Device and method for establishing an artificial arterio-venous fistula

1. An intravascular connector, comprising:

a first pair of clinch members comprising a first member and an apposed second member;

a second pair of clinch members opposite from the first pair of clinch members and comprising a first member and an apposed second member;

wherein the first and second pairs of clinch members has a deployed configuration longitudinally disposed relative to contiguous portions of a first vessel and a second vessel such that the first and second pairs of clinch members are biased to close upon contiguous parallel portions of the first and second vessels,

wherein the first member of the first and second pair of clinch members each have a length less than each second member of the first and second pair of clinch members such that each first member is deployed on opposite ends of the connector within the first and second vessels, respectively, and each individual clinch member is deployable sequentially in a predetermined order within the first vessel and second vessel, and

wherein each first member is sized to arc entirely within each respective vessel into its deployed position when each second member contacts each respective vessel wall.

2. The connector of claim 1 further comprising at least a third pair of clinch members having a deployed configuration transverse to the first and second pairs such that the third pair of clinch members are biased to exert a nominal pressure on circumferentially spaced points on side walls of the first and second vessels.

3. The connector of claim 1 wherein each second member of the first and second pair of clinch members are deployed on opposite ends of the connector within first and second vessels, respectively.

4. The connector of claim 1 further comprising a clip connector extending between the first and second pair of clinch members and defining a lumen therethrough fluidly coupling the first and second vessels.

5. The connector of claim 4 wherein the clip connector is angled relative to a centerline of the connector.

6. The connector of claim 4 wherein the clip connector defines a tapered cross-sectional area along its length.

7. The connector of claim 4 wherein the clip connector is angled relative to a centerline of the connector and defines a tapered cross-sectional area along its length.

8. The connector of claim 4 further comprising at least one deformable segment along a length of the clip connector.

9. The connector of claim 1 further comprising a hinge or flange between clinch members.

10. The connector of claim 1 further comprising at least one break-away or frangible segment along a periphery of the connector.

11. The connector of claim 1 further comprising at least one deformable segment along a periphery of the connector.

12. The connector of claim 1 further comprising a delivery instrument having an outer sheath and an inner shaft slidable within the outer sheath such that the connector is deployable from within the outer sheath.

13. The connector of claim 12 further comprising an inflatable member near or at a distal end of the outer sheath and/or inner shaft.

14. The connector of claim 12 wherein the outer sheath and/or inner shaft are articulatable.

15. The connector of claim 12 wherein the delivery instrument further comprises an inflatable balloon thereupon.

16. The connector of claim 15 wherein the balloon defines a circular cross-sectional area when inflated.

17. The connector of claim 15 wherein the balloon defines a non-circular cross-sectional area when inflated.

18. The connector of claim 1 wherein the first and second pairs of clinch members are biased to evert such that a distal portion of each apposed member is proximate to one another when released in its deployed configuration.

19. The connector of claim 1 wherein a distal portion of each apposed clinch member is configured to form an atraumatic bearing surface therebetween for impingement on the first and second vessels.

20. The connector of claim 1 wherein the first and second pairs of clinch members comprise a continuously formed clip absent an intervening waist segment.

21. The connector of claim 1 wherein the first vessel comprises an artery.

22. The connector of claim 1 wherein the second vessel comprises a vein.

23. The connector of claim 2 wherein the third pair of clinch members each define a distal portion which is spaced apart from one another in the deployed configuration.

24. The connector of claim 2 wherein the third pair of clinch members comprise a continuously formed clip absent an intervening waist segment.

25. The connector of claim 1 further comprising a therapeutic drug coating or membrane at least partially covering the connector.