Abstract: A stent graft (1) has at least one fenestration (13) or low profile side arm (34). A guide assembly (17) surrounds the fenestration or low profile side arm. The guide assembly has a continuous wall extending laterally away from the outer surface of the stent graft. The continuous wall is substantially elliptical or circular and extends distally of the fenestration at a distal end of the wall and being coincident with a proximal part (25) of the periphery of the fenestration or low profile side arm at a proximal end of the wall (23). The wall acts to define a guide area to guide a flexible probe extended from a side branch vessel to enter the fenestration or low profile side arm. Where there are two fenestrations or low profile side arms there can be a single continuous wall (50) around both or separate walls for each. The wall may have a peripheral wire reinforcement (19).

Abstract: A stent graft (2) for placement in the thoracic arch of a patient has a first tubular body portion (6) with a first lumen therein for placement in the ascending aorta of a patient and a second tubular body portion (8) to extend along the thoracic arch and down the descending aorta. The second tubular body portion is of a lesser diameter than the first tubular body portion. There is a step portion (10) between the first body portion and the second body portion. The step portion is joined to and continuous with the first portion and the second portion. A first side of each of the first body portion, the step portion and the second body portion are substantially aligned so that there is a step (18) defined on a second side opposite to the first side of the body portion. There is an aperture (30) in the step portion and an internal tube (32) extending from the aperture towards the first body portion.

Abstract: A stent graft for deployment into the aorta of a patient has a tubular body with a proximal portion of a selected diameter; preferably a reduced diameter portion, distal of the proximal portion, having a diameter less than the selected diameter; a tapered portion, extending between the proximal portion and the reduced diameter portion; and optionally a distal portion, distal of the reduced diameter portion. At least three, preferably four or five, low profile side arms are provided, preferably in the reduced diameter portion and/or the tapered portion, for connection of an arm extension to an aortic branch vessel. All but one of the side arms are to be connected at the physician's choice, depending on the anatomy of the patient. One side arm is to provide temporary profusion to external of the stent graft after deployment of the stent grant into the aorta, and is subsequently blocked.

Abstract: A stent graft (2) for placement in the thoracic arch of a patient has a first tubular body portion (6) with a first lumen therein for placement in the ascending aorta of a patient and a second tubular body portion (8) to extend along the thoracic arch and down the descending aorta. The second tubular body portion is of a lesser diameter than the first tubular body portion. There is a step portion (10) between the first body portion and the second body portion. The step portion is joined to and continuous with the first portion and the second portion. A first side of each of the first body portion, the step portion and the second body portion are substantially aligned so that there is a step (18) defined on a second side opposite to the first side of the body portion. There is an aperture (30) in the step portion and an internal tube (32) extending from the aperture towards the first body portion.

Abstract: A stent graft for deployment into the aorta of a patient has a tubular body with a proximal portion of a selected diameter; preferably a reduced diameter portion, distal of the proximal portion, having a diameter less than the selected diameter; a tapered portion, extending between the proximal portion and the reduced diameter portion; and optionally a distal portion, distal of the reduced diameter portion. At least three, preferably four or five, low profile side arms are provided, preferably in the reduced diameter portion and/or the tapered portion, for connection of an arm extension to an aortic branch vessel. All but one of the side arms are to be connected at the physician's choice, depending on the anatomy of the patient. One side arm is to provide temporary perfusion to external of the stent graft after deployment of the stent graft into the aorta, and is subsequently blocked.

Abstract: A tubular side arm assembly configured for mounting onto a stent graft to provide an accessible side arm. The side arm includes a lightweight space frame comprising a resilient wire, and the space frame comprises a cylindrical portion and a funnel portion. The cylindrical portion includes first and second circular planar ring portions that are parallel to each other and spaced apart axially, and at least two longitudinal struts extending between the first and second circular ring portions. The frame also includes a funnel portion including a substantially circular ring portion to define a larger end of the funnel portion and a pair of spaced apart antis extending from the substantially circular ring portion towards the cylindrical portion. The lightweight space frame is configured to support a biocompatible graft material.

