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: 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: An endovascular stapler for securing an endograft to a vessel is disclosed. The stapler includes a staple housing adapted for storing at least one staple therein, the staple housing having an exit area for discharge of the at least one staple therethrough, an actuating assembly adapted for discharging the at least one staple through the exit area, and a displacement mechanism in operative association with the staple housing near the exit area. The displacement member is operative for pushing the exit area against the endograft when discharging the at least one staple therethrough. The discharged staple forms a plurality of opposed loops connected by a central element upon discharge. Also disclosed are staples and displacement mechanisms adapted for use with surgical instruments such as the present endovascular staplers. The staples may be formed from memory metal or other metal. The displacement mechanisms disclosed include balloons and rigid offsetting devices.

Abstract: Needle assemblies are disclosed. In some embodiments, the needle assembly includes a main housing including an obturator insertion opening and an opposite needle connection opening, a connector housing configured to engage the main housing, the connector housing including obturator, tubing, and plug openings, a self-sealing plug including a channel, the plug positioned within the connector housing so the channel is aligned with the tubing opening, a needle holder base, and a needle. The connector housing is configured to engage the main housing in first and second positions. The obturator opening is axially aligned with the obturator insertion opening and axially aligned with the needle in the first position. The tubing opening is axially aligned with the obturator insertion opening and in fluid connection with the needle in the second position.

Abstract: An endovascular stapler for securing an endograft to a vessel is disclosed. The stapler includes a staple housing adapted for storing at least one staple therein, the staple housing having an exit area for discharge of the at least one staple therethrough, an actuating assembly adapted for discharging the at least one staple through the exit area, and a displacement mechanism in operative association with the staple housing near the exit area. The displacement member is operative for pushing the exit area against the endograft when discharging the at least one staple therethrough. The discharged staple forms a plurality of opposed loops connected by a central element upon discharge. Also disclosed are staples and displacement mechanisms adapted for use with surgical instruments such as the present endovascular staplers. The staples may be formed from memory metal or other metal. The displacement mechanisms disclosed include balloons and rigid offsetting devices.

Abstract: A device for replacement of a bioprosthetic valve having an annulus (104) and one or more leaflets (105), the device having an outer housing (106) and an inner shaft (108) with a distal end (110). The outer housing (106) is slideable relative to the inner shaft (108) such that a portion of the inner shaft (108) may be revealed. A cap (112) is associated with the distal end (110) of the inner shaft (108), the cap (112) movable between a first position adjacent the inner shaft (108) and a second position displaced from the inner shaft (108). The cap (112) is adapted to trap a skirted valve frame (102) between said cap (112) and the inner shaft (108) when in the first position. The skirted valve frame (102) may be released by the cap (112) upon sliding of the outer housing (106) relative to the inner shaft (108) to reveal the inner shaft (108) and upon movement of the cap (112) to the second position. Also disclosed are associated methods.

Abstract: Vascular anastomotic staplers (100, 200, 300) for securing grafts to vessels and methods of using such staplers are disclosed. The staplers are capable of performing anastomoses between relatively small vessels (184, 240, 340) and grafts (186, 236, 316) such as prosthetic vascular grafts. The staplers are capable of discharging multiple staples simultaneously suitable for end-to-end anastomosis (200) and for end-to-side anastomosis (300).

Abstract: A system is provided for joining two tubular structures by a surgical stapling procedure. The system includes a series of sizers, a specifically designed graft, a loading unit, a wand, a tourniquet, and a stapling instrument. As a result, a plurality of staples may be simultaneously deployed quickly and accurately in a circumferential pattern so as to join together two tubular structures. The system may be used in either an open surgical procedure or laparascopically.

Abstract: An implantable access port in accordance with one embodiment of the invention comprises a hollow port casing having a first channel, a second channel and a third channel. A self-sealing insert may be disposed within the third channel. The implantable access port may further comprise a graft having a first branch, a second branch, and a third branch, the first branch extending from the first channel and adapted to be anastomosed to a vessel at a first location, the second branch extending from the second channel and adapted to be anastomosed to a vessel in a second location, the third branch extending at least partially into the third channel, wherein the third branch is disposed between the self-sealing insert and the hollow port casing. Methods for performing medical procedures associated with the implantable access port are also disclosed.

Abstract: An endovascular stapler for securing an endograft to a vessel is disclosed. The stapler includes a staple housing adapted for storing at least one staple therein, the staple housing having an exit area for discharge of the at least one staple therethrough, an actuating assembly adapted for discharging the at least one staple through the exit area, and a displacement mechanism in operative association with the staple housing near the exit area. The displacement member is operative for pushing the exit area against the endograft when discharging the at least one staple therethrough. The discharged staple forms a plurality of opposed loops connected by a central element upon discharge. Also disclosed are staples and displacement mechanisms adapted for use with surgical instruments such as the present endovascular staplers. The staples may be formed from memory metal or other metal. The displacement mechanisms disclosed include balloons and rigid offsetting devices.

