Abstract: A constraint arrangement for a stent-graft loaded onto a delivery system having a suture extending circumferentially around a surface of a graft from a first fixed end fixed to a stent-graft to a positionable region, and through the graft at a first constraining perforation into the lumen and returning out of the lumen to the surface of the graft at a second constraining perforation to a second fixed end fixed to the stent-graft, thereby forming a loop of the suture within a lumen of the graft, the loop wrapped circumferentially around a cannula such that a pair of legs of the loop hold the positionable region with respect to the cannula, wherein a bight of the loop extends through a gap between the legs and wherein the release wire extends through the bight thereby capturing the bight and releaseably securing the loop around the cannula.

Abstract: A stent graft adaptor has an outer graft tube and an inner graft tube with the inner graft tube substantially concentric with and within the outer graft tube. A joining member extends between the inner tube and the outer tube. The joining member can be a continuous fold of graft material extending from a proximal end of the outer tube to a proximal end of the inner tube. The inner tube has at least one self expanding stent on an outer surface thereof and the outer graft tube has at least one self expanding stent on an inner surface. The outer surface of the outer tube provides a sealing surface to engage against the wall of a vessel and the inner tube provides a sealing surface to engage with a corresponding sealing surface of a stent graft deployed through it. The outer sealing surface can include barbs.

Abstract: An iliac artery stent graft has a substantially inverted Y shape comprising a second arm terminating in a second end, and first and third arms terminating respectively in a first end and a third end. Each of the arms comprising a tubular graft of biocompatible graft material and the three arms joined being at a junction to allow fluid flow from the second arm into the first and third arms. In use the first end is deployed within the common iliac artery extending towards the external iliac artery, the second end is deployed within the common iliac artery extending towards the iliac bifurcation and the third end is within the common iliac artery and extends towards the internal iliac artery. Each of the three arms are mutually at an angle of approximately 120 degrees to each other. In use the first and second legs form a U shape to allow a deployment device to be smoothly deployed.

Abstract: A stent graft adaptor has an outer graft tube and an inner graft tube with the inner graft tube substantially concentric with and within the outer graft tube. A joining member extends between the inner tube and the outer tube. The joining member can be a continuous fold of graft material extending from a proximal end of the outer tube to a proximal end of the inner tube. The inner tube has at least one self expanding stent on an outer surface thereof and the outer graft tube has at least one self expanding stent on an inner surface. The outer surface of the outer tube provides a sealing surface to engage against the wall of a vessel and the inner tube provides a sealing surface to engage with a corresponding sealing surface of a stent graft deployed through it. The outer sealing surface can include barbs.

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 adaptor has an outer graft tube and an inner graft tube with the inner graft tube substantially concentric with and within the outer graft tube. A joining member extends between the inner tube and the outer tube. The joining member can be a continuous fold of graft material extending from a proximal end of the outer tube to a proximal end of the inner tube. The inner tube has at least one self expanding stent on an outer surface thereof and the outer graft tube has at least one self expanding stent on an inner surface. The outer surface of the outer tube provides a sealing surface to engage against the wall of a vessel and the inner tube provides a sealing surface to engage with a corresponding sealing surface of a stent graft deployed through it. The outer sealing surface can include barbs.

Abstract: A stent graft deployment device assembly (10) has a cylindrical fixed handle (6) to be gripped and held by a user and an tubular release handle (30) extending through the fixed handle. The release handle can be moved through the fixed handle. The deployment device assembly has a pusher assembly and a sheath (18) to cover a stent graft on the pusher assembly. The pusher assembly is connected to the fixed handle and the sheath is connected to the release handle so that retraction of the release handle through the fixed handle causes the sheath to be retracted from the stent graft on the pusher assembly. The fixed handle has a rotator component (36) with internal first and second screw threads. The tubular release handle has an external screw thread (31) which engages with the first screw thread. The external screw thread (31) can extend along part, all or in segments along the release handle. A release clamp (48) on the pusher has pins which engage with the second screw thread.

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 has a tubular side arm which can be angled proximally and distally and from side to side. The wall of the stent graft in the vicinity of the side arm has a loose fold of the graft material and the side arm is fastened to the loose fold of graft material. The tubular side arm has an inner end and an outer end and is fastened into the loose fold of graft material by a circumferential fastening around the tubular side arm between the inner end and the outer end so that the tubular side arm extends partially within the tubular body of the stent graft and partially outside the tubular body of the stent graft. The loose fold of graft material can be formed by the graft material defining a recess in the wall of the stent graft. To enable movement or angulation proximally and distally and from side to side the loose fold of graft material is provided both proximally and distally of the tubular side arm and circumferentially to each side of the tubular side arm.

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: An iliac artery stent graft has a substantially inverted Y shape comprising a second arm terminating in a second end, and first and third arms terminating respectively in a first end and a third end. Each of the arms comprising a tubular graft of biocompatible graft material and the three arms joined being at a junction to allow fluid flow from the second arm into the first and third arms. In use the first end is deployed within the common iliac artery extending towards the external iliac artery, the second end is deployed within the common iliac artery extending towards the iliac bifurcation and the third end is within the common iliac artery and extends towards the internal iliac artery. Each of the three arms are mutually at an angle of approximately 120 degrees to each other. In use the first and second legs form a U shape to allow a deployment device to be smoothly deployed.