Abstract: A stent graft (10) for deployment into the aorta of a patient has a tubular body (12) with a proximal portion (14) of a selected diameter and a portion (16) of a reduced diameter less than the selected diameter distal of the proximal portion and a tapered portion (18) extending between the proximal portion and the portion of reduced diameter. Low profile side arms (26, 28, 30, 32) are provided in the portion of reduced diameter and/or the tapered portion. The side arms are for connection of an arm extension to an aortic branch vessel. A paraplegia prevention vent tube (34) is provided in fluid communication with the main lumen and open to external of the tubular body in the region defined by the portion of reduced diameter and the tapered portion.

Abstract: A fenestrated stent graft (1) with a tubular side arm (11) extending therefrom in which the side arm can be turned inside out to extend into the stent graft during deployment of the stent graft and extended out during deployment. Also disclosed is a deployment device (19) for such a side arm stent graft which has a deployment catheter (26) and a side arm guide (32), the side arm guide is releasably fastened at a proximal end to the branch tube (11) and is able to be moved independently of the deployment catheter such that the branch tube can be extended from the tubular body of the stent graft while it is fastened onto the side arm guide. The side arm guide can be formed from a side arm catheter (32) and a side arm guide wire (34) carried in the side arm catheter.

Abstract: A thoracic arch stent graft (1) has a tubular body of a biocompatible graft material (3) and at least one fenestration (13, 15) in the wall on one side thereof. A combination guide and tubular side arm assembly (20, 22) is mounted into the or each fenestration. The combination guide and tubular side arm assembly comprises a tubular portion (24) and a funnel portion (26) extending from a distal end of the tubular portion. The funnel portion has an angled open end. The tubular portion and the funnel portion are formed from a biocompatible graft material wall and have a lightweight space frame (38 40) formed from a resilient wire and supporting the graft material and defining the combination guide and tubular side arm assembly.

Abstract: A stent graft introducer has a pusher, a nose cone, a region between the pusher and the nose cone for a stent graft, a sleeve extending over the pusher and proximally to the nose cone to cover the stent graft when retained in the region. An indwelling auxiliary catheter with a pre-curved proximal end is fitted into the introducer. The nose cone has an elongate groove and the auxiliary catheter has its proximal end in the elongate groove. In a partially retracted position of the sleeve the curved proximal end of the indwelling auxiliary catheter is exposed and uncovered by the sleeve and in an advanced position of the sleeve the curved proximal end of the indwelling auxiliary catheter is straightened, extends along the length of the groove in the nose cone and is covered by the sleeve.

Abstract: A pre-loaded stent graft delivery device and stent graft, the stent graft delivery device. The stent graft has at least one fenestration or side arm and the fenestration is preloaded with an indwelling guide wire. Indwelling access sheaths are provided within auxiliary lumens of a pusher catheter and dilators are preloaded into the access sheaths along with the indwelling guide wire. A handle assembly at a distal end of the guide wire catheter. The handle includes a multiport manifold with access ports to the auxiliary lumens in the pusher catheter. Upon deployment of the stent graft into the vasculature of a patient, the indwelling guide wire can be used to facilitate cathertisation of a side branch or target vessel through the fenestration or be used to stabilise the access sheath during catheterisation, advancement of the access sheath into the target vessel and deployment of a covered or uncovered stent therein through the access sheath.

Abstract: An endoluminal prosthesis includes an expandable stent graft that includes a cannula extending through a lumen of the stent graft. A suture is threaded along the perimeter of the graft through openings therein, with an inner end of the suture mounted to the cannula. The cannula is rotatable relative to the graft to wind or unwind the suture around the cannula and cause the graft to become compressed when wound or allow the graft to expand when unwound. The cannula includes an attachment member for retaining an inner end of the suture, and the attachment member can release the inner end of the suture when adjustment of the graft diameter is no longer desired.

Abstract: A pre-loaded stent graft delivery device and stent graft, the stent graft delivery device. The stent graft has at least one fenestration or side arm and the fenestration is preloaded with an indwelling guide wire. Indwelling access sheaths are provided within auxiliary lumens of a pusher catheter and dilators are preloaded into the access sheaths along with the indwelling guide wire. A handle assembly at a distal end of the guide wire catheter. The handle includes a multiport manifold with access ports to the auxiliary lumens in the pusher catheter. Upon deployment of the stent graft into the vasculature of a patient, the indwelling guide wire can be used to facilitate catheterization of a side branch or target vessel through the fenestration or be used to stabilize the access sheath during catheterization, advancement of the access sheath into the target vessel and deployment of a covered or uncovered stent therein through the access sheath.

