Abstract: A hub is slidable along a straight track, and an introducer sheath is fixed to and extends distally from the hub. A proximal handle is longitudinally slidable along the straight track and defines a helical track that has a travel length along the longitudinal axis. The hub and the proximal handle are mated, whereby rotation of the handle about the hub causes longitudinal travel of the hub and retraction of the introducer sheath from a prosthesis radially constrained within the introducer sheath. The hub proximally slidable along with straight track, thereby enabling retraction of the introducer sheath from the prosthesis by at least one of travel of the hub along the helical track during rotation of the proximal handle about the longitudinal axis, and by proximal longitudinal movement of the proximal handle along the straight track.

Abstract: A stent graft delivery system for delivering an aortic prosthetic device includes a handle, an internal lead screw assembly within a track of a handle body of the handle, a lead screw nut that extends about the handle body and threadable engaged with the threaded portion of the internal lead screw assembly, a support member fixed to the handle body, a sheath extending about a portion of the support member and fixed to the internal lead screw assembly, and a hemostasis valve about the supporting member and between the sheath and the lead screw assembly.

Abstract: The vascular prosthesis includes a luminal graft component having at least one fenestration. At least one fenestration ring borders the at least one fenestration and is fixed to the luminal graft component. The fenestration ring includes a main component with two opposing ends and a connecting component. The diameter of the fenestration ring can expand upon insertion of a branch prosthesis through the fenestration ring during implantation at a surgical site. The vascular prosthesis can be implanted in a patient to thereby treat, for example, an arterial aneurysm, spanning a region of an aneurysm that includes at least one arterial branch.

Abstract: A stent graft delivery system for delivering an aortic prosthetic device includes a handle, an internal lead screw assembly within a track of a handle body of the handle, a lead screw nut that extends about the handle body and threadable engaged with the threaded portion of the internal lead screw assembly, a support member fixed to the handle body, a sheath extending about a portion of the support member and fixed to the internal lead screw assembly, and a hemostasis valve about the supporting member and between the sheath and the lead screw assembly.

Abstract: A method for implanting a prosthesis centrally within a curved lumen includes loading a prosthesis into a delivery sheath, advancing the sheath in a patient towards the curved lumen to place at least the proximal end of the prosthesis within the curved lumen, and centering the proximal end of the prosthesis and/or the distal end of the sheath within the curved lumen. In a first advancing step, the outer catheter containing the inner sheath is advanced together towards the curved lumen to a location proximal of the curved lumen and, in a second advancing step, the inner sheath containing the prosthesis is advanced into the curved lumen to place at least the proximal end within the curved lumen while the outer catheter substantially remains at the location. After centering, the proximal end of the prosthesis is deployed centered within the curved lumen.

Abstract: A method for implanting a prosthesis centrally within a curved lumen includes loading a prosthesis into a delivery sheath, advancing the sheath in a patient towards the curved lumen to place at least the proximal end of the prosthesis within the curved lumen, and centering the proximal end of the prosthesis and/or the distal end of the sheath within the curved lumen. In a first advancing step, the outer catheter containing the inner sheath is advanced together towards the curved lumen to a location proximal of the curved lumen and, in a second advancing step, the inner sheath containing the prosthesis is advanced into the curved lumen to place at least the proximal end within the curved lumen while the outer catheter substantially remains at the location. After centering, the proximal end of the prosthesis is deployed centered within the curved lumen.

Abstract: A delivery system includes a handle, a guidewire catheter, a nose cone at the distal end of the guidewire catheter that with the guidewire catheter defines an opening concentric with the guidewire catheter, a plurality of wires that extend distally from the handle and essentially parallel with and distributed radially about the guidewire catheter and a stent graft. The wires each extend between a portion of the stents and wall of the stent graft, whereby the stent graft is radially constrained until the wires are retracted. The delivery system can be employed in methods of treating arterial disease, such as aortic aneurysms.

Abstract: A stent graft and methods for treatment of aortic aneurysms includes a tubular graft component defining an inside surface, and outside surface, an open proximal end, an open distal end, and the fenestration. A proximal radial stent is proximal to the fenestration and a distal radial stent is distal to the fenestration. A ring at the tubular graft component extends along the tubular graft component and around the fenestration. A liner extends between the inside surface and the outside surface, and through the fenestration, the ring thereby being sealed from exposure at one surface of the tubular graft component by the liner, and at the other surface of the tubular graft component by the tubular graft component and the liner.

Abstract: A delivery system and method for implanting a stent graft includes a flexible sheath that defines loops distributed longitudinally and wherein substantial alignment of the loops along a longitudinal axis of a guidewire catheter radially constrict the flexible sheath. The flexible sheath defines longitudinal edges that at least partially form a seem when the openings are aligned, whereby, upon alignment, the flexible sheath defines at least one fenestration in the luminal configuration of the flexible sheath. A ligature extends through the openings of the flexible sheath and causes the openings to be substantially aligned, thereby constraining the flexible sheath. The ligature is proximally retractable from the openings to thereby release the flexible sheath from a radially constricted configuration.

Abstract: A stent graft includes a tubular aortic component that defines a lumen and a fenestration with a pocket at the fenestration. At least one proximal tunnel graft extends proximally within the lumen from the proximal opening of the pocket and is secured at a proximal end to the tubular component, and at least one distal tunnel graft extends distally within the lumen from the distal opening of the pocket and is secured at a distal end to the tubular aortic component. The stent graft can further include at least one branch stent graft, each of which extends through the fenestration and within at least one of the proximal tunnel graft or the distal tunnel graft. The stent graft can be implanted in a patient to thereby treat an aneurysm, such as a suprarenal or thoracoabdominal aortic aneurysm.