Abstract: A stent graft introducer (1) has a distally opening capsule (5) on a nose cone dilator (3) and a plug device (17; 53) in the capsule. The plug device (17; 53) is movable longitudinally within the capsule (5) to move to a distal end (7) of the capsule (5) to extend from the capsule (5) whereby to provide a smooth transition from the otherwise distal opening (7) of the capsule (5) to enable retraction of the nose cone dilator (3) through a deployed stent graft (35). The capsule (5) includes an in-turned distal end (7) and the plug device (17; 53) has a proximal shoulder (25) whereby to prevent the plug device (17; 53) from being completely withdrawn from the capsule (5). The plug device (17; 53) has a distal linearly tapered surface (27) or a distally facing bullet shaped surface (57). There can be an arrangement (72; 80) to prevent subsequent retraction of the plug device (53; 17).

Abstract: An endoscopic access port and sheath assembly or laparoscopic port (10) comprises a sheath (12) and a haemostatic valve. The sheath has an elongate tubular body and a sheath lumen through it. The haemostatic valve comprising a housing (14), the housing comprises a tubular body with an internal lumen (18) and a first end and a second end. The first end is connected to the sheath and the sheath lumen and the internal lumen are in fluid communication. The second end of the housing has an access port. There is a substantially cylindrical valve assembly (27) within the housing at the second end of the housing. The substantially cylindrical valve assembly is formed from a plurality of valve segments (28). Each valve segment has an elongate body being in cross section a sector of a circle. Each valve segment is formed from a resilient material.

Abstract: An endovascular delivery device (1) has a portion, such as the nose cone dilator (8), being formed from a radiopaque material and that portion has a selected transverse profile such as a notch (26) so that in a selected rotational orientation of the endovascular delivery device the nose cone dilator can be observed by radiographic means during an endovascular procedure to be in that selected rotational orientation. The selected transverse profile can be a notch, protrusion or aperture. The notch or aperture can be filled with a radio-transparent material to provide a sooth outer surface.

Abstract: A stent graft delivery device (1) has an elongated extension piece (20) extending from its proximal end of the introducer portion (3). The elongate extension piece is selectively separable from the introducer portion. A plurality of auxiliary guide wires (50) extend from through the stent graft delivery device and through the elongate extension piece. The auxiliary guide wires can cross over at the proximal end of the extension piece and return. The stent graft delivery device can be introduced into a patient via a femoral artery and the elongated extension piece can extend out an artery of the thoracic arch whereby to extend the auxiliary guide wires out of such an artery to give through and through guide wires. Catheterization of pararenal arteries is then possible via a brachial route.

Abstract: An endoscopic access port and sheath assembly or laparoscopic port (10) comprises a sheath (12) and a haemostatic valve. The sheath has an elongate tubular body and a sheath lumen through it. The haemostatic valve comprising a housing (14), the housing comprises a tubular body with an internal lumen (18) and a first end and a second end. The first end is connected to the sheath and the sheath lumen and the internal lumen are in fluid communication. The second end of the housing has an access port. There is a substantially cylindrical valve assembly (27) within the housing at the second end of the housing. The substantially cylindrical valve assembly is formed from a plurality of valve segments (28). Each valve segment has an elongate body being in cross section a sector of a circle. Each valve segment is formed from a resilient material.

Abstract: A method of temporarily reducing the diameter of a stent graft (10) and a stent graft with its diameter reduced. The stent graft has a tubular body and self expanding stents.

Abstract: A method of temporarily reducing the diameter of a stent graft (10) and a stent graft with its diameter reduced. The stent graft has a tubular body and self expanding stents.

Abstract: A reinforcement member (10) for a fenestration in a stent graft (30) comprises a composite wire (12) formed from wire strands of at least two types (14, 16, 18). A first type of wire strand comprises a metal alloy with shape memory characteristics and a second type of wire strand comprising a metal with radiopaque characteristics. The first type of wire strand and the second type of wire strand are twisted or braided together to form the composite wire and then formed into the circular ring with at least two turns of the composite wire forming the ring. The reinforcement member can be a circular ring mounted into a fenestration (40) in a wall (32) of a stent graft, or mounted around a stent graft, or it can be a substantially U-shaped edging along the edge of a scalloped fenestration (44).

Abstract: A stent graft adaptor has an outer graft tube and an inner graft tube with the inner graft tube substantially concentric with and within the outer graft tube. A joining member extends between the inner tube and the outer tube. The s joining member can be a continuous fold of graft material extending from a proximal end of the outer tube to a proximal end of the inner tube. The inner tube has at least one self expanding stent on an outer surface thereof and the outer graft tube has at least one self expanding stent on an inner surface. The outer surface of the outer tube provides a sealing surface to engage against the wall of a vessel and the inner tube provides a sealing surface to engage with a corresponding sealing surface of a stent graft deployed through it. The outer sealing surface can include barbs.