Abstract: Various cutting devices and systems are described that excise and/or incise tissue from a target site. For example, the wall of an artery and/or adventitial to the artery wall from inside the artery. According to embodiments of the invention, a lateral incision catheter device configured to be introduced intra-luminally to a pre-selected site in the body is provided, generally including a rotating first catheter, including a proximal end, a distal end and lumen positioned therebetween; a first shell to a first rotating catheter and having a cutting surface; a second shell attached to a second catheter, whereby rotation of the first rotating catheter causes the first shell to rotate with respect to the second shell so as to permit the cutting surface to cut tissue at the pre-selected site.

Abstract: An endovascular bypass graft includes a tubular member, a first expandable mesh stent attached to one end of the tubular member, and a second expandable mesh stent attached to an opposite end of the tubular member. The second stent is provided with a plurality of fenestrations. The graft is inserted into a principal blood vessel such as the aorta and positioned in the vessel so that the fenestrations are aligned with junctions with ancillary blood vessels. The graft is attached to the principal blood vessel so that the fenestrations remain aligned with the respective junctions, thereby allowing blood flow between the principal vessel and the auxiliary vessels through the respective junctions upon completion of the bypass operation.