Abstract: A bifurcated endovascular prosthesis that includes a tubular main body having a diameter, a proximal end, a distal end, an internal lumen extending from the proximal end to the distal end, an anterior side, and a posterior side. The anterior and posterior sides are opposite each other circumferentially around the internal lumen. The prosthesis also includes a first limb that extends from the distal end of the tubular main body along the anterior side of the main body. The first limb has a diameter less than the diameter of the tubular main body and having a proximal end and a distal end. The prosthesis also includes a fenestration adjacent to the proximal end of the first limb. The fenestration extends from the proximal end of the first limb to the posterior side of the tubular main body. The prosthesis also includes a second limb that extends within the internal lumen from the fenestration toward the proximal end of the tubular main body.

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: An endograft comprising a proximal end and a distal end is disclosed. The endograft includes a tube of biocompatible material. The tube includes a main lumen extending longitudinally from the proximal end to the distal end, the main lumen including a proximal portion, an intermediate portion and a distal portion; a branch lumen within the intermediate portion of the main lumen; and a seam, the seam extending longitudinally beside both the branch lumen and the distal portion of the main lumen, wherein the tube includes a lateral cross-section defining a tubular wall pinched together by the seam to form a branch portion. The branch portion includes an entrance within the intermediate portion of the main lumen and an exit through the tubular wall of the main lumen.

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 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.

Abstract: A method of making an internal bidirectional branch and an endoluminal prosthesis from a tubular segment of graft material. The tubular segment is partitioned into first and second sections along a length of the tubular segment. The first section has a width less than a width of the tubular segment, and the second section has a width less than the first section. The second section is partitioned into at least three sub-sections. The tubular segment is connected along a lateral edge of the first and third sub-sections of the second section. The tubular segment is turned inside out such that the bidirectional branch is positioned within a lumen of the first section and an opening of the second sub-section is exposed.

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: 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: 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: 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: The disclosure is directed to a targeting guidewire. The guidewire includes a distal portion including four portions and three transition zones between the adjacent portions. A first and a third portions have a smaller stiffness than a second and a fourth portions. The first and the third portions may also have a smaller overall outer diameters than the second and the fourth portions. The three transition zones comprises marking elements so as to delineate their locations.

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: 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: 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: A stent graft delivery device that is pre-loaded with a single guide wire for both tracking the device within a main vessel as well as for cannulating one or more branch vessels is described. The delivery device comprises a delivery catheter having a prosthesis releasably secured thereto and a nose cone extending from the proximal end of the catheter. In a delivery configuration, a secondary catheter is coaxial with the guide wire and extends through at least a portion of the prosthesis lumen and is held within a channel formed in the nose cone. In a released configuration, secondary catheter and guide wire are retracted distally out of the channel formed in the sidewall of the nose cone dilator and can be manipulated for cannulating a branch vessel.

Abstract: A device for delivering and deploying a radially expandable prosthesis is disclosed and comprises a proximal prosthesis release mechanism having a first resistance and a distal prosthesis release mechanism having a second resistance. The device further comprises an actuation mechanism for actuating the distal and proximal release mechanisms in a single coordinated movement and a biasing compensator for regulating the relationship between the first resistance and the second resistance. Additional aspects of the invention include devices and methods for delivering and deploying a radially expandable prosthesis.

Abstract: The present embodiments describe a multi-component endograft having a first endograft with first and second wall openings, a second endograft with a third wall opening, a third endograft with a fourth wall opening, where during an adjustment state the second and third endografts are independently adjustable, both vertically along a longitudinal axis and rotationally relative to the longitudinal axis, (1) while keeping the perimeter of the third wall opening primarily encompassed by the perimeter of the first wall opening and (2) while keeping the perimeter of the fourth wall opening primarily encompassed by the perimeter of the second wall opening.

Abstract: An introducer for an endoluminal prosthesis and a methods for delivering a prosthesis within a body vessel are described. The introducer comprises pusher catheter having a lumen extending therethrough, the lumen being in communication with an opening formed in the sidewall of the pusher. A sheath is disposed over the pusher catheter and also has an opening formed in its sidewall. The sheath is longitudinally movable relative to the pusher catheter between a prosthesis delivery position and a prosthesis deployment position. When the sheath is in the deployment position, the opening formed in the sidewall of the pusher catheter is at least partially longitudinally aligned with the opening formed in the sidewall of the sheath. A wire may extend though the opening in the sheath, the opening in the pusher, through the lumen of the pusher and through a fenestration in a prosthesis to cannulate a branch vessel.

Abstract: A pre-loaded prosthesis delivery device is described. In one example, the prosthesis delivery device is pre-loaded with a single wire that allows the device to be tracked into place within a vessel and also facilitates cannulation of a branch vessel. The delivery device further comprises a prosthesis that is releasably coupled to a delivery catheter by using two attachment wires to secure the proximal end of the prosthesis to the delivery device in a tri-fold configuration.

Abstract: A delivery device and methods for deploying an endovascular prosthesis within the common and internal iliac arteries are described. The device comprises a pusher catheter having a proximal end and a pusher extension extending proximally therefrom. A tubular prosthesis having a side branch is releasably coupled to the pusher extension. An extension dilator extends proximally from the proximal end of the pusher catheter, extends at least partially along an external surface of the main tubular body, into a distal end of the side branch and exits a proximal end of the tubular prosthesis. The extension dilator can be tracked over a guide wire which serves to both position the device within a vessel and also to facilitate cannulation of an internal iliac artery.