Methods and apparatus for creating an artificial arteriovenous fistula between an artery and an adjacent vein are disclosed. Methods include utilizing a hollow spiral shunt that defines a fluid passageway between a proximal port and a distal port thereof. The spiral shunt is loaded within a delivery device that is transversely advanced through a wall of the artery. A piercing end of the spiral shunt is than exposed and the delivery device is rotated to pierce an opposing wall of the artery and a wall of the adjacent vein with the spiral shunt piercing end. Rotation of the delivery device corkscrews the spiral shunt through the walls of the artery and the vein in order to position the spiral shunt to fluidly connect the artery and vein. Once so positioned, the spiral shunt is released to be deployed between the artery and vein lumens thereby forming an artificial arteriovenous fistula therebetween.
