Abstract: Devices, systems, and methods for implanting expandable prostheses in the body lumens rely on stapling or anchoring the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable, and may include a single lumen or more than one lumen. After initial placement, a stapling system is introduced within the expanded prosthesis to deploy a plurality of fasteners to at least one prosthesis end. The stapling system may apply a force to the prosthesis to modify the shape of the prosthesis to conform to the shape of the vessel wall. The stapling system can be deflected in one or more distinct steerable segments. A lumen extension or lumens may be coupled to the prosthesis to extend the reach of the prosthesis within the implantation site. Fasteners may also be applied to the lumen extensions.

Abstract: Devices, systems, and methods for implanting expandable prostheses in the body lumens rely on stapling or anchoring the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable, and may include a single lumen or more than one lumen. After initial placement, a stapling system is introduced within the expanded prosthesis to deploy a plurality of fasteners to at least one prosthesis end. The stapling system may apply a force to the prosthesis to modify the shape of the prosthesis to conform to the shape of the vessel wall. The stapling system can be deflected in one or more distinct steerable segments. A lumen extension or lumens may be coupled to the prosthesis to extend the reach of the prosthesis within the implantation site. Fasteners may also be applied to the lumen extensions.

Abstract: Apparatus and methods utilize an intraluminal fastener applier having a guide body with a longitudinal axis. The guide body is sized and configured for intraluminal deployment in a hollow body organ. An actuated assembly is carried by the guide body that is selectively operable to generate an implantation force to implant at least one fastener into tissue within the hollow body organ. The actuated assembly includes a driven member extending generally along the longitudinal axis, which is sized and configured to engage a selected fastener. The actuated assembly also includes a drive member coupled to the driven member to impart the implantation force to the driven element in a direction that is at an angle to the longitudinal axis of the guide body.

Abstract: Apparatus and methods implant a fastener in a targeted body region, e.g., a hollow body cavity or an intraluminal space. The apparatus and methods deploy in the targeted body region a fastener attachment assembly that carries an actuated member. The actuated member is selectively operable to generate an implantation force to implant a fastener into tissue within the targeted body region. The fastener can be implanted, e.g., to secure a prosthesis, e.g., an endovascular graft. The systems and apparatus apply a resolution force at or near the actuated member, thereby making possible a stable and dependable catheter-based fastening platform.

Abstract: A helical fastener having a high retentive surface area is provided and has a first end for enhancing penetration into tissue and a second end comprising a coil sectioning a diameter of the fastener for receiving longitudinal and rotational forces. The helical fasteners are attached to body tissue by a fastener applicator having a proximal portion comprising a handle and an actuator and an elongate distal portion for housing a plurality of fasteners. A transferring action of the actuator provides longitudinal and rotational movement of the fasteners out of the distal portion and into body tissue.

Abstract: Systems and methods introduce a tissue fastener applier to apply tissue-piercing fasteners to a prosthesis sequentially along a path established by the directing device that, between fastener applications, is manipulated into orientation with different desired fastening sites, until a plurality of tissue-piercing fasteners are placed, one-at-a-time, in the prosthesis.

Abstract: Systems and methods for deploying a prosthesis in a tissue region in a hollow body organ or blood vessel provide a first prosthesis and a second prosthesis, each having a prosthetic material and a scaffold that supports the prosthetic material. The first prosthesis has a proximal neck region, and the second prosthesis has an end region. The end region is sized and configured to telescopically fit with the proximal neck region to form a composite prosthesis. The systems and methods manipulate a fastener attachment assembly to implant at least one fastener to secure the composite prosthesis in the tissue region.

Abstract: Systems and methods introduce a tissue fastener applier to apply tissue-piercing fasteners to a prosthesis sequentially along a path established by the directing device that, between fastener applications, is manipulated into orientation with different desired fastening sites, until a plurality of tissue-piercing fasteners are placed, one-at-a-time, in the prosthesis.

Abstract: A method of treatment of congestive heart failure comprises the steps of introducing an aortic occlusion catheter through a patient's peripheral artery, the aortic occlusion catheter having an occluding member movable from a collapsed position to an expanded position; positioning the occluding member in the patient's ascending aorta; moving the occluding member from the collapsed shape to the expanded shape after the positioning step; introducing cardioplegic fluid into the patient's coronary blood vessels to arrest the patient's heart; maintaining circulation of oxygenated blood through the patient's arterial system; and reshaping an outer wall of the patient's heart while the heart is arrested so as to reduce the transverse dimension of the left ventricle.

Abstract: Apparatus and method deliver a prosthesis into a hollow body organ or blood vessel. The systems and methods make use of a catheter. A carrier on the distal end of the catheter is sized and configured to carry the prosthesis. A release mechanism and an enclosure mechanism on the distal end are operable to retain and enclose the prosthesis on the carrier. The release mechanism and the enclosure mechanism are also operable to selectively expose and release the prosthesis from the carrier for deployment in the hollow body organ or blood vessel.

