Abstract: A stent graft (10) has a tubular body (12) of a biocompatible material and at least one fenestration (18, 20). The or each fenestration has a tubular side branch stitched into it with a portion of the tubular side branch extending within the tubular body and a portion of the tubular side branch extending exteriorly of the tubular body. The stitching by which the tubular side branch is mounted into the fenestration extends circumferentially and diagonally from one end of the tubular side branch to the other such that the tubular side branch extends from the tubular body at an angle thereto. The tubular side branch has a resilient ring around at least one and preferably both ends thereof and a self expanding stent in between them. The tubular side branch can have a circumferential linear portion (46) at an inner end to engage against the inner wall (58) of the tubular body.

Abstract: A stent graft (10) is retained on an introducer (38) by retention of an exposed stent (16) of the stent graft to the introducer with trigger wires (44). The introducer has a trigger wire catheter (40) and four trigger wires and each trigger wire extending in a loop from the trigger wire catheter. The stent graft has a tubular body (12) of a graft material and an exposed stent joined to and extending from one end of the tubular body. The exposed stent is a self expanding Z stent with struts (20) and bends (22, 28, 30) between them. A pair of struts and a bend between define an apex a selected distance to the bend away from the tubular body. Adjacent apices of the exposed stent are different distances to the bends from the tubular body so that they stack under the trigger wires in an neat fashion. Distally extending barbs (26) on alternate struts of the exposed stent are spaced selected distances from their respective apices to prevent tangling during deployment.

Abstract: A stent graft introducer has a nose cone dilator (8) and a distally opening capsule (18) on the nose cone dilator, a balloon guide (2, 30) extending into the capsule and affixed therein. Upon completion of deployment of a stent graft, a balloon catheter (96) including an inflatable balloon (98) thereon can be advanced over the balloon guide at least partially into the nose cone whereby the balloon can be inflated therein to provide a smooth transition from the nose cone to a delivery sheath (10) for retraction of the nose cone dilator through the deployed stent graft. The balloon guide can be a separate wire (30).

Abstract: A multi-port stent graft delivery device (2) has an annular access lumen (26) between a delivery catheter (24) and a main sheath (6), at least one indwelling access sheath (28, 30) within the access lumen, and an indwelling guide wire (36, 38) within the or each access sheath and a stent graft (16) retained in the delivery device. Upon deployment of the stent graft into the vasculature of a patient the indwelling guide wire can be used to facilitate stabilization of the access sheath during cathertization of a side branch and deployment of a side arm covered or uncovered stent therein through the advanced access sheath. A manifold associated (4) with a handle provides a plurality of access ports (41, 43). A docking balloon may also be used.

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 side branch stent graft (1) suitable for the iliac arteries has a main tubular body (3) of a biocompatible graft material and a tubular side branch (5). The tubular side branch is affixed into the main tubular body so that a side branch lumen is in fluid communication with a main lumen. There is at least one external zig-zag stent (13) on the main tubular body proximal of the tubular side branch, one central external stent (14) which also encompasses the side arm, at least one external zig-zag stent (16) on the main tubular body distal of the tubular side branch and one internal zig-zag stent (15) at the distal end of the main tubular body. A reinforcing ring (9) is around the proximal end of the main tubular body and stitched thereto.

Abstract: A stent graft deployment device (10) has a tubular fixed handle (34, 36) to be gripped and held by a user and an elongate release handle (30) extending through the fixed handle so that the release handle can be moved through the fixed handle. The deployment device assembly has a pusher (38) and a sheath (18) to cover a stent graft (64) on the pusher. The pusher is connected to the fixed handle and the sheath is connected to the release handle so that retraction of the release handle through the fixed handle causes the sheath to be retracted from the stent graft on the pusher. The fixed handle includes a grip component (34) that grips the pusher and a rotator component (36) that grips a release clamp (48) on the pusher. The release clamp has trigger wires for the release of the stent graft attached to it.

Abstract: A stent graft for endovascular introduction into the pararenal region of the descending aorta. The stent graft has an elongate tubular body (10) with a proximal portion (12), a distal portion (16) of a diameter less than the proximal portion and a tapered central portion (14). A notional transverse clock face on the tubular body has 12 o'clock at a notional anterior longitudinal datum line. The stent graft has a scalloped cut out (26) centered at about 12:30 o'clock and a fenestration (28) at about 12:00 o'clock in the proximal portion and first and second fenestration assemblies which can be low profile side arms at about 2:15 o'clock and about 10:00 o'clock in the tapered central portion. The tapered central portion can have an arcuate side wall (30) so that the tapered portion has an outer face which is concave.

Abstract: A trigger wire guide for a prosthesis deployment device. The prosthesis deployment device has a proximal end extending to a proximal nose cone dilator and having a trigger wire or wires and trigger wire release mechanism to retain the proximal end of a prosthesis adjacent the nose cone dilator. The trigger wire guide retains the trigger wire or wires to prevent fouling of the trigger wire with a prosthesis when the prosthesis is carried on the deployment device. The guide can be crimped or soldered to a guide wire catheter or concentric with it.

Abstract: A stent graft introducer actuation assembly (1) having a fixed handle (3) and at least one sliding handle (5, 7), the sliding handle or handles telescoping within the fixed handle, and a winch arrangement (9) to retract the sliding handle into the fixed handle. There may be provided arrangements to give a mechanical advantage to the winch arrangement.

