Systems and methods for creating arteriovenous (AV) fistulas

A system for creating an arteriovenous (AV) fistula, comprising:

• 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 said sheath;
• a needle configured to be inserted into a vessel through said side access needle catheter;
• a toggle delivery catheter configured to fit within the hollow interior of said sheath;
• and
• a toggle apparatus configured to be delivered into the vessel through said toggle delivery catheter, said toggle apparatus comprising a shaft and a toggle member pivotally attached to a distal end of said shaft, the toggle member comprising an elongate bar defining a guidewire passage, wherein the toggle member is received in the toggle delivery catheter when the toggle member is in a first orientation, the toggle member being biased toward the first orientation.

A system for creating an arteriovenous (AV) fistula, comprising:

• 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 said sheath, wherein said side access needle catheter comprises a primary lumen and a secondary lumen;
• a needle configured to be inserted into a vessel through said side access needle catheter;
• a toggle delivery catheter configured to fit within the hollow interior of said sheath;
• and
• a toggle apparatus configured to be delivered into the vessel through said toggle delivery catheter, said toggle apparatus comprising a shaft and a toggle member pivotally attached to a distal end of said shaft, the toggle member comprising an elongate bar;
• and
• a heater in said toggle delivery catheter, for the purpose of creating an elongated communicating aperture between the vessel and an adjacent vessel, the device further comprising a source of energy for energizing the heater, wherein said heater comprises a heater insert which is structurally separate from said toggle delivery catheter so that the insert may be removed therefrom.