Patent ID: 8236014

Claim:
A method of creating an aorto-caval fistula in a patient at or near a bifurcation of an Aorta and an Inferior Vena Cava, between a starting vessel and a target vessel, wherein the starting vessel and the target vessel comprise the Aorta and the Inferior Vena Cava or the Inferior Vena Cava and the Aorta, respectively, comprising: placing an arterial catheter into the Aorta superior to the aortic bifurcation; placing a venous catheter in the Inferior Vena Cava, inferior to the fistula creation site; introducing a crossing needle device into the starting vessel; injecting contrast medium through one of the venous and arterial catheters into the target vessel; advancing a crossing needle between the Aorta and Inferior Vena Cava in multiple discrete steps; passing a first guidewire through the crossing needle into said target vessel; confirming access of the target vessel by advancing a second guidewire through the crossing needle; advancing an anastomotic clip delivery device over said first guidewire; deploying a clip from the delivery device to form a side-to-side anastomosis between the Aorta and the Inferior Vena Cava.