Abstract: An endovascular stapler (100) for securing an endograft to a vessel is disclosed. The stapler has a staple housing (104), an actuating mechanism (148) and an expansion mechanism (126). The staple housing (104) has a plurality of staple cartridges (128) adapted for storing at least one staple (180) therein. The staple cartridges (128) have an exit area (130) for discharging at least one of the staples (180) therethrough. The actuating assembly (148) is adapted for actuating the plurality of staple cartridges (128) to discharge the at least one staple through the exit area. The expansion mechanism (126) is in operative association with staple cartridges (128). The expansion mechanism (126) is operative for pushing the exit area (130) against the endograft when discharging the at least one staple therethrough.

Abstract: An access needle assembly for use with implanted hemodialysis access ports is disclosed. In some embodiments, the assembly includes the following: a tubular needle having an internal cavity including an open leading end having a beveled edge and an open trailing end opposite the leading end, the cavity including a side outflow opening adjacent the trailing end; an obturator configured to be removably positioned within the tubular needle; an interface portion including a central cavity so that the interface portion is positioned adjacent the opening, the interface including a flanged portion extending substantially perpendicular from the central cavity and positioned concentrically over the opening; a conduit portion fluidly connected with the cavity via the flanged portion; and a depth block joined with the interface portion below the flanged portion, the depth block including a lower end opposite the interface portion.

Abstract: An implantable access post having a port casing core with an aperture therethrough, a patch associated with the port casing core, the patch adapted to be sewn to a vessel to connect the port casing core to the vessel to permit fluid communication from the vessel through the aperture of the port casing core, and an insert disposed within the aperture of the port casing core, the insert adapted to prevent fluid flow through the aperture. The insert may be self-sealing and may include a valve. The port may also include a port outer casing at least partially surrounding the port casing core and further including an anti-vessel-compression mechanism.

Abstract: A system is provided for joining two tubular structures by a surgical stapling procedure. The system includes a series of sizers, a specifically designed graft, a loading unit, a wand, a tourniquet, and a stapling instrument. The sizers are for determining the diameter of a target aorta and the availability of a sufficient transected aortic length to perform a stapling procedure. The loading unit holds the graft in position in the body and deploys a circumferential line of staples through the graft and an overlapping end of the aorta. The graft includes a side port by which the loading unit holds the graft during the stapling procedure, and which may be closed once the stapling procedure has been completed. The wand may be used to introduce the loading unit and graft into the body, to position them within the transected aorta, and to hold them in place during the application of the tourniquet.

Abstract: A device for replacement of a bioprosthetic valve having an annulus (104) and one or more leaflets (105), the device having an outer housing (106) and an inner shaft (108) with a distal end (110). The outer housing (106) is slideable relative to the inner shaft (108) such that a portion of the inner shaft (108) may be revealed. A cap (112) is associated with the distal end (110) of the inner shaft (108), the cap (112) movable between a first position adjacent the inner shaft (108) and a second position displaced from the inner shaft (108). The cap (112) is adapted to trap a skirted valve frame (102) between said cap (112) and the inner shaft (108) when in the first position. The skirted valve frame (102) may be released by the cap (112) upon sliding of the outer housing (106) relative to the inner shaft (108) to reveal the inner shaft (108) and upon movement of the cap (112) to the second position. Also disclosed are associated methods.

Abstract: Vascular anastomotic staplers (100, 200, 300) for securing grafts to vessels and methods of using such staplers. The staplers are capable of performing anastomoses between relatively small vessels (184, 240, 340) and grafts (186, 236, 316) such as prosthetic vascular grafts. The staplers are capable of discharging multiple staples simultaneously suitable for end- to-end anastomosis (200) and for end- to- side anastomosis (300) .

Abstract: A system is provided for joining two tubular structures by a surgical stapling procedure. The system includes a series of sizers, a specifically designed graft, a loading unit, a wand, a tourniquet, and a stapling instrument. The sizers are for determining the diameter of a target aorta and the availability of a sufficient transected aortic length to perform a stapling procedure. The loading unit holds the graft in position in the body and deploys a circumferential line of staples through the graft and an overlapping end of the aorta. The graft includes a side port by which the loading unit holds the graft during the stapling procedure, and which may be closed once the stapling procedure has been completed. The wand may be used to introduce the loading unit and graft into the body, to position them within the transected aorta, and to hold them in place during the application of the tourniquet.

Abstract: An endovascular stapler (100) for securing an endograft to a vessel is disclosed. The stapler has a staple housing (104), an actuating mechanism (148) and an expansion mechanism (126). The staple housing (104) has a plurality of staple cartridges (128) adapted for storing at least one staple (180) therein. The staple cartridges (128) have an exit area (130) for discharging at least one of the staples (180) therethrough. The actuating assembly (148) is adapted for actuating the plurality of staple cartridges (128) to discharge the at least one staple through the exit area. The expansion mechanism (126) is in operative association with staple cartridges (128). The expansion mechanism (126) is operative for pushing the exit area (130) against the endograft when discharging the at least one staple therethrough.