# US 10,869,717 B2 · Devices and methods for fistula formation > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,869,717 B2 - Document ID: US10869717B2 - Status: Granted - Kind: B2 - Application number: 15/344,332 - Filed: 2016-11-04 - Published: 2017-05-04 - Granted: 2020-12-22 - Earliest claimed: 2012-10-11 - Assignees: TVA Medical, Inc. - Applicants: TVA Medical, Inc. - Inventors: Jesus M. Rios; William E. Cohn; Dheeraj K. Rajan; Adam L. Berman; Dana R. Mester; Damian A. Jelich - Web page: https://patentgrep.com/patent/US10869717B2 ## CPC - A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)} - A61B 17/11: for performing anastomosis; Buttons for anastomosis - A61B 17/320016: {Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes (A61B10/0233, A61B17/29, A61B17/3207 take precedence)} - A61B 17/3478: {Endoscopic needles, e.g. for infusion (biopsy needles A61B10/0233; catheters with injection needles A61M25/0067)} - A61B 18/148: {having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy} - A61M 1/3655: {Arterio-venous shunts or fistulae} - A61M 25/01: Introducing, guiding, advancing, emplacing or holding catheters (A61M25/10 takes precedence) - A61B 2017/00252: {for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel} - A61B 2017/1107: {for blood vessels} - A61B 2017/22077: {with a part piercing the tissue (A61B2017/22044 takes precedence)} - A61B 2018/00202: {rotating} - A61B 2018/00404: {Blood vessels other than those in or around the heart} - A61B 2018/00577: {Ablation} - 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 Described here are devices and methods for forming a fistula between two vessels. In some instances, the fistula may be formed between a proximal ulnar artery and a deep ulnar vein. The fistula may be formed using an electrode, and may be formed with a first catheter placed in a first blood vessel and a second catheter placed in a second blood vessel. In some instances, access to the proximal ulnar artery may be achieved through a brachial artery, and access to the deep ulnar vein may be achieved through a brachial vein. ## Claims ### Claim 1 A method for treating a patient comprising: forming an access site in an arm location; and forming a first fistula between a proximal ulnar artery and a first deep ulnar vein, the first deep ulnar vein being substantially parallel to the proximal ulnar artery between a brachial artery and an interosseous artery. ### Claim 2 (depends on 1) The method of claim 1 wherein the arm location is a wrist, forearm, or upper arm. ### Claim 3 (depends on 2) The method of claim 2 wherein the access site is formed in an ulnar artery at the wrist. ### Claim 4 (depends on 1) The method of claim 1 further comprising endovascularly advancing a distal portion of a first catheter through the access site and into an ulnar artery. ### Claim 5 (depends on 1) The method of claim 1 further comprising endovascularly advancing a distal portion of a first catheter into the first deep ulnar vein. ### Claim 6 (depends on 5) The method of claim 5 wherein the first catheter comprises a fistula-forming element, and wherein forming the first fistula between the proximal ulnar artery and the first deep ulnar vein comprises forming the first fistula using the fistula-forming element. ### Claim 7 (depends on 6) The method of claim 6 wherein the fistula-forming element comprises an electrode. ### Claim 8 (depends on 7) The method of claim 7 further comprising moving the electrode away from the first catheter against a vessel wall of the first deep ulnar vein and wherein forming the first fistula between the proximal ulnar artery and the first deep ulnar vein comprises ablating the vessel wall of the first deep ulnar vein and a vessel wall of the proximal ulnar artery. ### Claim 9 (depends on 5) The method of claim 5 further comprising advancing a distal portion of a second catheter into the proximal ulnar artery. ### Claim 10 (depends on 9) The method of claim 9 wherein the first and second catheters each comprise one or more magnets and further comprising aligning the first and second catheters using the one or more magnets of each of the first and second catheters. ### Claim 11 (depends on 9) The method of claim 9 wherein the second catheter comprises a fistula-forming element, and wherein forming the first fistula between the proximal ulnar artery and the first deep ulnar vein comprises forming the first fistula using the fistula-forming element. ### Claim 12 (depends on 11) The method of claim 11 wherein the fistula-forming element comprises an electrode. ### Claim 13 (depends on 12) The method of claim 12 further comprising moving the electrode away from the second catheter against a vessel wall of the proximal ulnar artery, and wherein forming the first fistula between the proximal ulnar artery and the first deep ulnar vein comprises ablating the vessel wall of the proximal ulnar artery and a vessel wall of the first deep ulnar vein. ### Claim 14 (depends on 9) The method of claim 9 wherein endovascularly advancing the distal portion of the second catheter into the proximal ulnar artery comprises endovascularly advancing the distal portion of the second catheter into the proximal ulnar artery from the brachial artery. ### Claim 15 (depends on 14) The method of claim 14 further comprising creating a second access site in the brachial artery and advancing the second catheter into the brachial artery through the second access site. ### Claim 16 A method for treating a patient comprising: endovascularly advancing a distal portion of a first catheter through a portion of an ulnar vein and into a first deep ulnar vein, the first deep ulnar vein being substantially parallel to an ulnar artery between a brachial artery and an interosseous artery; endovascularly advancing a distal portion of a second catheter through a portion of the brachial artery and into the ulnar artery; and forming a fistula between the first deep ulnar vein and the ulnar artery. ### Claim 17 A method for treating a patient comprising: endovascularly advancing a distal portion of a first catheter through a portion of a radial artery and into an ulnar artery; endovascularly advancing a distal portion of a second catheter through a portion of a brachial vein and into an ulnar vein; and forming a fistula between a first deep ulnar vein and the ulnar artery, the first deep ulnar vein being substantially parallel to the ulnar artery between the brachial artery and an interosseous artery.