Abstract: Systems, devices and methods described herein relate to endovascular devices for delivering sutures for securing grafts or other objects to patient vessels. In some embodiments, a suture includes a set of two legs having proximal ends joined to each other and elongate bodies that extend parallel to one another such that the set of two legs form a U-shaped structure. A suture delivery system can include a housing configured to contain a suture in a flattened configuration, and a deployment element having a ribbon-shaped distal portion disposed in the housing and including a set of formations, where the housing and the set of formations of the deployment element are configured to collectively constrain the suture in the flattened configuration until the suture is released through the opening of the housing.

Abstract: Devices, systems, and methods for coupling a prosthetic implant to a fenestrated body are disclosed herein. In some embodiments, a branch stent graft is provided. The branch stent graft can include an engagement portion for engagement with an opening in a fenestrated body, such as a vessel wall or an aortic stent graft. The engagement portion of the branch stent graft can be coupled to the fenestrated body such that the branch stent graft can move, rotate or shift relative to the fenestrated body but such that axial movement of the branch stent graft is restricted and/or prevented.

Abstract: Systems, devices and methods described herein relate to endovascular devices for delivering sutures for securing grafts or other objects to patient vessels. In some embodiments, a suture includes a set of two legs having proximal ends joined to each other and elongate bodies that extend parallel to one another such that the set of two legs form a U-shaped structure. A suture delivery system can include a housing configured to contain a suture in a flattened configuration, and a deployment element having a ribbon-shaped distal portion disposed in the housing and including a set of formations, where the housing and the set of formations of the deployment element are configured to collectively constrain the suture in the flattened configuration until the suture is released through the opening of the housing.

Abstract: Systems, devices and methods described herein relate to endovascular devices for delivering sutures for securing grafts or other objects to patient vessels. In some embodiments, a suture includes a set of two legs having proximal ends joined to each other and elongate bodies that extend parallel to one another such that the set of two legs form a U-shaped structure. A suture delivery system can include a housing configured to contain a suture in a flattened configuration, and a deployment element having a ribbon-shaped distal portion disposed in the housing and including a set of formations, where the housing and the set of formations of the deployment element are configured to collectively constrain the suture in the flattened configuration until the suture is released through the opening of the housing.

Abstract: Systems, devices and methods described herein relate to endovascular devices for delivering sutures for securing grafts or other objects to patient vessels. In some embodiments, a suture includes a set of two legs having proximal ends joined to each other and elongate bodies that extend parallel to one another such that the set of two legs form a U-shaped structure. A suture delivery system can include a housing configured to contain a suture in a flattened configuration, and a deployment element having a ribbon-shaped distal portion disposed in the housing and including a set of formations, where the housing and the set of formations of the deployment element are configured to collectively constrain the suture in the flattened configuration until the suture is released through the opening of the housing.

Abstract: Devices, systems, and methods for coupling a prosthetic implant to a fenestrated body are disclosed herein. In some embodiments, a branch stent graft is provided. The branch stent graft can include an engagement portion for engagement with an opening in a fenestrated body, such as a vessel wall or an aortic stent graft. The engagement portion of the branch stent graft can be coupled to the fenestrated body such that the branch stent graft can move, rotate or shift relative to the fenestrated body but such that axial movement of the branch stent graft is restricted and/or prevented.

Abstract: Devices, systems, and methods for marking and/or reinforcing fenestrations in grafts are disclosed herein. In some embodiments, a radiopaque marker for a graft is provided. The marker can be secured to the graft in the area near a fenestration such that the marker is visible via radiographic imaging. The radiopaque marker can be in the form of a radiopaque thread, a radiopaque bead, a radiopaque additive, or a radiopaque adhesive. In some embodiments, the radiopaque marker is in the form of a circular disc shaped and sized to surround a fenestration, the circular disc being formed of a radiopaque material. The radiopaque marker can be configured to or can be attached to a reinforcement member configured to reinforce a fenestration such that one or more edges of the fenestration are protected and/or to aid in engagement with and sealing to a mating stent.

