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 (10) for deployment into the aorta of a patient has a tubular body (12) with a proximal portion (14) of a selected diameter and a portion (16) of a reduced diameter less than the selected diameter distal of the proximal portion and a tapered portion (18) extending between the proximal portion and the portion of reduced diameter. Low profile side arms (26, 28, 30, 32) are provided in the portion of reduced diameter and/or the tapered portion. The side arms are for connection of an arm extension to an aortic branch vessel. A paraplegia prevention vent tube (34) is provided in fluid communication with the main lumen and open to external of the tubular body in the region defined by the portion of reduced diameter and the tapered portion.

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 coupling device (28) is formed of a double tubing (50) of a substantially non-porous membrane material, typically a conventional graft material, that is of inner and outer layers of membrane material (52, 54). The inner and outer layers (52, 54) are coupled by bridging rings (56, 58) which allow the layers (52, 54) to be spaced from one another in use. Attached to the inner and outer layers (52, 54) are first and second stents (60, 62). The stent (60) is located on the inside of the double tubing, while the stent (62) is located on the outside of the double tubing (50). The device (28) can expand in effect to ‘bulge’ and thus to fill the gaps to the vessel wall and to the stent-graft sections (24, 26). The device can provide reliable coupling of stent-grafts in vessels of varying diameter or in vessels inflicted with one or more aneurysms.

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 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 pre-loaded stent graft delivery device and stent graft, the stent graft delivery device. The stent graft has at least one fenestration or side arm and the fenestration is preloaded with an indwelling guide wire. Indwelling access sheaths are provided within auxiliary lumens of a pusher catheter and dilators are preloaded into the access sheaths along with the indwelling guide wire. A handle assembly at a distal end of the guide wire catheter. The handle includes a multiport manifold with access ports to the auxiliary lumens in the pusher catheter. Upon deployment of the stent graft into the vasculature of a patient, the indwelling guide wire can be used to facilitate cathertisation of a side branch or target vessel through the fenestration or be used to stabilise the access sheath during catheterisation, advancement of the access sheath into the target vessel and deployment of a covered or uncovered stent therein through the access sheath.

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 stent graft (2) for placement in the thoracic arch of a patient has a first tubular body portion (6) with a first lumen therein for placement in the ascending aorta of a patient and a second tubular body portion (8) to extend along the thoracic arch and down the descending aorta. The second tubular body portion is of a lesser diameter than the first tubular body portion. There is a step portion (10) between the first body portion and the second body portion. The step portion is joined to and continuous with the first portion and the second portion. A first side of each of the first body portion, the step portion and the second body portion are substantially aligned so that there is a step (18) defined on a second side opposite to the first side of the body portion. There is an aperture (30) in the step portion and an internal tube (32) extending from the aperture towards the first body portion.

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 coupling device (28) is formed of a double tubing (50) of a substantially non-porous membrane material, typically a conventional graft material, that is of inner and outer layers of membrane material (52, 54). The inner and outer layers (52, 54) are coupled by bridging rings (56, 58) which allow the layers (52, 54) to be spaced from one another in use. Attached to the inner and outer layers (52, 54) are first and second stents (60, 62). The stent (60) is located on the inside of the double tubing, while the stent (62) is located on the outside of the double tubing (50). The device (28) can expand in effect to ‘bulge’ and thus to fill the gaps to the vessel wall and to the stent-graft sections (24, 26). The device can provide reliable coupling of stent-grafts in vessels of varying diameter or in vessels inflicted with one or more aneurysms.

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 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 medical grasping device (10) for vascular use, having an outer sheath (12), an elongate control member (50) extending within an outer sheath (12) to a distal tip section (54), and a proximal control assembly (22) including an actuation section (24) joined to the elongate control member (50). Adjacent to the distal tip section (54) is a grasping portion (70,70?) that is extendable from the outer sheath (12) to create loops (74,74?) for grasping a target object (T) for repositioning within the vascular system, or for removal from the patient, with loops being retractable into the outer sheath to hold the target object against the device (10) during movement of the device. Elongate control member (50) is preferably a cannula or tube having a lumen (58) extending completely therethrough for placement over a guide wire (28) already in the patient.

Abstract: A medical grasping device (10) for vascular use, having an outer sheath (12), an elongate control member (50) extending within an outer sheath (12) to a distal tip section (54), and a proximal control assembly (22) including an actuation section (24) joined to the elongate control member (50). Adjacent to the distal tip section (54) is a grasping portion (70, 70?) that is extendable from the outer sheath (12) to create loops (74, 74?) for grasping a target object (T) for repositioning within the vascular system, or for removal from the patient, with loops being retractable into the outer sheath to hold the target object against the device (10) during movement of the device. Elongate control member (50) is preferably a cannula or tube having a lumen (58) extending completely therethrough for placement over a guide wire (28) already in the patient.