Abstract: The present embodiments provide a prosthesis comprising first and second segments, and an axially extendable segment coupled to the first and second segments. A valve is coupled to at least one of the axially extendable segment or the second segment. The axially extendable segment comprises a first state in which the valve at least partially overlaps with the first segment, and the axially extendable segment comprises a second state in which the valve lacks an overlap with the first segment.

Abstract: Various stents and stent-graft systems for treatment of medical conditions are disclosed. In one embodiment, an exemplary stent-graft system may be used for endovascular treatment of a thoracic aortic aneurysm. The stent-graft system may comprise proximal and distal components, each comprising a graft having proximal and distal ends, where upon deployment the proximal and distal components at least partially overlap with one another to provide a fluid passageway therebetween. The proximal component may comprise a proximal stent having a plurality of proximal and distal apices connected by a plurality of generally straight portions, where a radius of curvature of at least one of the proximal apices may be greater than the radius of curvature of at least one of the distal apices. The distal component may comprise a proximal z-stent coupled to the graft, where the proximal end of the graft comprises at least scallop formed therein that generally follows the shape of the proximal z-stent.

Abstract: A system may include an endoluminal prosthesis and a guide wire. The prosthesis may include a tubular body including a graft material wall, a proximal end opening, a distal end opening, and a lumen extending longitudinally therein. The prosthesis may include first and second fenestrations in the graft material wall. The first and second fenestrations may be spaced from one another circumferentially about the tubular body. The guide wire may have a first end and a second end both extending from a region proximal of the proximal end opening. The guide wire may enter the proximal end opening, exit the first fenestration, partially traverse an exterior surface of the prosthesis, enter the second fenestration, and exit the proximal end opening. One or more of the fenestrations may include a branch.

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 prosthesis delivery device and method of using the same is described. The delivery device comprises a rotatable inner cannula extending from a proximal end to a distal end with a prosthesis releasably coupled to the proximal end. A delivery handle assembly is disposed at the distal end of the delivery device. The handle comprises a first handle disposed about the inner cannula, a rotary dial rotatably disposed about a distal end of the first handle and a second handle disposed about at least a portion of the distal end of the first handle. The second handle is longitudinally moveable relative to the first handle between a first position wherein the sheath is coaxially disposed about the prosthesis and rotation of the rotary dial is prevented, and a second position wherein the sheath is retracted distally to expose at least a portion of the prosthesis and rotation of the dial is permitted.

Abstract: Devices for delivering and deploying an endoluminal prosthesis are disclosed and comprise a delivery catheter, an endoluminal prosthesis disposed at a distal end portion of the delivery catheter, and a wire. The prosthesis comprises a tubular graft having at least one fenestration. The wire extends distally from a first wire end through an axial lumen of the delivery catheter and the prosthesis, and through the fenestration in the graft. The wire extends proximally through a lumen of the prosthesis and through an axial lumen of the delivery catheter towards a second wire end. Additional devices, systems, and methods are disclosed.

Abstract: The present embodiments provide an endoluminal prosthesis deployment system and method for deploying the prosthesis for cannulation of branch vessels. The prosthesis includes an anterior fenestration and a posterior opening. A guide is disposed to exit the prosthesis lumen through a lateral fenestration, enter through the anterior fenestration, and exit the prosthesis lumen through the posterior opening. A sheath can be preloaded over the branch wire at the lateral fenestration for vessel cannulation, such as in renal arteries. The sheath can include another branch wire that extends from the lateral fenestration to another lateral fenestration. An end of the guide is retracted after partial expansion of the prosthesis, and another sheath is inserted over the retracted guide and moved through the posterior opening and to the anterior fenestration. A separate branch guide wire is then directed through the sheath for vessel cannulation, such as the SMA.

Abstract: The present embodiments provide a stent for use in a medical procedure that comprises a series of proximal apices disposed at a proximal end of the stent and a series of distal apices disposed at a distal end of the stent. A trigger wire is adapted to be coupled to at least one of the proximal apices to restrain a proximal end of the stent during delivery. In a first embodiment, a first proximal apex comprises a bore for receiving the trigger wire, and a second proximal apex, disposed adjacent to the first proximal apex, comprises at least one barb. The trigger wire therefore is only coupled to selected ones of the proximal apices. In an alternative embodiment, a first proximal apex comprises a first bore and a second, adjacent proximal apex comprises a second bore, such that a single trigger wire may be disposed through the first and second bores to restrain the first and second proximal apices during delivery.

Abstract: The present disclosure relates to an endoluminal prosthesis, such as a stent graft that includes one or more fenestrations to accommodate endovascular disease, such as an aneurysm in cases where one or more side branches is involved. In one aspect, the prosthesis includes fenestrations that are pivotable to accommodate the dynamic geometry of the aortic branches. In another aspect, the pivotable fenestrations include a first perimeter, a band of flexible material attached and surrounding the first perimeter, and a second perimeter attached to and surrounding the band of flexible material. The first perimeter, band of flexible material, and second perimeter have a geometric shape.