Abstract: The vascular prosthesis includes a luminal graft component having at least one fenestration. At least one fenestration ring borders the at least one fenestration and is fixed to the luminal graft component. The fenestration ring includes a main component with two opposing ends and a connecting component. The diameter of the fenestration ring can expand upon insertion of a branch prosthesis through the fenestration ring during implantation at a surgical site. The vascular prosthesis can be implanted in a patient to thereby treat, for example, an arterial aneurysm, spanning a region of an aneurysm that includes at least one arterial branch.

Abstract: A delivery system and method for implanting a stent graft includes a flexible sheath that defines openings distributed longitudinally and wherein substantial alignment of the openings along a longitudinal axis of a guidewire catheter radially constrict the flexible sheath. The flexible sheath includes at least one fenestration. A ligature extends through the openings of the flexible sheath and causes the openings to be substantially aligned, thereby constraining the flexible sheath. The ligature is proximally retractable from the openings to thereby release the flexible sheath from a radially constricted configuration.

Abstract: A stent graft includes a tubular aortic component that defines a lumen and a fenestration with a pocket at the fenestration. At least one proximal tunnel graft extends proximally within the lumen from the proximal opening of the pocket and is secured at a proximal end to the tubular component, and at least one distal tunnel graft extends distally within the lumen from the distal opening of the pocket and is secured at a distal end to the tubular aortic component. The stent graft can further include at least one branch stent graft, each of which extends through the fenestration and within at least one of the proximal tunnel graft or the distal tunnel graft. The stent graft can be implanted in a patient to thereby treat an aneurysm, such as a suprarenal or thoracoabdominal aortic aneurysm.

Abstract: A stent graft system includes a tubular graft component, a bare stent component, an infrarenal stent component at least one suprarenal barb extending distally from at least one suprarenal portion of the bare stent component and at least one infrarenal barb extending distally from at least one infrarenal portion of the bare stent component. A stent graft system can also include at least one barb.

Abstract: The vascular prosthesis includes a luminal graft component having at least one fenestration. At least one fenestration ring borders the at least one fenestration and is fixed to the luminal graft component. The fenestration ring includes a main component with two opposing ends and a connecting component. The diameter of the fenestration ring can expand upon insertion of a branch prosthesis through the fenestration ring during implantation at a surgical site. The vascular prosthesis can be implanted in a patient to thereby treat, for example, an arterial aneurysm, spanning a region of an aneurysm that includes at least one arterial branch.

Abstract: A stent graft includes a luminal graft component defining at least one fenestration. At least one ligature traverses the fenestration and at least partially defines an opening within the fenestration that secures a branch prosthesis. The stent graft is implanted in a patient to thereby treat an arterial aneurysm, such as an aortic aneurysm in a region of the aorta that includes at least one arterial branch, including juxtarenal and short-neck aortic aneurysms.

Abstract: A stent graft for treating an arterial aneurysm includes loops fixed to struts of stents, wherein the struts define distal and proximal apices. The ends of a ligature can be linked by a wire in a stent graft delivery system that threads anchor loops longitudinally spanning ends of the ligature to maintain the stent in a radially constricted position during delivery to the aneurysm. A delivery system and method for implanting a stent graft prosthesis includes and employs a torque component at a distal end of the stent graft prosthesis, whereby following advancement of the stent graft to a surgical site in a constrained or partially constrained configuration, torque is applied to the torque component to rotationally align the stent graft about a longitudinal axis of the stent graft, followed by deployment of the stent graft in correct rotational alignment.

Abstract: A stent graft includes a luminal graft component defining at least one fenestration. At least one ligature traverses the fenestration and at least partially defines an opening within the fenestration that secures a branch prosthesis. The stent graft is implanted in a patient to thereby treat an arterial aneurysm, such as an aortic aneurysm in a region of the aorta that includes at least one arterial branch, including juxtarenal and short-neck aortic aneurysms.

Abstract: A thoraco-abdominal branch graft prosthesis includes a lumen main graft component that defines a lumen and at least one main graft wall fenestration. An open distal end of the main graft component is tapered and has a smaller diameter than the proximal end of the main graft component. At least one tunnel graft component of the branch graft prosthesis defines at least one tunnel graft fenestration. The tunnel graft component is within the main graft lumen defined by the luminal main graft component. A luminal wall of the tunnel graft component is fixed to the luminal wall of the main graft component. The fenestration of the tunnel graft wall is aligned with the fenestration of the main graft wall. The thoraco-abdominal branch graft prosthesis can be implanted in a patient at a site of a thoraco-abdominal aneurysm.

Abstract: A thoraco-abdominal branch graft prosthesis includes a lumen main graft component that defines a lumen and at least one main graft wall fenestration. An open distal end of the main graft component is tapered and has a smaller diameter than the proximal end of the main graft component. At least one tunnel graft component of the branch graft prosthesis defines at least one tunnel graft fenestration. The tunnel graft component is within the main graft lumen defined by the luminal main graft component. A luminal wall of the tunnel graft component is fixed to the luminal wall of the main graft component. The fenestration of the tunnel graft wall is aligned with the fenestration of the main graft wall. The thoraco-abdominal branch graft prosthesis can be implanted in a patient at a site of a thoraco-abdominal aneurysm.