# US 10,499,919 B2 · Systems and methods for percutaneous access and formation of arteriovenous fistulas

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- Number: US 10,499,919 B2
- Document ID: US10499919B2
- Status: Granted
- Kind: B2
- Application number: 15/242,453
- Filed: 2016-08-19
- Published: 2017-02-23
- Granted: 2019-12-10
- Earliest claimed: 2015-08-21
- Assignees: Avenu Medical, Inc.
- Applicants: Avenu Medical, Inc.
- Inventors: Seth Arnold Foerster
- Web page: https://patentgrep.com/patent/US10499919B2

## CPC

- A61B 17/11: for performing anastomosis; Buttons for anastomosis
- A61B 18/082: {Probes or electrodes therefor}
- A61B 2017/00336: {with a protective sleeve, e.g. retractable or slidable}
- A61B 2017/1107: {for blood vessels}
- A61B 2017/1139: {Side-to-side connections, e.g. shunt or X-connections}
- A61B 2018/00142: {lubricating}
- A61B 2018/00404: {Blood vessels other than those in or around the heart}
- A61B 2018/00577: {Ablation}
- A61B 2018/00601: {Cutting}
- A61B 2018/00619: {Welding}
- A61B 2018/00791: {Temperature}
- A61B 2090/034: {abutting on parts of the device itself}
- A61B 2090/061: {for measuring dimensions, e.g. length}
- A61B 2090/064: {for measuring force, pressure or mechanical tension}
- A61M 25/0067: {characterised by the distal end, e.g. tips (A61M25/0054, A61M25/04 take precedence; balloon catheters A61M25/10)}
- A61M 25/0068: {Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure}
- A61M 25/0069: {Tip not integral with tube}
- A61M 25/0662: {Guide tubes}
- A61M 2025/0681: {Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube}
- A61M 2025/0687: {having means for atraumatic insertion in the body or protection of the tip of the sheath during insertion, e.g. special designs of dilators, needles or sheaths}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}

## Abstract

A catheter system includes a proximal base having a distal diagonal end surface and a distal tip connected to the proximal base and movable relative to the proximal base, wherein the distal tip has a proximal diagonal end surface. The distal diagonal end surface and the proximal diagonal end surface contact opposing sides of a tissue portion to create the fistula. A peripheral edge defines the proximal distal end surface. A proximal point is disposed on the peripheral edge. The proximal point comprises a shortened angle and a fully radiused edge relative to a remaining portion of the peripheral edge and a relief recess is disposed on a distal end of the proximal base, both for the purpose of minimizing tissue snagging.

## Claims

### Claim 1

A catheter system for creating an arteriovenous (AV) fistula, comprising:
a proximal base having a distal diagonal end surface;
a distal tip connected to the proximal base and movable relative to the proximal base, the distal tip having a proximal diagonal end surface, the distal diagonal end surface and the proximal diagonal end surface being adapted to contact opposing sides of a tissue portion to create the fistula;
a peripheral edge defining said proximal diagonal end surface;
a proximal point on said peripheral edge; and
a relief recess disposed along a side wall defining a length of the proximal base, wherein the relief recess has a depth extending radially inwardly from an outer surface of the side wall toward a straight operating axis along which an entire length of the proximal base is disposed, the relief recess having an axial length which is greater than the depth of the recess.

### Claim 2 (depends on 1)

The catheter system as recited in claim 1, wherein the relief recess is peripherally spaced from the proximal point on an opposed side of the straight operating axis relative to the proximal point.

### Claim 3 (depends on 1)

The catheter system as recited in claim 1, and further comprising a sheath adapted to be disposed about said proximal base, the sheath having a distal end wherein a first portion of the sheath distal end is adapted to be disposed in said relief recess when the sheath is disposed about said proximal base, and further wherein a space is created at a second portion of the sheath distal end into which the proximal point may pass when the first portion of the sheath distal end is disposed in said relief recess, the second portion of the sheath distal end being radially opposed to the first portion of the sheath distal end.

### Claim 4 (depends on 1)

The catheter system as recited in claim 1, and further comprising a stop formed in a peripheral edge of the distal diagonal end surface of the proximal base, the stop being disposed at a peripheral location directly aligned with the proximal point and radially opposed to the relief recess.

### Claim 5 (depends on 1)

The system as recited in claim 1, and further comprising a shaft for connecting the distal tip to the proximal base, the shaft being extendable and retractable to extend and retract said distal tip relative to the proximal base.

### Claim 6 (depends on 1)

The system as recited in claim 1, and further comprising a heating assembly comprising an energizable heating element disposed on at least one of the distal diagonal end surface and the proximal diagonal end surface.

### Claim 7 (depends on 1)

The system as recited in claim 1, wherein said proximal point comprises a fully radiused edge relative to a remaining portion of said peripheral edge.

### Claim 8 (depends on 7)

The system as recited in claim 7, wherein the proximal point further comprises a shortened angle.

### Claim 9

A catheter system for creating an arteriovenous (AV) fistula, comprising:
a proximal base having a distal diagonal end surface;
a distal tip connected to the proximal base and movable relative to the proximal base, the distal tip having a proximal diagonal end surface, the distal diagonal end surface and the proximal diagonal end surface being adapted to contact opposing sides of a tissue portion to create the fistula; and
a relief recess disposed along a side wall defining a length of the proximal base, wherein the relief recess has a depth extending radially inwardly from an outer surface of the side wall toward a straight operating axis along which an entire length of the proximal base is disposed, the relief recess having an axial length which is parallel to the straight operating axis and is greater than the depth of the recess.

### Claim 10 (depends on 9)

The catheter system as recited in claim 9, and further comprising:
a peripheral edge defining said proximal diagonal end surface; and
a proximal point on said peripheral edge.

### Claim 11 (depends on 10)

The catheter system as recited in claim 10, wherein the relief recess is peripherally spaced from the proximal point on an opposed side of the straight operating axis relative to the proximal point.

### Claim 12 (depends on 11)

The catheter system as recited in claim 11, and further comprising a sheath adapted to be disposed about said proximal base, the sheath having a distal end wherein a first portion of the sheath distal end is adapted to be disposed in said relief recess when the sheath is disposed about said proximal base, and further wherein a space is created at a second portion of the sheath distal end into which the proximal point may pass when the first portion of the sheath distal end is disposed in said relief recess, the second portion of the sheath distal end being radially opposed to the first portion of the sheath distal end.

### Claim 13 (depends on 11)

The catheter system as recited in claim 11, and further comprising a stop formed in a peripheral edge of the distal diagonal end surface of the proximal base, the stop being disposed at a peripheral location directly aligned with the proximal point and radially opposed to the relief recess.

### Claim 14 (depends on 10)

The system as recited in claim 10, wherein said proximal point comprises a fully radiused edge relative to a remaining portion of said peripheral edge.

### Claim 15 (depends on 14)

The system as recited in claim 14, wherein the proximal point further comprises a shortened angle.

### Claim 16 (depends on 9)

The system as recited in claim 9, and further comprising a shaft for connecting the distal tip to the proximal base, the shaft being extendable and retractable to extend and retract said distal tip relative to the proximal base.

### Claim 17 (depends on 9)

The system as recited in claim 9, and further comprising a heating assembly comprising an energizable heating element disposed on at least one of the distal diagonal end surface and the proximal diagonal end surface.