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: A stent graft for placement in the thoracic arch of a patient has a tubular body defining a main lumen therethrough, a plurality of zig zag stents along the tubular body, each of the stents comprising a plurality of struts and bends, the bends being between adjacent struts. At least a first stent and an adjacent second stent having at least a pair of adjacent bends on the first stent aligned with an adjacent pair of bends on the second stent, whereby a first pair of adjacent struts of the first stent and a second pair of adjacent struts of the second adjacent stent together define a diamond shape region. A recess is within the diamond shaped region with the recess extending into the lumen of the tubular body. A fenestration extending into the tubular body within the recess in the diamond shaped region and a graft tube leading from the fenestration into the main lumen.

Abstract: A stent graft defining a main lumen bounded by a wall of graft material is disclosed. The stent graft has a valve portion between proximal and distal portions. The valve portion is formed by a wall portion having a part-circumferential double layer portion comprising an inner underlap portion and an outer overlap portion, the double layer portion forming a passageway parallel to the main lumen. The passageway has an entrance mouth and an exit mouth. The passageway has an open condition where the underlap and overlap portions are spaced apart to form a vent lumen. The wall portion is broken by a narrow cut. The cut is openable by relative radial movement between its edges. This allows re-perfusion of an aneurism and perfusion of blood from within the lumen out towards blood vessels such as intercostals and can assist in minimising the chance of paraplegia.

Abstract: A stent graft introducer has a pusher, a nose cone, a region between the pusher and the nose cone for a stent graft, a sleeve extending over the pusher and proximally to the nose cone to cover the stent graft when retained in the region. An indwelling auxiliary catheter with a pre-curved proximal end is fitted into the introducer. The nose cone has an elongate groove and the auxiliary catheter has its proximal end in the elongate groove. In a partially retracted position of the sleeve the curved proximal end of the indwelling auxiliary catheter is exposed and uncovered by the sleeve and in an advanced position of the sleeve the curved proximal end of the indwelling auxiliary catheter is straightened, extends along the length of the groove in the nose cone and is covered by the sleeve.

Abstract: A fenestrated stent graft (1) with a tubular side arm (11) extending therefrom in which the side arm can be turned inside out to extend into the stent graft during deployment of the stent graft and extended out during deployment. Also disclosed is a deployment device (19) for such a side arm stent graft which has a deployment catheter (26) and a side arm guide (32), the side arm guide is releasably fastened at a proximal end to the branch tube (11) and is able to be moved independently of the deployment catheter such that the branch tube can be extended from the tubular body of the stent graft while it is fastened onto the side arm guide. The side arm guide can be formed from a side arm catheter (32) and a side arm guide wire (34) carried in the side arm catheter.

Abstract: A stent graft delivery system (50) has a stent graft (74) retained on it. The stent graft has an exposed proximally extending self expanding stent (76) which is retained in a distally opening capsule (78) at the distal end of a nose cone dilator (58) on the delivery system. A trigger wire (80) extends from a release mechanism (82) the distal end of the delivery system into a first aperture (84) in the capsule, around a proximal bend (86) of the exposed stent and out of the first aperture in the capsule and extending proximally into a second aperture (88). The trigger wire prevents premature release of the exposed stent.

Abstract: A stent graft (10) has a tubular body with a side aperture (16) covered by a valve arrangement (18) and an arrangement to hold the valve open (32) with a release wire (30). Retraction of the release wire closes the valve. The stent graft can have a tubular body with a first bifurcation (134) with first and second legs (130, 132) extending from the bifurcation. The side aperture and valve arrangement can be in one of the legs. One of the legs (132) has a further bifurcation (142) to define a side arm (140). The stent graft can be deployed into the vasculature of a patient with the tubular body being in an aorta of the patient, a first leg extending down an iliac artery, a second leg being directed towards a contralateral iliac artery and the side arm directed to an internal artery of the contralateral iliac artery.

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 fenestration (32) for a stent graft (30). The fenestration is an aperture in the biocompatible graft material and has at least one flap (38, 40) of a biocompatible graft material covering the aperture on the inside whereby the flap closes off the aperture but can be displaced to allow access through the fenestration. An array of such fenestrations may be placed on a stent graft to facilitate alignment of a branch vessel with a fenestration. A slip knot (46, 46) which can be released by forcing a dilator between the flaps can be used to hold the flaps together.

Abstract: A fenestrated stent graft with a tubular side arm extending there from in which the side arm can be turned inside out to extend into the stent graft during deployment of the stent graft and extended out during deployment. Also disclosed is a deployment device for such a side arm stent graft which has a deployment catheter and a side arm guide, the side arm guide is releasably fastened at a proximal end to the branch tube and is able to be moved independently of the deployment catheter such that the branch tube can be extended from the tubular body of the stent graft while it is fastened onto the side arm guide. The side arm guide can be formed from a side arm catheter and a side arm guide wire carried in the side arm catheter.

