A system for performing an image-guided transvascular shunting procedure between a first vessel and a target vessel in a portion of an anatomy of a patient, the system comprising: a needle assembly comprising: a first elongated needle portion comprising a hollow tube having a bend toward its distal tip, a puncture needle that includes at least one position indicating element at its tip, the puncture needle being slidably mounted within the hollow tube of the first elongated needle portion such that a distal tip of the puncture needle is able to be extended from an opening in the distal tip of the first elongated needle portion in a direction that is substantially tangent to a terminal portion of the bend of the first elongated needle portion, and a fluid flow lumen portion that permits fluid flow between a distal tip of the fluid flow lumen portion and an external portion of the needle assembly; and one or more processing devices configured to: determine, using one or more images of the portion of the anatomy of a patient, a path of the target vessel in three dimensions; produce, based at least in part on position and orientation information regarding the at least one position indicating element and the determined path of the target vessel, a display of: a position of the puncture needle relative to the target vessel, a projected path of the puncture needle, the projected path including a path of the puncture needle will follow if the puncture needle is extended past a distal end portion of the guide needle, a point at which the puncture needle will intersect the target vessel if the projected path of the puncture needle intersects the determined path of the target vessel, and an indicator of the closest approach from the puncture needle to the target vessel if the projected path of the puncture needle does not intersect the determined path of the target vessel. a needle assembly comprising: a first elongated needle portion comprising a hollow tube having a bend toward its distal tip, a puncture needle that includes at least one position indicating element at its tip, the puncture needle being slidably mounted within the hollow tube of the first elongated needle portion such that a distal tip of the puncture needle is able to be extended from an opening in the distal tip of the first elongated needle portion in a direction that is substantially tangent to a terminal portion of the bend of the first elongated needle portion, and a fluid flow lumen portion that permits fluid flow between a distal tip of the fluid flow lumen portion and an external portion of the needle assembly; and one or more processing devices configured to: a first elongated needle portion comprising a hollow tube having a bend toward its distal tip, a puncture needle that includes at least one position indicating element at its tip, the puncture needle being slidably mounted within the hollow tube of the first elongated needle portion such that a distal tip of the puncture needle is able to be extended from an opening in the distal tip of the first elongated needle portion in a direction that is substantially tangent to a terminal portion of the bend of the first elongated needle portion, and a fluid flow lumen portion that permits fluid flow between a distal tip of the fluid flow lumen portion and an external portion of the needle assembly; and one or more processing devices configured to: determine, using one or more images of the portion of the anatomy of a patient, a path of the target vessel in three dimensions; produce, based at least in part on position and orientation information regarding the at least one position indicating element and the determined path of the target vessel, a display of: a position of the puncture needle relative to the target vessel, a projected path of the puncture needle, the projected path including a path of the puncture needle will follow if the puncture needle is extended past a distal end portion of the guide needle, a point at which the puncture needle will intersect the target vessel if the projected path of the puncture needle intersects the determined path of the target vessel, and an indicator of the closest approach from the puncture needle to the target vessel if the projected path of the puncture needle does not intersect the determined path of the target vessel. a position of the puncture needle relative to the target vessel, a projected path of the puncture needle, the projected path including a path of the puncture needle will follow if the puncture needle is extended past a distal end portion of the guide needle, a point at which the puncture needle will intersect the target vessel if the projected path of the puncture needle intersects the determined path of the target vessel, and an indicator of the closest approach from the puncture needle to the target vessel if the projected path of the puncture needle does not intersect the determined path of the target vessel.