Abstract: A hybrid stent graft device for treatment of a Type A dissection having a first tubular portion for placement into the ascending aorta and a second tubular portion for extending around the thoracic arch and down the descending aorta is disclosed. The first tubular portion is connectable to the aorta between the sinotubular junction and the brachiocephalic artery so that it essentially replaces the ascending aorta. A temporary bypass tube allows perfusion during an operation. The second tubular portion has an elongate recess outside of the second tubular portion and an aperture defining a fluid flow path into the recess. The recess is intended to engage an outer curve of the thoracic arch to enable blood flow into the arteries of the thoracic arch. An introduction device in combination with the hybrid stent graft described above is also disclosed.

Abstract: A stent graft defining a main lumen bounded by a wall of graft material is disclosed. The stent graft has a valve portion between proximal and distal portions. The valve portion is formed by a wall portion having a part-circumferential double layer portion comprising an inner underlap portion and an outer overlap portion, the double layer portion forming a passageway parallel to the main lumen. The passageway has an entrance mouth and an exit mouth. The passageway has an open condition where the underlap and overlap portions are spaced apart to form a vent lumen. The wall portion is broken by a narrow cut. The cut is openable by relative radial movement between its edges. This allows re-perfusion of an aneurism and perfusion of blood from within the lumen out towards blood vessels such as intercostals and can assist in minimizing the chance of paraplegia.

Abstract: A fenestration (32) for a stent graft (30). The fenestration is an aperture in the biocompatible graft material and has at least one flap (38, 40) of a biocompatible graft material covering the aperture on the inside whereby the flap closes off the aperture but can be displaced to allow access through the fenestration. An array of such fenestrations may be placed on a stent graft to facilitate alignment of a branch vessel with a fenestration. A slip knot (46, 46) which can be released by forcing a dilator between the flaps can be used to hold the flaps together.

Abstract: A coupling device is formed of a double tubing of a substantially non-porous membrane material, typically a conventional graft material, that is of inner and outer layers of membrane material. The inner and outer layers are coupled by bridging rings which allow the layers to be spaced from one another in use. Attached to the inner and outer layers are first and second stents. The stent is located on the inside of the double tubing, while the stent is located on the outside of the double tubing. The device can expand in effect to ‘bulge’ and thus to fill the gaps to the vessel wall and to the stent-graft sections. The device can provide reliable coupling of stent-grafts in vessels of varying diameter or in vessels inflicted with one or more aneurysms.

Abstract: A deployment system for introducing stent grafts which have a side arm or into which a side arm can be deployed. For instance the stent graft can be deployed into the thoracic arch of a patient. The deployment system including an introducer (1), an auxiliary catheter (13) disposed within the introducer and an auxiliary guide wire (14) disposed within the auxiliary catheter. The auxiliary guide wire extends to adjacent the proximal end (6) of the introducer an can be extended from the proximal end of the introducer so that it can be snared from a side branch artery (56) to assist with deployment of a side arm (23) of the stent graft into the side artery or for the deployment of a side arm stent graft into the stent graft.

Abstract: The disclosure relates to an implantable woven graft for bridging a defect in a main vessel near one or more branch vessels. The graft includes a region of reduced density. Reduced density regions are alignable with at least one of the one or more branch vessels, and are suitable for in situ fenestration, for example by perforation. The disclosed examples are particularly suited for bridging abdominal aortic aneurysms.

Abstract: A coupling device is formed of a double tubing of a substantially non-porous membrane material, typically a conventional graft material, that is of inner and outer layers of membrane material. The inner and outer layers are coupled by bridging rings which allow the layers to be spaced from one another in use. Attached to the inner and outer layers are first and second stents. The stent is located on the inside of the double tubing, while the stent is located on the outside of the double tubing. The device can expand in effect to ‘bulge’ and thus to fill the gaps to the vessel wall and to the stent-graft sections. The device can provide reliable coupling of stent-grafts in vessels of varying diameter or in vessels inflicted with one or more aneurysms.