Abstract: The present embodiments provide a medical device for implantation in a patient comprising a stent and a valve. The stent comprises a proximal region comprising a cylindrical shape having a first outer diameter in an expanded state, and a distal region comprising a cylindrical shape having a second outer diameter in the expanded state. The second outer diameter is greater than the first outer diameter. A proximal region of the valve is at least partially positioned within the proximal region of the stent, and the distal region of the valve is at least partially positioned within one of tapered and distal regions of the stent. When implanted, the proximal region of the stent and the proximal region of the valve are aligned with a native valve, and the distal region of the valve is distally spaced-apart from the native valve.

Abstract: A branched and fenestrated prosthesis may include a main tubular graft body including a proximal end opening, a distal end opening, a lumen, and a sidewall. A branch may extend from the sidewall and may include a first end opening, a second end opening, and a lumen. A fenestration may be disposed in the sidewall and positioned distal of the second end opening of the branch. The branched and fenestrated prosthesis may include a plurality of branches and a plurality of fenestrations.

Abstract: Examples of prostheses are provided having an internal branch. A tubular graft body of the prosthesis defines a main lumen extending between an inflow end and an outflow end of the graft body. A stent structure is coupled along the graft body. A trough is at least partially defined by a trough wall extending into the main lumen from a sidewall of the graft body. A side branch defines a branch lumen and extends from the trough within the main lumen towards one of the inflow or outflow ends of the graft body. A branch lumen facing surface of the trough wall is a continuous surface with an outer surface of the sidewall of the graft body. A boundary of the trough may be configured to provide a smooth transition surface between the trough and the sidewall.

Abstract: The present embodiments provide a medical device for implantation in a patient comprising a stent and a valve. The stent comprises a proximal region comprising a cylindrical shape having a first outer diameter in an expanded state, and a distal region comprising a cylindrical shape having a second outer diameter in the expanded state. The second outer diameter is greater than the first outer diameter. A proximal region of the valve is at least partially positioned within the proximal region of the stent, and the distal region of the valve is at least partially positioned within one of tapered and distal regions of the stent. When implanted, the proximal region of the stent and the proximal region of the valve are aligned with a native valve, and the distal region of the valve is distally spaced-apart from the native valve.

Abstract: A stent graft having an internal bidirectional branch formed from a tubular segment of graft material. The internal bidirectional branch extends within the lumen of the stent graft and proximally and distally from a lateral opening in the sidewall of the stent graft. The tubular segment from which the stent graft is made is partitioned into first and second sections along a length of the tubular segment to form the internal bidirectional branch. The lateral opening has a length and a width that may be greater than the diameter of the internal bidirectional branch and may be in the shape of a quadrilateral. The internal bidirectional branch and the stent graft are formed from a single piece of graft material.

Abstract: A branched and fenestrated prosthesis may include a main tubular graft body including a proximal end opening, a distal end opening, a lumen, and a sidewall. A branch may extend from the sidewall and may include a first end opening, a second end opening, and a lumen. A fenestration may be disposed in the sidewall and positioned distal of the second end opening of the branch. The branched and fenestrated prosthesis may include a plurality of branches and a plurality of fenestrations.

Abstract: The present embodiments provide a medical device for implantation in a patient comprising a stent and a valve. The stent comprises a proximal region comprising a cylindrical shape having a first outer diameter in an expanded state, and a distal region comprising a cylindrical shape having a second outer diameter in the expanded state. The second outer diameter is greater than the first outer diameter. A proximal region of the valve is at least partially positioned within the proximal region of the stent, and the distal region of the valve is at least partially positioned within one of tapered and distal regions of the stent. When implanted, the proximal region of the stent and the proximal region of the valve are aligned with a native valve, and the distal region of the valve is distally spaced-apart from the native valve.

Abstract: A stent for use in a medical procedure having opposing sets of curved apices, where the curved section of one set of apices has a radius of curvature that is greater than the curved section of the other set of apices. One or more such stents may be attached to a graft material for use in endovascular treatment of, for example, aneurysm, thoracic dissection, or other body vessel condition.

Abstract: The present embodiments provide a medical device for implantation in a patient comprising a stent and a valve. The stent comprises a proximal region comprising a cylindrical shape having a first outer diameter in an expanded state, and a distal region comprising a cylindrical shape having a second outer diameter in the expanded state. The second outer diameter is greater than the first outer diameter. A proximal region of the valve is at least partially positioned within the proximal region of the stent, and the distal region of the valve is at least partially positioned within one of tapered and distal regions of the stent. When implanted, the proximal region of the stent and the proximal region of the valve are aligned with a native valve, and the distal region of the valve is distally spaced-apart from the native valve.

Abstract: A stent graft having an internal bidirectional branch formed from a tubular segment of graft material. The internal bidirectional branch extends within the lumen of the stent graft and proximally and distally from a lateral opening in the sidewall of the stent graft. The tubular segment from which the stent graft is made is partitioned into first and second sections along a length of the tubular segment to form the internal bidirectional branch. The lateral opening has a length and a width that may be greater than the diameter of the internal bidirectional branch and may be in the shape of a quadrilateral. The internal bidirectional branch and the stent graft are formed from a single piece of graft material.

