Catheter apparatus and method for arterializing a vein

A catheter apparatus for arterializing a vein by creating a fistula between the vein and an artery, the apparatus comprising:

• an arterial catheter having a distal end insertable to a position wherein the distal end is adjacent a site within the artery for the fistula,
• a venous catheter having a distal end insertable to a position wherein the distal end is adjacent a site within the vein for the fistula, the venous catheter including a radially expandable structure adjacent the distal end which selectively extends outwardly a portion of the wall of the vein adjacent the venous fistula site towards contact with the wall of the artery adjacent the arterial fistula site, and
• a tool for creating an opening through the wall of the artery adjacent the arterial fistula site and an opening through the outwardly extending portion of the wall of the vein adjacent the venous fistula site, wherein the tool includes a needle coupled to the arterial catheter adjacent the distal end of the arterial catheter, the needle being selectively switchable between a first, inactive configuration wherein the needle can be guided through the artery without causing trauma to the artery wall and a second, active configuration wherein the needle is operative to create the opening in the artery wall, and wherein the needle is hollow and terminates in a beveled, pointed tip, and wherein the tool further includes a wire selectively insertable through the needle, the wire having a generally blunt distal end, the wire and needle providing the inactive configuration when the distal end of the wire extends through the needle to a position at least flush with the needle tip, and the wire and needle providing the active configuration when the wire is retracted from the needle tip.

A method of arterializing a peripheral vein by creating a fistul a between the vein and a peripheral artery, the method comprising:

• providing an arterial catheter having a distal end and inserting the arterial catheter into the artery to a position wherein the distal end is adjacent a site for the fistula within the artery;
• providing a venous catheter having a distal end and inserting the venous catheter into the vein to a position wherein the distal end is adjacent a site for the fistula within the artery;
• after positioning the arterial and venous catheters, radially expanding a portion of the vein wall adjacent the venous fistula site to bring the venous fistula site in closer proximity to the arterial fistula site;
• after radially expanding the portion of the vein wall, creating an opening through the wall of the artery adjacent the arterial fistula site and creating an opening through the wall of the vein adjacent the venous fistula site,
• wherein the venous catheter includes a wire basket deployable adjacent the distal end of the venous catheter,
• and wherein the step of radially expanding a portion of the vein wall includes deploying the wire basket.