Abstract: Devices, systems, and methods for implanting prostheses in the body lumens rely on tacking or anchoring the prostheses with separately introduced fasteners. After initial placement, a fastener applier system is introduced within the expanded prostheses to deploy a plurality of fasteners to at least one prosthesis end. The fasteners are usually helical fasteners which are releasably restrained on the fastener driver, and are delivered by rotation of the fastener driver. The fasteners may be applied singly, typically in circumferentially spaced-apart patterns about the interior of at least one end of the prosthesis. A lumen extension or lumens may be coupled to the prosthesis to extend the reach of the prosthesis within the implantation site. Fasteners may also be applied to the lumen extensions.

Abstract: Methods implant one or more fastening structure(s) in a targeted body region, e.g., within a hollow body organ or an intraluminal space. The fastening structure(s) are implanted to a vessel wall, and serve to secure a prosthesis within the hollow body organ or intraluminal space.

Abstract: A method for repairing a diseased or damaged section of an aorta (i) introduces an intraluminal directing device from a remote access site to a location within a prosthesis at a target site in an aorta where the diseased or damaged section exists, the intraluminal directing device including a deflectable distal region; (ii) establishes a path to a desired fastening site on the prosthesis by manipulating the intraluminal directing device within the prosthesis to orient the distal region with respect to the desired fastening site; (iii) introduces from an intraluminal fastener applier, that is introduced along the path established in (ii), at least one tissue-piercing fastener into tissue at the desired fastening site to anchor the prosthesis; (iv) establishes a path to a different desired fastening site on the prosthesis by manipulating the intraluminal directing device within the prosthesis to orient the distal region with respect to the different desired fastening site; (v) introduces from an intraluminal fa

Abstract: Apparatus and methods utilize an intraluminal fastener applier having a guide body with a longitudinal axis. The guide body is sized and configured for intraluminal deployment in a hollow body organ. An actuated assembly is carried by the guide body that is selectively operable to generate an implantation force to implant at least one fastener into tissue within the hollow body organ. The actuated assembly includes a driven member extending generally along the longitudinal axis, which is sized and configured to engage a selected fastener. The actuated assembly also includes a drive member coupled to the driven member to impart the implantation force to the driven element in a direction that is at an angle to the longitudinal axis of the guide body.

Abstract: Devices, systems and methods support tissue in a body organ for the purpose of restoring or maintaining native function of the organ. The devices, systems, and methods do not require invasive, open surgical approaches to be implemented, but, instead, lend themselves to catheter-based, intra-vascular and/or percutaneous techniques.

Abstract: Apparatus and method deliver a prosthesis into a hollow body organ or blood vessel. The systems and methods make use of a catheter. A carrier on the distal end of the catheter is sized and configured to carry the prosthesis. A release mechanism and an enclosure mechanism on the distal end are operable to retain and enclose the prosthesis on the carrier. The release mechanism and the enclosure mechanism are also operable to selectively expose and release the prosthesis from the carrier for deployment in the hollow body organ or blood vessel.

Abstract: Systems and methods implant one or more fastening structure(s) in a targeted body region, e.g., within a hollow body organ or an intraluminal space. The fastening structure(s) are implanted to a vessel wall, and serve to secure a prosthesis within the hollow body organ or intraluminal space.

Abstract: Methods for treating total and partial occlusions employ a perfusion conduit which is penetrated through the occlusive material. Oxygenated blood or other medium is then perfused through the conduit in a controlled manner, preferably at a controlled pressure below the arterial pressure, to maintain oxygenation and relieve ischemia in tissue distal to the occlusion. In another aspect, interventional devices, such as stents or balloon catheters, are passed through the perfusion catheter to remove obstructions. Optionally, the occlusion may be treated while perfusion is maintained, typically by introducing a thrombolytic or other agent into the occlusive material using the perfusion conduit or by employing mechanical means to remove the obstruction. Such methods are particularly suitable for treating acute stroke to prevent damage to the cerebral tissue.

Abstract: A guide device establishes a guide passage through a guide tube, through which an operative tool can be deployed into an interior body region for use. A steering assembly, in use, deflects or bends the distal end region of the guide tube, so that the operative tool can be placed in a desired orientation with respect to tissue. The steering assembly is desirable configured for single handed operation by the clinician. The steering assembly is also desirably configured to provide a mechanical advantage sufficient to translate relatively small increments of clinician control into relatively larger increments of guide tube deflection. In one arrangement, the steering assembly includes a rack and pinion linkage system. In another arrangement, the steering assembly includes a pivoting lever system.

Abstract: Devices, systems, and methods use a catheter device sized and configured for introduction to a targeted site in a hollow body organ or blood vessel. The catheter device includes a first release mechanisms coupled to the prosthesis to secure at least one region of the prosthesis to the catheter shaft, and a second release mechanism coupled to the prosthesis in cooperation with the first release mechanism to prevent full release of the at least one region of the at least one region of the prosthesis from the catheter shaft after actuation of the first release mechanism. A fastening device sized and configured for introduction to the targeted site in the hollow body organ or blood vessel occupied by the catheter device, includes an actuator to deploy a fastener in the at least one region of the prosthesis after actuation of the first release mechanism and before actuation of the second release mechanism.