Abstract: Devices, systems, and methods for coupling a prosthetic implant to a fenestrated body are disclosed herein. In some embodiments, a branch stent graft is provided. The branch stent graft can include an engagement portion for engagement with an opening in a fenestrated body, such as a vessel wall or an aortic stent graft. The engagement portion of the branch stent graft can be coupled to the fenestrated body such that the branch stent graft can move, rotate or shift relative to the fenestrated body but such that axial movement of the branch stent graft is restricted and/or prevented.

Abstract: Devices, systems, and methods for marking and/or reinforcing fenestrations in grafts are disclosed herein. In some embodiments, a radiopaque marker for a graft is provided. The marker can be secured to the graft in the area near a fenestration such that the marker is visible via radiographic imaging. The radiopaque marker can be in the form of a radiopaque thread, a radiopaque bead, a radiopaque additive, or a radiopaque adhesive. In some embodiments, the radiopaque marker is in the form of a circular disc shaped and sized to surround a fenestration, the circular disc being formed of a radiopaque material. The radiopaque marker can be configured to or can be attached to a reinforcement member configured to reinforce a fenestration such that one or more edges of the fenestration are protected and/or to aid in engagement with and sealing to a mating stent.

Abstract: Devices, systems, and methods for coupling a prosthetic implant to a fenestrated body are disclosed herein. In some embodiments, a branch stent graft is provided. The branch stent graft can include an engagement portion for engagement with an opening in a fenestrated body, such as a vessel wall or an aortic stent graft. The engagement portion of the branch stent graft can be coupled to the fenestrated body such that the branch stent graft can move, rotate or shift relative to the fenestrated body but such that axial movement of the branch stent graft is restricted and/or prevented.

Abstract: Devices, systems, and methods for marking and/or reinforcing fenestrations in grafts are disclosed herein. In some embodiments, a radiopaque marker for a graft is provided. The marker can be secured to the graft in the area near a fenestration such that the marker is visible via radiographic imaging. The radiopaque marker can be in the form of a radiopaque thread, a radiopaque bead, a radiopaque additive, or a radiopaque adhesive. In some embodiments, the radiopaque marker is in the form of a circular disc shaped and sized to surround a fenestration, the circular disc being formed of a radiopaque material. The radiopaque marker can be configured to or can be attached to a reinforcement member configured to reinforce a fenestration such that one or more edges of the fenestration are protected and/or to aid in engagement with and sealing to a mating stent.

Abstract: An interventional catheter assembly comprising a catheter for insertion and guidance to a target site in a body lumen or a cavity and an operating head mounted in proximity to a distal end of the catheter and comprising a system for removing obstructive material from the target site is provided. In certain embodiments, the catheter assembly includes at least one aspiration port located proximal to the operating head that communicates with a first sealed lumen for withdrawing fluids and obstructive material from the target site, together with at least one liquid infusion port penetrating the catheter and located proximal to the at least one aspiration port that communicates with a second sealed lumen for supplying fluid to a location in proximity to the target site.

Abstract: A rotatable operating head for removal of obstructive material from a target site in a body lumen or cavity is operably connected to a rotatable, translatable drive shaft, that is driven by a drive motor and received through an elongated catheter. The operating head includes a plurality of differential cutting blades, with at least one of the cutting blades being a stepped blade, the stepped blade comprising a raised cutting surface positioned adjacent, or in proximity to, a shoulder region.

Abstract: A catheter including an elongate drive shaft having a proximal end and a distal end, an ablation burr disposed at the distal end expandable between a first position and a second position, wherein in the second position has a greater transverse dimension than in the first position. The catheter of the present invention can include a mechanism for positioning the burr eccentrically within a vessel lumen. In this context, expansion means that the burr can ablate a lumen having a larger diameter than the diameter of the lumen of the guide catheter to which the device is advanced.