Abstract: A hybrid stent graft device for treatment of a Type A dissection having a first tubular portion for placement into the ascending aorta and a second tubular portion for extending around the thoracic arch and down the descending aorta is disclosed. The first tubular portion is connectable to the aorta between the sinotubular junction and the brachiocephalic artery so that it essentially replaces the ascending aorta. A temporary bypass tube allows perfusion during an operation. The second tubular portion has an elongate recess outside of the second tubular portion and an aperture defining a fluid flow path into the recess. The recess is intended to engage an outer curve of the thoracic arch to enable blood flow into the arteries of the thoracic arch. An introduction device in combination with the hybrid stent graft described above is also disclosed.

Abstract: A reinforcing ring (10) for a fenestration (32) of a stent graft which can be surface treated such as by passivation and/or electropolishing. The reinforcing ring has several turns of a substantially inextensible resilient wire (12) in a circular two dimensional planar shape and terminal ends (14) at each end of the wire. The terminal ends each comprising a loop (14) and a tail (16). The tail is folded back and extends around the circular shape. Each of the tails of the terminal loops can have an enlarged end. The reinforcing ring can be straightened out for surface treatment such as passivation and/or electropolishing with substantially no part of the circular shape, the loops or tails touching each other.

Abstract: A method of sizing of a stent graft (20) including placement of fenestrations (30, 32) to ensure access to side branch vessels (13, 15) through the fenestrations when the stent graft is introduced into a body vessel and an assembly method for a stent graft including temporary diameter reduction arrangements to enable partial release of a stent graft to assist with positioning of fenestrations with respect to side branch vessels. The method includes spacing the fenestrations to be the same circumferential distance as the side branch vessels irrespective of the diameter of the stent graft.

Abstract: A fenestration (32) for a stent graft (30). The fenestration is an aperture in the biocompatible graft material and has at least one flap (38, 40) of a biocompatible graft material covering the aperture on the inside whereby the flap closes off the aperture but can be displaced to allow access through the fenestration. An array of such fenestrations may be placed on a stent graft to facilitate alignment of a branch vessel with a fenestration. A slip knot (46, 46) which can be released by forcing a dilator between the flaps can be used to hold the flaps together.

Abstract: A stent graft (2) for treatment of an emergency rupture of, for instance, the aorta adjacent the aortic bifurcation. The stent graft comprising a tubular body (8) with a bifurcation (10) in the tubular body defining a first long leg (12) and a second short leg (14). The second leg has a valve arrangement (18) to prevent fluid flow through the second leg from the stent graft. The valve can be opened from external of the stent graft for the placement of a leg extension stent graft (90) therethrough.

Abstract: A curve forming stent graft for curved vessels such as the thoracic arch. The stent graft has a tubular body zig zag self expanding stents fastened to and supporting the tubular body. The zig zag self expanding stents comprising struts and points between adjacent struts thereby defining proximal end points and distal end points. A temporary diameter constriction arrangement associated with the least some of the plurality of zig zag self expanding stents comprises a pair of adjacent distal end points being releasably retained adjacent each other whereby at rest the tubular body of the stent graft is in a substantially sawtooth form and when released in a curved configuration a distal end point of a stent overlaps a proximal end point of a distally adjacent stent to facilitate curvature of the stent graft in a curved vessel.

Abstract: A prosthesis deployment device having a elongate catheter body and a trigger wire guide concentric about the elongate catheter body where the trigger wire guide comprises three trigger wire lumens separate and apart from a guide wire lumen, with three trigger wires being at least partially disposed in the three trigger wire lumens and configured to engage a portion of a prosthesis to retain the prosthesis adjacent to the trigger wire guide.

Abstract: A stent arrangement which has at least a first ring (3) and zig zag struts (5) extending axially from the periphery of the ring. There can be first and second rings (3, 4) axially spaced apart and defining substantially parallel planes and a plurality of zig zag portions (5) between the first and second ring portions around the periphery thereof. The stent can be formed from a single wire or laser cut from a cannula and can be covered or uncovered.

Abstract: A reinforcing and marker ring for a stent graft is disclosed. The reinforcing and marker ring comprises a plurality of turns of a substantially inextensible resilient wire in a circular shape and terminal ends at each end of the wire. The terminal ends each comprise a loop, each loop attachable to a stent graft having an opening or a fenestration so as to substantially lock a peripheral length of the circular shape. A marker winding is wound helically around the reinforcing wire, the marker winding being viewable on an image display system employing electromagnetic radiation so as to indicate the location of a periphery of the fenestration. The circular shape of the resilient wire, with the marker winding wound around it, is collapsible under radial pressure to form a squashed circular shape for loading into a delivery device, the squashed circular shape self-expandable back to a substantially circular shape upon release from the delivery device.

Abstract: A stent graft introducer for intraluminal deployment of a stent graft (26), the introducer comprising a stent graft release mechanism (6) to allow partial release of the stent graft (26) when carried on the introducer, whereby control of the stent graft can be maintained while allowing access into the lumen of the stent graft from at least one end of the stent graft. The partial release can comprise partial release of one end of the stent graft.