Abstract: A delivery system for delivering a prosthesis includes a sheath, a slide shaft having a threaded outer surface, and a handle. The handle includes an internal spring assembly for selectively engaging and disengaging the handle with the threaded outer surface of the slide shaft. The internal spring assembly includes at least one spring arm, a head coupled to the spring arm and having a circumferentially rounded threaded inner surface, and a ring slidably disposed over the spring arm. When the ring is in a first longitudinal position, the threaded inner surface of the head is spaced apart from the threaded outer surface of the slide shaft. When the ring is in a second longitudinal position, the threaded inner surface of the head is threadedly engaged with the threaded outer surface of the slide shaft. The handle may include a resilient cover to provide the internal spring assembly with a biased or nominal operational position.

Abstract: A delivery system for a stent-graft is disclosed having a tip capture device and a tip release handle mechanism configured to actuate the tip capture device. The tip release handle mechanism includes a rotatable grip component and a tip release actuation component. The grip component may be rotatable in a first direction to transition a proximal stent of the stent-graft from the delivery state to a partially deployed state and rotatable in an opposite, second direction to transition the proximal stent from the partially deployed state to a fully deployed state. The grip component is operably coupled to the tip release actuation component. The delivery system further includes a shaft component operably coupled to the tip release actuation component and the tip capture device.

Abstract: A system for forming a suture connector in situ includes a suture connector placement device having a handle, an outer shaft, an intermediate shaft, and a push rod, and a suture connector having a sleeve and a plug. The intermediate shaft is slidingly disposed through a lumen of the outer shaft, and the push rod is slidingly disposed through a lumen of the intermediate shaft. When the suture connector is in a loaded configuration within the suture connector placement device, the sleeve is radially disposed over the intermediate shaft and the plug is positioned proximal to the sleeve within the lumen of the intermediate shaft. Distal advancement of the push rod moves the plug into the sleeve and proximal retraction of the intermediate shaft releases the resilient sleeve onto the plug, thereby securing two suture portions between the sleeve and the plug. The system is then utilized to trim the suture portions.

Abstract: A system for forming a suture connector in situ includes a suture connector placement device having a handle, an outer shaft, an intermediate shaft, and a push rod, and a suture connector having a sleeve and a plug. The intermediate shaft is slidingly disposed through a lumen of the outer shaft, and the push rod is slidingly disposed through a lumen of the intermediate shaft. When the suture connector is in a loaded configuration within the suture connector placement device, the sleeve is radially disposed between the intermediate shaft and the outer shaft and the plug is positioned proximal to the sleeve within the lumen of the intermediate shaft. Distal advancement of the push rod moves the plug into the sleeve and proximal retraction of the intermediate shaft releases the resilient sleeve onto the plug, thereby securing two suture portions between the sleeve and the plug.

Abstract: A suturing device includes a handle, an elongated body, at least one suture snag, at least one pair of needles, and at least one suture pair. The suture snag is moveable between a deployed position in which two distal arm portions thereof radially extend away from the elongated body and a retracted position in which the two distal arm portions are disposed within the elongated body. The suture pair is slidingly disposed through the needle pair. The suturing device deploys the suture snag within a vessel adjacent to an arteriotomy, extends the needle pair through a vessel wall around the arteriotomy and through the deployed suture snag, extends the suture pair beyond the distal ends of the needle pair, and then utilizes the suture snag to capture the extended suture pair by retracting the suture snag to pull first or distal ends of the sutures back into the suturing device.

Abstract: Stent-graft delivery systems having a tip capture mechanism with a plurality of elongated cables that allow for gradual deployment and repositioning of a stent-graft prosthesis. The tip capture mechanism includes a guiding assembly, a distal tip assembly, and a plurality of cables. In a first relative position, the distal tip assembly extends the guiding assembly to temporarily constrain the distal ends of the cables and an intermediate portion of each cable constrains an endmost crown of the prosthesis. In this first relative position, tension on the cables may be selectively adjusted to allow for both gradual continuous radial expansion and contraction of the endmost crowns of the stent-graft prosthesis. In a second relative position, the distal tip assembly does not extend over the guiding assembly and thus does not constrain the distal ends of the cables, and thereby the cables do not constrain the endmost crowns.

Abstract: A segmented balloon expandable stent graft includes a graft material and a plurality of cylindrical stent elements coupled to the graft material. The plurality of cylindrical stent elements are plastically deformable when expanded from a radially compressed configuration to a radially expanded configuration. The plurality of cylindrical stent elements includes a first end stent element, a second end stent element, and a plurality of middle stent elements. The first and second end stent elements are independent of the plurality of middle stent elements. The first and second end stent elements are more resistant to radial expansion than the plurality of middle stent elements such that the plurality of middle stent elements plastically deform from the radially compressed configuration to the radially expanded configuration when inflated by a balloon prior the first and second end stent elements.

