Abstract: An endovascular delivery system includes an endovascular prosthetic device and a signal active guide wire engaging the endovascular prosthetic device. A rotary encoder is coupled with the guide wire and the endovascular prosthetic device to provide an encoder signal on the guide wire. The encoder signal is indicative of axial angular position of the endovascular prosthetic device during implantation of the endovascular prosthetic device in a body of a patient.

Abstract: An endovascular graft delivery system includes an endovascular prosthetic device and one or more trigger wires deployably engaging portions of the endovascular prosthetic device. An electrical element is positioned at a proximal end of a trigger wire. The electrical element is in signal communication with the trigger wire to communicate operational signals over the trigger wire. The operational signals may be power or control signals to assist with positioning the endovascular prosthetic device at a desired deployment location.

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 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 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 method is provided for renal neuromodulation. One step of the method includes providing an expandable support member having a cuff-like configuration and including a main body portion (MBP). The MBP includes a lumen for engaging a wall of a blood vessel including a portion of a renal vasculature. At least one electrode connected with the MBP is arranged to selectively deliver electric current to a desired location. An insulative material is attached to at least a portion of the MBP. Next, the MBP is implanted extravascularly so that the MBP is in direct contact with a portion of the renal vasculature. At least one electrode is positioned substantially adjacent a desired location where modulation of the sympathetic nervous system (SNS) is effective to alter renal function. Electric current is then delivered to the at least one electrode to effect a change in the SNS.

Abstract: An apparatus for renal neuromodulation includes an expandable support member having a main body portion for engaging a wall of a blood vessel proximate a renal vasculature and at least one electrode connected with the main body portion. The at least one electrode is arranged to selectively deliver electric current to a desired location where modulation of the sympathetic nervous system is effective to alter renal function. The apparatus further includes an insulative material attached to at least a portion of the main body portion for isolating blood flow through the vessel from the electric current delivered by the at least one electrode.

Abstract: A stent graft introducer for intraluminal deployment of a stent graft (26), the introducer comprising a stent graft release mechanism (6) to allow partial release of the stent graft (26) when carried on the introducer, whereby control of the stent graft can be maintained while allowing access into the lumen of the stent graft from at least one end of the stent graft. The partial release can comprise partial release of one end of the stent graft.

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 introduction arrangement for a fenestrated or branched stent graft (13) intended for deployment into the lumen of a vessel having a blind vessel extending from it. The introducer (1) has a distal end intended to remain outside a patient in use and a proximal end with a nose cone dilator (11) and an arrangement to retain the branched stent graft distally of the nose cone dilator. A sheath (15) on the introducer extends over the branched stent graft to the nose cone dilator. An indwelling catheter (22) extends from the distal end of the introducer and enters the fenestration or side arm and through to the nose cone dilator, the indwelling catheter has a guide wire (29) extending through it. The guide wire can be extended beyond the nose cone dilator in use before the sheath is withdrawn from the branched stent graft so that it can be snared from the contra-lateral artery.

Abstract: A stent graft introducer for intraluminal deployment of a stent graft (26), the introducer comprising a stent graft release mechanism (6) to allow partial release of the stent graft (26) when carried on the introducer, whereby control of the stent graft can be maintained while allowing access into the lumen of the stent graft from at least one end of the stent graft. The partial release can comprise partial release of one end of the stent graft.

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 delivery device (30) has a pull wire arrangement with a pull wire (46) fastened to the distal end of a nose cone dilator (45) and extending to a wire pull mechanism (60) for the pull wire associated with a handle (52) of the stent graft delivery device. The pull wire can be pulled by the wire pull mechanism to induce a curve in a guide wire catheter (44) distally of the nose cone dilator such that the proximal end of the delivery device more closely fits the shape of a portion of the vasculature of a patient into which the device is deployed.

Abstract: An introduction arrangement for a fenestrated or branched stent graft (13) intended for deployment into the lumen of a vessel having a blind vessel extending from it. The introducer (1) has a distal end intended to remain outside a patient in use and a proximal end with a nose cone dilator (11) and an arrangement to retain the branched stent graft distally of the nose cone dilator. A sheath (15) on the introducer extends over the branched stent graft to the nose cone dilator. An indwelling catheter (22) extends from the distal end of the introducer and enters the fenestration or side arm and through to the nose cone dilator, the indwelling catheter has a guide wire (29) extending through it. The guide wire can be extended beyond the nose cone dilator in use before the sheath is withdrawn from the branched stent graft so that it can be snared from the contra-lateral artery.

Abstract: Prosthesis for implantation in the ascending aorta comprising a tubular body made of biocompatible graft material, a cuff at the proximal portion of the tubular body for biasing pressure onto a sino-tubular junction and that is configured to conform to the junction. A stent assembly can also be used to the prosthesis to bias pressure on the wall of a dissection to substantially deflate a false lumen.

Abstract: Modular graft systems with conjoinable grafts comprising graft material with the system comprising a first and second graft prosthesis with mating ends, securing rods attached to one of the mating ends comprising at least one spike that juts from the securing rod. The other of the mating ends is double layered with graft material for receiving at least one spike in the first layer of graft material when the mating ends are conjoined.

Abstract: A method for treating erectile dysfunction in a subject includes providing an expandable support member for engaging a wall of a blood vessel. The expandable support member includes at least one electrode connected with the expandable support member and arranged to selectively deliver electric current to modulate the autonomic nervous system (ANS). The expandable support member includes and an insulative material attached to at least a portion of the expandable support member for isolating blood flowing through the vessel from the electric current delivered by the at least one electrode. The expandable support member is implanted intravascularly so that at least a portion of the expandable support member is positioned substantially adjacent a desired location where modulation of the ANS is effective to improve erectile function. After implanting the expandable support member, electric current is delivered to the at least one electrode to effect a change in the ANS.

Abstract: A computer implemented method (350) for determining a centerline of a three-dimensional tubular structure is described. The method includes providing an edge-detected data set of voxels that characterize a boundary of the tubular structure according to a three-dimensional voxel data set for the tubular structure (360). a gradient field of a distance transformation is computed for the edge-detected dataset (380). a voxel data set corresponding to a centerline of the tubular structure is computed according to derivative of gradient field (390).

Abstract: An apparatus for repairing the function of a diseased valve includes an annular first support member expandable to a first diameter. An annular second support member is spaced axially apart from the first support member and is expandable to a second diameter that is independent of the first diameter. A tubular graft section interconnects the first and second support members. The graft section defines an annulus having a third diameter that is independent of each of the first and second diameters. A prosthetic valve is secured within the annulus of the graft section. The bioprosthetic valve has at least two valve leaflets that are coaptable to permit the unidirectional flow of blood. Methods for repairing the function of a diseased valve and for making the apparatus are also provided.

Abstract: An apparatus and method for endovascular removal of a cardiac valve having at least two valve cusps is disclosed. The apparatus is insertable through a blood vessel to access the cardiac valve. The apparatus includes a first catheter assembly for insertion into a blood vessel, deployable cutting means for cutting at least one valve cusp of the cardiac valve, and a deployable filter assembly disposed adjacent the distal end of the first catheter assembly. The first catheter assembly has a longitudinal axis and a distal end. The cutting means is attached to the distal end of the first catheter assembly. The filter assembly is operable to collect the severed valve cusps and is collapsible for removal from the blood vessel with the severed valve cusps retained therein.