Abstract: Examples of prostheses are provided having an internal branch. A tubular graft body of the prosthesis defines a main lumen extending between an inflow end and an outflow end of the graft body. A stent structure is coupled along the graft body. A trough is at least partially defined by a trough wall extending into the main lumen from a sidewall of the graft body. A side branch defines a branch lumen and extends from the trough within the main lumen towards one of the inflow or outflow ends of the graft body. A branch lumen facing surface of the trough wall is a continuous surface with an outer surface of the sidewall of the graft body. A boundary of the trough may be configured to provide a smooth transition surface between the trough and the sidewall.

Abstract: Methods and apparatuses to place a prosthesis within a receiving structure are provided. A delivery apparatus includes an elongated support member including a support member distal end. A stop cap is disposed at the support member distal end and includes a stop cap transverse dimension larger than an inner diameter of a receiving lumen of the receiving structure. An elongated prosthesis-positioning member extends along the support member and stop cap so a distal surface of the prosthesis-positioning member is disposed at a position longitudinally coincident with a portion of the stop cap. A sheath comprises a sheath lumen receiving the prosthesis-positioning member so the sheath translates longitudinally relative to the prosthesis-positioning member. The delivery apparatus has a loaded configuration in which the prosthesis is received in the sheath lumen with a proximal end of the prosthesis abutting the prosthesis-positioning member distal surface.

Abstract: A stent for use in a medical procedure having opposing sets of curved apices, where the curved section of one set of apices has a radius of curvature that is greater than the curved section of the other set of apices. One or more such stents may be attached to a graft material for use in endovascular treatment of, for example, aneurysm, thoracic dissection, or other body vessel condition.

Abstract: Examples of prostheses are provided having an internal branch. A tubular graft body of the prosthesis defines a main lumen extending between an inflow end and an outflow end of the graft body. A stent structure is coupled along the graft body. A trough is at least partially defined by a trough wall extending into the main lumen from a sidewall of the graft body. A side branch defines a branch lumen and extends from the trough within the main lumen towards one of the inflow or outflow ends of the graft body. A branch lumen facing surface of the trough wall is a continuous surface with an outer surface of the sidewall of the graft body. A boundary of the trough may be configured to provide a smooth transition surface between the trough and the sidewall.

Abstract: Prostheses and methods of making the same are provided. The prosthesis has an internal branch configuration. A trough or branch opening is at least partially defined by a trough wall extending into a main lumen from a sidewall of the prosthesis. The internal branch extends from the trough within the main lumen towards one of the outflow end of the graft body in a helical, retrograde arrangement. Other arrangements are described. The prosthesis may include a scalloped fenestration having a width larger than the trough. The trough may be positioned along a tapered region of the prosthesis. The trough and internal branch may be made from the same graft material. The trough and internal branch, in addition to the main graft body, may be made from the same graft material.

Abstract: Systems and methods to place a prosthesis to have a preselected overlap with a receiving structure are provided. In one embodiment, a delivery system may include a primary sheath comprising a primary sheath lumen. The delivery system may further include a secondary sheath comprising a secondary sheath lumen. The primary sheath may be at least partially received within the secondary sheath lumen such that the primary sheath may translate longitudinally within the secondary sheath lumen. The delivery system may further include a prosthesis having proximal and distal ends and being received within the primary sheath lumen adjacent to the primary sheath distal end in a contracted delivery state. The delivery system may further include a length reference mechanism that indicates a length of the primary sheath distal end that extends distal to the secondary sheath distal end during the contracted delivery state of the prosthesis.

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. The auxiliary lumens have an oblong cross-section. 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, 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 stent therein.

Abstract: Methods of reducing air within a stent graft delivery device are disclosed, utilizing various flushing techniques. A port in a manifold that includes a pusher catheter coaxially disposed about a guide wire catheter is flushed. A portion in a sheath hub that excludes a longitudinally extended outer sheath coaxially disposed about the pusher catheter is flushed with a flushing fluid and/or a blood soluble gas, such as carbon dioxide. The guide wire catheter is also flushed.

Abstract: An endovascular prosthesis delivery system comprising: a guide wire catheter; a nose cone dilator at the proximal end of the guide wire catheter; and a pusher catheter comprising a lumen configured to receive the guide wire catheter therethrough and at least one longitudinal auxiliary lumens configured to receive an auxiliary catheter. The pusher catheter may have recess in the guide wire lumen. The recess may be configured to receive a portion of the nose cone dilator when the guide wire catheter is withdrawn distally.

Abstract: A device includes a medusa wire group with at least three separate wires slidably received in a vascular catheter. The multiple wires of the medusa wire group maximize the chances of at least one wire entering a target branch vessel during an attempt to achieve access. Entry into the branch vessel may then be gained by advancing the vascular catheter over the at least one wire that successfully entered the branch passageway.