Abstract: A method includes covering ostai of branch vessels emanating from a main vessel and an aneurysm with a high metal to vessel ratio stent. A metal to vessel ratio of the high metal to vessel ratio stent is sufficiently high to encourage tissue ingrowth around the high metal to vessel ratio stent yet is sufficiently low to ensure perfusion of the branch vessels through the high metal to vessel ratio stent. The ingrowth of tissue provides secure fixation and sealing of the high metal to vessel ratio stent to the main vessel and remodels and essentially eliminates the aneurysm. Further, as the entire high metal to vessel ratio stent is permeably, the high metal to vessel ratio stent is deployed without having to rotationally position the high metal to vessel ratio stent.

Abstract: A suturing device including an elongated body, a distal tip, at least two support arms, and at least two extendable and retractable needles. The distal tip is moveable between an extended position in which the distal tip distally extends from a distal end of the elongated body and a retracted position in which the distal tip is disposed within the elongated body. The support arms are pivotally coupled to the distal tip. When the distal tip is in the extended position, each support arm is in a collapsed position disposed within the elongated body, and when the distal tip is in the retracted position, each support arm is in a deployed position extending radially away from the elongated body. Each needle includes a distal end configured to penetrate through a vessel wall and capture a suture releasably held within a portion of a support arm.

Abstract: A delivery system for percutaneously delivering and deploying a stented prosthetic heart valve. The delivery device includes a delivery sheath slidably disposed over an inner shaft, and a capture assembly. The capture assembly includes a spindle and a biasing member. The spindle is attached to the inner shaft and defines slot. The biasing member is disposed within the slot and self-transitions from a deflected condition to a normal condition. In a delivery state, the delivery sheath retains the prosthesis over the inner shaft and coupled to the spindle via the capture slot, including a portion of the prosthetic valve being engaged within the slot and the biasing member forced to the deflected condition. In a deployment state, the delivery sheath is proximally withdrawn and the biasing member self-transitions toward the normal condition to eject the prosthetic valve from the capture slot.

Abstract: A method includes covering ostai of branch vessels emanating from a main vessel and an aneurysm with an integrated mesh high metal to vessel ratio stent. The integrated mesh high metal to vessel ratio stent includes serpentine rings integrated with an integrated mesh having holes formed therein. A metal to vessel ratio of the integrated mesh high metal to vessel ratio stent is sufficiently high to encourage tissue ingrowth around the integrated mesh high metal to vessel ratio stent yet is sufficiently low to ensure perfusion of the branch vessels through the integrated mesh high metal to vessel ratio stent.

Abstract: A delivery system for delivering a prosthesis, the delivery system including a housing, a sheath extending from within the housing, a clutching mechanism housed within the housing, and a cable. The clutching mechanism includes a one-way clutch that transmits a torque from an actuator to an inner shaft assembly when the actuator is rotated in a first direction and does not transmit a torque from the actuator to the inner shaft assembly when the actuator is rotated in a second opposing direction. The actuator is accessible from an exterior of the housing. The cable has a first end coupled to a proximal portion of the sheath and a second end coupled to the inner shaft assembly, and actuation of the actuator causes the actuator to rotate in the first direction, thereby causing the inner shaft assembly to wind up a portion of cable and retract the sheath.

Abstract: A stent graft is deployed by a steerable catheter delivery system having a integral tip capture release mechanism. The steering mechanism provides for a locked interference with a distal lock at the distal end of the delivery catheter. The configuration allows for selective circumferentially distributed release of one half or less of the number of crowns of a proximal spring which are captured by a tip capture mechanism so that new positioning of the stent graft can be verified and assured before full release of all proximal spring crowns is done. In this way, one or more steering elements of a catheter can be maintained in tension until catheter position is verified and acceptable stent graft position is achieved. This apparatus and method is particularly useful for deploying stent graft in curved passages such a thoracic aorta.

Abstract: A delivery system for percutaneously delivering and deploying a stented prosthetic heart valve. The delivery device includes a delivery sheath slidably disposed over an inner shaft, and a capture assembly. The capture assembly includes a spindle and a biasing member. The spindle is attached to the inner shaft and defines slot. The biasing member is disposed within the slot and self-transitions from a deflected condition to a normal condition. In a delivery state, the delivery sheath retains the prosthesis over the inner shaft and coupled to the spindle via the capture slot, including a portion of the prosthetic valve being engaged within the slot and the biasing member forced to the deflected condition. In a deployment state, the delivery sheath is proximally withdrawn and the biasing member self-transitions toward the normal condition to eject the prosthetic valve from the capture slot.

