hydraulic port and the skin region when the self-sealing membrane is implanted adjacent to the underside of the skin region, a controllable valve actuation member in fluid communication with the hydraulic port, wherein the controllable valve actuation member is movable, in response to pressurized injection of a hydraulic fluid through the self-sealing membrane and the hydraulic port to act upon the controllable valve actuation member, to alter ...

METHODS AND SYSTEMS FOR ESTABLISHING RETROGRADE CAROTID ARTERIAL BLOOD FLOW

Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. The flow control assembly includes one or more components that interact with the blood flow through the shunt. 114.-. (canceled)15. A system for use in accessing and treating a carotid artery , said system comprising:an arterial access sheath formed of an elongated body sized and shaped to be introduced into a common carotid artery, the arterial access sheath having an internal lumen that can receive blood flow;a shunt that fluidly communicates with the arterial access sheath, wherein the shunt provides a pathway for blood to flow from the arterial access sheath; anda flow control assembly mechanically attached to the pathway of the shunt, wherein the flow control assembly defines two or more parallel flow paths and a valve to open or close one or more of the flow paths to selectively direct blood flow through one or more of the flow paths.16. A system as in claim 15 , further comprising a port fluidly communicating with the shunt claim 15 , wherein the port may be used to connect an aspiration device to the shunt.17. A system as in claim 16 , further comprising an control valve that controls fluid communication between the shunt and the port.18. A system as in claim 17 , wherein the control valve automatically opens upon attachment of an aspiration or injection device claim 17 , and wherein the control valve automatically closes with removal of the aspiration or injection device.19. A system as in claim 16 , wherein the aspiration ...

STENT TO ASSIST IN ARTERIOVENOUS FISTULA FORMATION

There is described an arteriovenous fistula stent, having a tubular body comprising a series of sinusoidal shaped struts along the length of the tubular body. A plurality of curvilinear connectors extend between and are attached to adjacent struts wherein a first end of a connector is attached to a distal face of a proximal strut apex and a second end of a connector is attached to a proximal face of a distal strut apex. A pair of unconnected strut apexes are between pairs of connected apexes. When the tubular body is in a stowed configuration a proximal aperture and a distal aperture are circular and when the tubular body is in a deployed configuration the distal aperture is oblong or ovoid. There is also described a method for inserting a stent for use in creation of an arteriovenous fistula by identifying a candidate artery and a candidate vein and dissecting the candidate vein. Next, inserting a stent into the vein and creating a breach in the candidate artery at a desired angle and location. Next, introducing the stent and vein into the candidate artery and forming the stent into a curvature angle selected to minimize turbulent blood flow in an anastomosis formed by the vein and the artery. Optionally, there is a step of fastening a distal portion of the stent to the artery. 113.-. (canceled)14. A method for inserting a stent for use in creation of an arteriovenous fistula , comprising the steps of:identifying a candidate artery and a candidate vein;dissecting the candidate vein;inserting a stent into the vein;creating a breach in the candidate artery at a desired angle and location;introducing the stent and vein into the candidate artery;forming the stent into a curvature angle selected to minimize turbulent blood flow in an anastomosis formed by the vein and the artery; andfastening a distal portion of the stent to the artery to form an anastomosis.15. The method of wherein after the fastening step the anastomosis formed by the vein and the artery forms an ...

UNITARY BODY SYSTEMS AND DEVICES AND METHODS TO USE THE SAME FOR RETROPERFUSION

Unitary body systems and devices and methods to use the same for retroperfusion. In an exemplary device embodiment of the present disclosure, the device comprises a unitary body having a wall and a lumen defined therethrough, a first portion terminating at a first end and configured for at least partial placement within a mammalian artery, a first one-way valve positioned at or near an end of the first portion opposite the first end, a second portion terminating at a second end and configured for at least partial placement within a mammalian vein, and a second one-way valve positioned at or near an end of the second portion opposite the second end. 1. A perfusion device , comprising:a unitary body having a wall and a lumen defined therethrough;a first portion terminating at a first end and configured for at least partial placement within a mammalian artery;a first one-way valve positioned at or near an end of the first portion opposite the first end;a second portion terminating at a second end and configured for at least partial placement within a mammalian vein; anda second one-way valve positioned at or near an end of the second portion opposite the second end.2. (canceled)3. (canceled)4. The device of claim 1 , wherein the first portion has a first length claim 1 , wherein the second portion has a second length claim 1 , and wherein the first length is less than the second length.5. (canceled)6. (canceled)7. (canceled)8. (canceled)9. The device of claim 1 , wherein in use at least part of the first portion is configured to be positioned within a subclavian artery or axiallary artery claim 1 , and wherein at least part of the second portion is configured to be positioned within a subclavian vein or an axillary vein for use and/or treatment at or near the heart.10. The device of claim 1 , wherein in use at least part of the first portion is configured to be positioned within an iliac artery claim 1 , and wherein at least part of the second portion is configured to ...

