Devices and methods for forming vascular access

A method for creating a vascular access site, the method comprising:

• providing a catheter comprising:
• an elongate body comprising a distal end,
• an exit port near the distal end of the elongate body, and
• an imaging assembly operably associated with the elongate body;
• introducing the catheter into a first vessel to generate image data;
• imaging, with the imaging assembly, the first vessel and a second vessel other than the first vessel;
• determining a location to form a vascular access site between the first vessel and the second vessel based on the imaging step;
• extending a penetrating member from inside the catheter out of the exit port of the catheter toward the determined location of the vascular access site such that the penetrating member passes through walls of the first vessel and the second vessel, thereby creating the vascular access site, wherein the penetrating member comprises an interior lumen terminating at a distal tip of a needle;
• and
• while the penetrating member remains extended out of the exit port to the vascular access site, extending a cauterizing element through the interior lumen of the needle into the vascular access site.