Abstract: A suturing device includes a handle, an elongated body, at least one suture snag, at least one pair of needles, and at least one suture pair. The suture snag is moveable between a deployed position in which two distal arm portions thereof radially extend away from the elongated body and a retracted position in which the two distal arm portions are disposed within the elongated body. The suture pair is slidingly disposed through the needle pair. The suturing device deploys the suture snag within a vessel adjacent to an arteriotomy, extends the needle pair through a vessel wall around the arteriotomy and through the deployed suture snag, extends the suture pair beyond the distal ends of the needle pair, and then utilizes the suture snag to capture the extended suture pair by retracting the suture snag to pull first or distal ends of the sutures back into the suturing device.

Abstract: A suturing device includes a handle, an elongated body, at least one suture snag, at least one pair of needles, and at least one suture pair. The suture snag is moveable between a deployed position in which two distal arm portions thereof radially extend away from the elongated body and a retracted position in which the two distal arm portions are disposed within the elongated body. The suture pair is slidingly disposed through the needle pair. The suturing device deploys the suture snag within a vessel adjacent to an arteriotomy, extends the needle pair through a vessel wall around the arteriotomy and through the deployed suture snag, extends the suture pair beyond the distal ends of the needle pair, and then utilizes the suture snag to capture the extended suture pair by retracting the suture snag to pull first or distal ends of the sutures back into the suturing device.

Abstract: A suturing device includes a handle, an elongated body, at least one suture snag, at least one pair of needles, and at least one suture pair. The suture snag is moveable between a deployed position in which two distal arm portions thereof radially extend away from the elongated body and a retracted position in which the two distal arm portions are disposed within the elongated body. The suture pair is slidingly disposed through the needle pair. The suturing device deploys the suture snag within a vessel adjacent to an arteriotomy, extends the needle pair through a vessel wall around the arteriotomy and through the deployed suture snag, extends the suture pair beyond the distal ends of the needle pair, and then utilizes the suture snag to capture the extended suture pair by retracting the suture snag to pull first or distal ends of the sutures back into the suturing device. An inflatable balloon or an expandable suture capture component may be alternatives to the suture snag for capturing the suture ends.

Abstract: A suturing device includes a handle, an elongated body, at least one suture snag, at least one pair of needles, and at least one suture pair. The suture snag is moveable between a deployed position in which two distal arm portions thereof radially extend away from the elongated body and a retracted position in which the two distal arm portions are disposed within the elongated body. The suture pair is slidingly disposed through the needle pair. The suturing device deploys the suture snag within a vessel adjacent to an arteriotomy, extends the needle pair through a vessel wall around the arteriotomy and through the deployed suture snag, extends the suture pair beyond the distal ends of the needle pair, and then utilizes the suture snag to capture the extended suture pair by retracting the suture snag to pull first or distal ends of the sutures back into the suturing device. An inflatable balloon or an expandable suture capture component may be alternatives to the suture snag for capturing the suture ends.

Abstract: A stent-graft delivery system includes a balloon, a sleeve disposed over the balloon, and a stent graft mounted over the sleeve. The sleeve includes a weakened area between a first end and a second end of the sleeve such that when the balloon is expanded, the balloon expands from a center portion of the balloon towards the ends of the balloon. The weakened area of the sleeve may be a slit, a thinner wall section, grooves, notches, or other weakening features. The sleeve may be adhesively attached to an outer shaft of the catheter or to an outer surface of the balloon.

Abstract: Stent-graft delivery systems having a tip capture mechanism with a plurality of elongated cables that allow for gradual deployment and repositioning of a stent-graft prosthesis. The tip capture mechanism includes a guiding assembly, a distal tip assembly, and a plurality of cables. In a first relative position, the distal tip assembly extends the guiding assembly to temporarily constrain the distal ends of the cables and an intermediate portion of each cable constrains an endmost crown of the prosthesis. In this first relative position, tension on the cables may be selectively adjusted to allow for both gradual continuous radial expansion and contraction of the endmost crowns of the stent-graft prosthesis. In a second relative position, the distal tip assembly does not extend over the guiding assembly and thus does not constrain the distal ends of the cables, and thereby the cables do not constrain the endmost crowns.