Abstract: An endograft comprising a proximal end and a distal end is disclosed. The endograft comprises a tube of biocompatible material. The tube comprises: 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 comprises a lateral cross-section defining a tubular wall pinched together by the seam to form a branch portion. The branch portion comprises an entrance within the intermediate portion of the main lumen and an exit through the tubular wall of the main lumen.

Abstract: A system for facilitating deployment of an endoluminal 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. A wire segment may include a proximal portion positioned proximal of the proximal end opening and a distal portion positioned distal of the distal end opening. The wire segment extend through the fenestration and through the lumen of the branch in a preloaded configuration.

Abstract: A stent graft assembly having a tubular body and a constraining patch attached to the interior surface of the tubular body. The constraining patch delineates a small passageway close to the inner surface of the tubular body. A cannula may extend through the passageway.

Abstract: A capsule assembly for an endograft introducer is disclosed. The assembly comprises: a capsule retriever having a plug portion and a tail portion, the plug portion having a lead-in surface, the tail portion having an elongate body extending proximally from the plug portion to an end stop feature receiver; a capsule tube having an end stop feature at a proximal end thereof and terminating in a distal end, the end stop feature and the end stop receiver arranged such that proximal movement of the capsule tube relative to the plug portion is limited; and a capsule cavity inside the capsule tube, a proximal end of a prosthesis being receivable in the cavity. The capsule tube is slidably movable with respect to the capsule retriever to a position in which the distal end of the capsule tube is adjacent to the lead-in surface of the plug portion.

Abstract: The present disclosure relates to an endoluminal prosthesis, such as a stent graft that includes one or more fenestrations to accommodate endovascular disease, such as an aneurysm in cases where one or more side branches is involved. In one aspect, the prosthesis includes fenestrations that are pivotable to accommodate the dynamic geometry of the aortic branches.

Abstract: A system may include an endoluminal prosthesis and a guide wire. The prosthesis may include a tubular body including a graft material wall, a proximal end opening, a distal end opening, and a lumen extending longitudinally therein. The prosthesis may include first and second fenestrations in the graft material wall. The first and second fenestrations may be spaced from one another circumferentially about the tubular body. The guide wire may have a first end and a second end both extending from a region proximal of the proximal end opening. The guide wire may enter the proximal end opening, exit the first fenestration, partially traverse an exterior surface of the prosthesis, enter the second fenestration, and exit the proximal end opening. No portion of the guide wire may extend distally beyond the distal end opening.

Abstract: An endoluminal prosthesis introducer may include an elongate tubular sheath including a reinforced longitudinal segment and a peelable longitudinal segment extending distally from the reinforced segment. An elongate tubular cannula may be disposed within the sheath. Upon application of a force applied to a distal end of the sheath, the peelable segment may progressively split in a proximal direction, and the reinforced segment may longitudinally move relative to the cannula in a distal direction.

Abstract: A method of making a stent-graft is provided. The method includes mounting a stent on a mandrel so that the stent is stretched when it is on the mandrel. A graft layer is then adhered to the stent while it is mounted on the mandrel. When the stent-graft is removed from the mandrel, the stent contracts and the graft layer becomes partially wrinkled when the stent is in its expanded relaxed state.

Abstract: The present embodiments provide a stent for use in a medical procedure that comprises a series of proximal apices disposed at a proximal end of the stent and a series of distal apices disposed at a distal end of the stent. In a first embodiment, a first proximal apex comprises a bore for receiving a trigger wire, and a second proximal apex, disposed adjacent to the first proximal apex, comprises at least one barb. In an alternative embodiment, a first proximal apex comprises a first bore and a second, adjacent proximal apex comprises a second bore, such that a single trigger wire may be disposed through the first and second bores to restrain the first and second proximal apices during delivery.

Abstract: A prosthesis delivery comprising a rotatable inner cannula and a prosthesis releasably coupled to a proximal end of the inner cannula is disclosed. The inner cannula has a first position in which the prosthesis is retained on the cannula and a second position in which the prosthesis is released. At least one magnet is disposed on the inner cannula. A handle assembly is disposed about a distal portion of the inner cannula, the handle assembly comprising a rotary collar having at least one magnet disposed on the inner surface thereof, wherein the at least one magnet disposed on the rotatable inner cannula and the at least one magnet disposed on the inner surface of the rotary collar comprise a magnetic attraction. The magnetic attraction translates torque from rotation of the rotary collar to rotate the inner cannula from the first position to the second position to thereby release the prosthesis.