VASCULAR ACCESS SYSTEM WITH CONNECTOR

A connector for fluidly coupling proximal and distal tubular segments of a fluid conduit is provided. In one embodiment, the connector can include a connector body having an outer surface defining a first outer perimeter and an inner surface defining a lumen. The connector can also include a connecting device having an open configuration and a plurality of closed configurations. The connecting device can include first and second members configured to engage each other to secure the fluid conduit to the connector. The connecting device can also include a plurality of closed configurations for securing fluid conduits of different sizes. 119-. (canceled)20. A vascular access system for providing blood flow between two locations in a cardiovascular system of a patient , the vascular access system comprising:a conduit comprising a conduit lumen, the conduit comprising a first end configured to be coupled to a blood vessel; and a distal portion configured to engage a second end of the conduit;', 'a body extending from the distal portion to a proximal portion;', 'a flange disposed on the body between the distal portion and the proximal portion;', wherein the first and second members are selectively disposable in a first receiving configuration and a second engaged figuration;', 'wherein in the first receiving configuration the connecting device is configured to receive and couple to the conduit; and', 'wherein in the second engaged configuration the connecting device is configured to provide a fluid pathway from the conduit through the connecting device., 'a connecting device comprising a first and a second member;'}], 'a connector comprising21. The vascular access system of claim 20 , where the first and second members comprise engagement features.22. The vascular access system of claim 20 , further comprising a safety mechanism configured to lock the first and second members in the second engaged configuration.23. The vascular access system of claim 20 , wherein ...

APPARATUS AND METHOD FOR IMPLANTING AN ARTERIOVENOUS GRAFT

An apparatus for delivery of a vascular arteriovenous graft comprises a tubular sleeve defining an interior lumen adapted for being slidably positioned over a tunneling instrument. Once the tunneling instrument has been advanced to a desired subcutaneous anatomical location the shaft is removed while the sleeve remains in the tissue. The sleeve has a linear slit extending from a proximal end to a point intermediate the length of the sleeve. The lumen receives the distal end of the graft and at least a portion of a cannulation chamber such that the end of the sleeve progressively expands along the slit to provide an enlarged diameter for accommodating the cannulation chamber. Longitudinal force to the sleeve during removal of the sleeve from the tissue secures the graft in the sleeve by radial compression of the sleeve for pulling the graft and the sleeve through the tunnel and deploying the vascular graft. 2. The subcutaneous delivery apparatus as recited in claim 1 , wherein the sleeve is adapted to receive substantially the entire length of the shaft between the handle and the tip.3. The subcutaneous delivery apparatus as recited in claim 1 , wherein the sleeve is uniformly tapered from the proximal end to the distal such that distal end has a reduced diameter from the proximal end.4. The subcutaneous delivery apparatus as recited in claim 1 , wherein the slit is linear.5. The subcutaneous delivery apparatus as recited in claim 1 , wherein the sleeve comprises an enlarged diameter portion adjacent the proximal end claim 1 , the enlarged diameter portion of the sleeve adapted for receiving the cannulation chamber.7. The subcutaneous implantation apparatus as recited in claim 6 , wherein the sleeve is configured to receive substantially the entire length of the shaft between the handle and the tip.8. The subcutaneous implantation apparatus as recited in claim 6 , wherein the sleeve is uniformly tapered from the proximal end to the distal such that distal end has a ...

Catheter Assembly Including a Multi-Lumen Configuration

A catheter assembly for use in accessing a vasculature of a patient is disclosed. In one embodiment, the catheter assembly includes a catheter body that includes a flattened oval outer surface and defines first and second lumens. The catheter body defines a distal tip region that includes a venous lateral opening that is in fluid communication with the first lumen and includes a distal-facing portion. The distal tip region further includes an arterial lateral opening that is in fluid communication with the second lumen, includes a distal-facing portion, and is substantially un-staggered with respect to the venous lateral opening. A distal end opening is in fluid communication with a power injectable third lumen. In another embodiment, the first and second lumens each generally include a reniform cross-sectional shape. In yet another embodiment, a dual-lumen catheter includes first and second lumens that each define a modified ellipse cross-sectional shape.