Abstract: A rotational ablation atherectomy device including a flexible drive shaft and a compressible burr that may be inserted and extracted from a patient using a catheter having a diameter that is smaller than the operational diameter of the burr. In one embodiment, the burr includes a nose portion coupled to the drive shaft and one or more flexible abrasive disks disposed rearwardly from the nose portion. The flexible disks are foldable to be slidably received within a catheter. In another embodiment, the burr includes a support member coupled to the drive shaft, the support member having a resilient panel that spirals outwardly, forming a generally cylindrical ablation surface. The flexible panel can be elastically urged toward the support member and slidably inserted into the catheter. In a third embodiment, the burr includes a plurality of struts that are coupled to the drive shaft. An elastically compressible body disposed between the struts permits the struts to flex inwardly to reduce the burr diameter.

Abstract: A catheter including an elongate drive shaft having a proximal end and a distal end, an ablation burr disposed at the distal end expandable between a first position and a second position, wherein in the second position has a greater transverse dimension than in the first position. The catheter of the present invention can include a mechanism for positioning the burr eccentrically within a vessel lumen. In this context, expansion means that the burr can ablate a lumen having a larger diameter than the diameter of the lumen of the guide catheter to which the device is advanced.

Abstract: A catheter including an elongate drive shaft having a proximal end and a distal end, an ablation burr disposed at the distal end expandable between a first position and a second position, wherein in the second position has a greater transverse dimension than in the first position. The catheter of the present invention can include a mechanism for positioning the burr eccentrically within a vessel lumen. In this context, expansion means that the burr can ablate a lumen having a larger diameter than the diameter of the lumen of the guide catheter to which the device is advanced.

Abstract: A rotational ablation atherectomy device including a flexible drive shaft and a compressible burr that may be inserted and extracted from a patient using a catheter having a diameter that is smaller than the operational diameter of the burr. In one embodiment, the burr includes a nose portion coupled to the drive shaft and one or more flexible abrasive disks disposed rearwardly from the nose portion. The flexible disks are foldable to be slidably received within a catheter. In another embodiment, the burr includes a support member coupled to the drive shaft, the support member having a resilient panel that spirals outwardly, forming a generally cylindrical ablation surface. The flexible panel can be elastically urged toward the support member and slidably inserted into the catheter. In a third embodiment, the burr includes a plurality of struts that are coupled to the drive shaft. An elastically compressible body disposed between the struts permits the struts to flex inwardly to reduce the burr diameter.

Abstract: An atherectomy burr has an operating diameter that is larger than the diameter of a catheter in which the burr is routed. The burr may include a polymeric balloon that is coated with an abrasive and that expands when the burr is rotated. Alternatively, the burr may include a polymeric tube that is coated with an abrasive and secured to the proximal end of the burr. When the burr is rotated, the polymeric tube expands by centrifugal force. Alternatively, the burr may comprise a metallic strip wound over a mandrel. When the strip is tightly coiled to the mandrel, its outer diameter decreases. The outer diameter of the burr increases as the metallic strip expands. In addition, the burr can be formed as a wire spring wound over a drive tube. The distal end of the spring is coupled to a nose cone that can move within a distal lumen in the drive tube. The maximum expansion of the burr is controlled by the distance that the nose cone can be retracted into the lumen.

Abstract: An ablation burr has a body provided with an inner circumferential rim and an outer circumferential rim that are concentric and spaced longitudinally by a selected distance along the length of the burr. The outer circumferential rim has a generally smooth convex outer surface that reduces damage to a vessel wall or stent A leading surface of the burr extends between the inner and outer circumferential rims in a substantially uniform, concave manner. An abrasive, for example, diamond grit, is provided on the leading surface. The burr is selectively rotated by a drive shaft, causing the abrasive leading surface of the burr to ablate unwanted deposits. If desired, a wire extends co-axially through the body such that a distal end of the wire extends out of the distal end of the burr. An abrasive tip may be coupled to the distal end of the wire, and is selectively rotated, to ablate unwanted deposits.