Abstract: A multi-port stent graft delivery device (100) has an annular access lumen (107) between a delivery catheter (112) and a main sheath (106), at least one indwelling access sheath (118, 122) within the access lumen, and an indwelling guide wire (138, 146) within the or each access sheath and a stent graft (131) retained in the delivery device. Upon deployment of the stent graft into the vasculature of a patient the indwelling guide wire can be used to facilitate stabilisation of the access sheath during cathertisation of a side branch and deployment of a side arm covered or uncovered stent therein through the advanced access sheath. A two part handle enables withdrawal of a nose cone dilator before final placement of the side arm stents. A manifold (114) associated with a proximal handle portion provides a plurality of access ports (116, 120).

Abstract: A medical grasping device (1) has an elongate control member (9) with a grasping member (17) proximal to its distal tip. An outer sheath (3) with a passageway therethrough surrounds the elongate control member and is relatively movable with respect to the control member. A control assembly (2) disposed at a proximal end of said outer sheath has a fixed handle (5) and a sliding handle (7) and the proximal end of the elongate control member is fixed to the sliding handle to move the control member. The grasping member (17) has a plurality of pre-formed wire loops (50, 52, 54, 56) which self-deploy transversely upon emerging from said distal end of said outer sheath. Each wire loop is fastened to substantially opposite sides of the elongate control member so that each of said wire loops is substantially semi-circular upon full deployment and the respective ends (27, 29) of each wire loop extend substantially in opposite directions from the elongate control member.

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: An arrangement for mounting a stent graft prosthesis (1) onto a deployment device (2) with a retention arrangement (3) which includes retention at a number of points of the circumference of the proximal end of the stent graft prosthesis (1). The arrangement provides a greater circumferential distance (13) between two adjacent retention points (9) then other of the points. When the deployment device is deployed in a curved lumen such as the thoracic arch it is oriented so that the greater circumferential distance (13) is on the inner side of the curve.

Abstract: A guide wire (1) to assist percutaneous endovascular deployment which has zones of varying stiffness. An elongate central zone (3) of high stiffness, a proximal zone (4) of transition from high stiffness to semi-stiffness and a distal zone (5) of transition from high stiffness to being relatively flexible. The distal zone (5) has three zones, a semi stiff zone (11) adjacent the central zone, a transition zone (13) being of flexibility of from semi-stiff extending to flexible and a tip zone (15) being of high flexibility. The distal tip has a small J curve (16) to ensure that it is atraumatic in vessels and to prevent damage to the aortic heart valve. The distal zone (5) can also have a large curve to assist with anchoring the guide wire into the aortic arch.

Abstract: A stent graft (20) has a tubular body of graft material (21), a number of self expanding stents (67) associated with the tubular body to define a fluid flow path through the stent graft when the self expanding stents are in their expanded configurations. At least one fenestration (22) in the tubular body is adapted to receive a side arm stent graft (71) to provide a fluid flow path from the tubular body and through the side arm stent graft. The or each fenestration has at least an inner ring (26) and an outer ring (24) and graft material (28) extending from the inner ring to the outer ring and the outer ring being in the tubular body of graft material. The inner ring can be hinged (31) to the outer ring or concentric within the outer ring. An intermediate ring (86) may also be used between the inner and outer rings.

Abstract: A stent graft deployment apparatus (10) which has a deployment catheter (11) with a proximal end (5) to be introduced into a patient and a distal end (3) to remain outside a patient and at a proximal end thereof a region to contain a stent graft (21). A sheath (25) extends over and covers the stent graft and can be moved to expose the stent graft to enable deployment of the stent graft. A nose cone dilator (17) is positioned at the proximal end of the deployment catheter and can be curved. A capsule (40) provides a distal retention arrangement for the stent graft.

Abstract: A deployment system for introducing stent grafts which have a side arm or into which a side arm can be deployed. For instance the stent graft can be deployed into the thoracic arch of a patient. The deployment system including an introducer (1), an auxiliary catheter (13) disposed within the introducer and an auxiliary guide wire (14) disposed within the auxiliary catheter. The auxiliary guide wire extends to adjacent the proximal end (6) of the introducer an can be extended from the proximal end of the introducer so that it can be snared from a side branch artery (56) to assist with deployment of a side arm (23) of the stent graft into the side artery or for the deployment of a side arm stent graft into the stent graft.

Abstract: A stent graft delivery arrangement for a stent graft (50) has a proximal end to be deployed into a patient in use and a distal end to remain outside the patient. The stent graft (50) is a tubular body of a biocompatible graft material with a plurality of self expanding stents (54). The stent graft is releasably retained onto the delivery device (132) towards the proximal end thereof. A curve forming arrangement (56) on the stent graft is arranged to curve a portion of the stent graft towards its proximal end. A pulling arrangement (58) extends along the delivery device. The pulling arrangement releasably engages the curve forming arrangement such that pulling on the pulling arrangement causes the a curve forming arrangement on the stent graft to form a curve in a portion of the stent graft towards the proximal end.

Abstract: A deployment system for introducing stent grafts which have a side arm or into which a side arm can be deployed. For instance the stent graft can be deployed into the thoracic arch of a patient. The deployment system including an introducer (1), an auxiliary catheter (13) disposed within the introducer and an auxiliary guide wire (14) disposed within the auxiliary catheter. The auxiliary guide wire extends to adjacent the proximal end (6) of the introducer and can be extended from the proximal end of the introducer so that it can be snared from a side branch artery (56) to assist with deployment of a side arm (23) of the stent graft into the side artery or for the deployment of a side arm stent graft into the stent graft.