Abstract: An introduction arrangement for a fenestrated or branched stent graft (13) intended for deployment into the lumen of a vessel having a blind vessel extending from it. The introducer (1) has a distal end intended to remain outside a patient in use and a proximal end with a nose cone dilator (11) and an arrangement to retain the branched stent graft distally of the nose cone dilator. A sheath (15) on the introducer extends over the branched stent graft to the nose cone dilator. An indwelling catheter (22) extends from the distal end of the introducer and enters the fenestration or side arm and through to the nose cone dilator, the indwelling catheter has a guide wire (29) extending through it. The guide wire can be extended beyond the nose cone dilator in use before the sheath is withdrawn from the branched stent graft so that it can be snared from the contra-lateral artery.

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 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 cathertization of a side branch or target vessel through the fenestration or be used to stabilize the access sheath during catheterization, advancement of the access sheath into the target vessel and deployment of a covered or uncovered stent therein through the access sheath.

Abstract: An endovascular graft delivery system includes an endovascular prosthetic device and one or more trigger wires deployably engaging portions of the endovascular prosthetic device. An electrical element is positioned at a proximal end of a trigger wire. The electrical element is in signal communication with the trigger wire to communicate operational signals over the trigger wire. The operational signals may be power or control signals to assist with positioning the endovascular prosthetic device at a desired deployment location.

Abstract: A stent graft leg extension (10) to extend from a bifurcated aortic stent graft into an iliac artery. The stent graft has a tubular body. (12) of a biocompatible graft material and a plurality of self-expanding stents (14) joined to and supporting the tubular body. An uncovered tubular self-expanding stent assembly (26) extends from a first end of the tubular body and is fastened thereto. The uncovered tubular self-expanding stent assembly (26) provides a smooth transition from the leg extension into the iliac artery to reduce the chance of kinks causing problems in the leg extension.

Abstract: A pre-loaded delivery device that facilitates accurate placement of a stent graft assembly in the aorta is disclosed. A stent graft is carried on the delivery device and held in a pre-deployment configuration by a sheath. A split in the sheath facilitates the pre-cannulation of one or more branch arteries extending from the aorta before the stent graft is fully released in the aorta. The stent graft comprises a tubular body having at least one scalloped fenestration formed in one end of the graft material and at least one fenestration formed in the graft material of the main tubular body. A helical internal side branch extends from the fenestration within the lumen of the main tubular body. The helical side branch is configured to curve at least partially around the scalloped fenestration. The assembly further comprises a connection stent graft extending from the fenestration into a branch vessel.

Abstract: A delivery system for an endoluminal device including an introducer, the introducer having a distal end intended to remain outside a patient in use and a proximal end. A stent graft having a first and second end is retained upon the introducer, the stent graft defining a fenestration disposed through a wall of the stent graft between the first and second end. A valve arrangement is disposed within an interior lumen of the stent graft about the fenestration. A retention system including a trigger wire engages and retains the valve arrangement away from the fenestration. The fenestration is in fluid communication with the interior lumen of the stent graft.

Abstract: A system for facilitating deployment of an endoluminal prosthesis may include a main tubular graft body including a proximal end opening, a distal end opening, a lumen, and a sidewall. A branch may extend from the sidewall and may include a first end opening, a second end opening, and a lumen. A fenestration may be disposed in the sidewall and positioned distal of the second end opening of the branch. A wire segment may include a proximal portion positioned proximal of the proximal end opening and a distal portion positioned distal of the distal end opening. The wire segment extend through the fenestration and through the lumen of the branch in a preloaded configuration.

Abstract: An endoluminal prosthesis comprises a prosthetic trunk having a trunk lumen and a trunk wall, a first prosthetic branch having a first branch lumen and a branch wall, and a second prosthetic branch having a second branch lumen. The first branch lumen and the second branch lumen are both in fluid communication with the trunk lumen through the trunk wall and the second branch lumen is in fluid communication with the first branch lumen through the branch wall. Additional devices, systems, and methods are disclosed.

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 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 method for treating erectile dysfunction in a subject includes providing an expandable support member for engaging a wall of a blood vessel. The expandable support member includes at least one electrode connected with the expandable support member and arranged to selectively deliver electric current to modulate the autonomic nervous system (ANS). The expandable support member includes and an insulative material attached to at least a portion of the expandable support member for isolating blood flowing through the vessel from the electric current delivered by the at least one electrode. The expandable support member is implanted intravascularly so that at least a portion of the expandable support member is positioned substantially adjacent a desired location where modulation of the ANS is effective to improve erectile function. After implanting the expandable support member, electric current is delivered to the at least one electrode to effect a change in the ANS.

Abstract: A system for facilitating deployment of an endoluminal prosthesis may include a main tubular graft body including a proximal end opening, a distal end opening, a lumen, and a sidewall. A branch may extend from the sidewall and may include a first end opening, a second end opening, and a lumen. A fenestration may be disposed in the sidewall and positioned distal of the second end opening of the branch. A wire segment may include a proximal portion positioned proximal of the proximal end opening and a distal portion positioned distal of the distal end opening. The wire segment extend through the fenestration and through the lumen of the branch in a preloaded configuration.

Abstract: A computer implemented method for determining a centerline of a three-dimensional tubular structure is described. The method includes providing an edge-detected data set of voxels that characterize a boundary of the tubular structure according to a three-dimensional voxel data set for the tubular structure. A gradient field of a distance transformation is computed for the edge-detected dataset. A voxel data set corresponding to a centerline of the tubular structure is computed according to derivative of gradient field.

Abstract: An endoluminal prosthesis comprises a prosthetic trunk having a trunk lumen and a trunk wall, a first prosthetic branch having a first branch lumen and a branch wall, and a second prosthetic branch having a second branch lumen. The first branch lumen and the second branch lumen are both in fluid communication with the trunk lumen through the trunk wall and the second branch lumen is in fluid communication with the first branch lumen through the branch wall. Additional devices, systems, and methods are disclosed.

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 computer implemented method (350) for determining a centerline of a three-dimensional tubular structure is described. The method includes providing an edge-detected data set of voxels that characterize a boundary of the tubular structure according to a three-dimensional voxel data set for the tubular structure (360). A gradient field of a distance transformation is computed for the edge-detected dataset (380). A voxel data set corresponding to a centerline of the tubular structure is computed according to derivative of gradient field (390).

Abstract: An endovascular delivery system includes an endovascular prosthetic device and a signal active guide wire engaging the endovascular prosthetic device. A rotary encoder is coupled with the guide wire and the endovascular prosthetic device to provide an encoder signal on the guide wire. The encoder signal is indicative of axial angular position of the endovascular prosthetic device during implantation of the endovascular prosthetic device in a body of a patient.

Abstract: An apparatus for repairing the function of a diseased valve includes an annular first support member expandable to a first diameter. An annular second support member is spaced axially apart from the first support member and is expandable to a second diameter that is independent of the first diameter. A tubular graft section interconnects the first and second support members. The graft section defines an annulus having a third diameter that is independent of each of the first and second diameters. A prosthetic valve is secured within the annulus of the graft section. The bioprosthetic valve has at least two valve leaflets that are coaptable to permit the unidirectional flow of blood. Methods for repairing the function of a diseased valve and for making the apparatus are also provided.

Abstract: The present embodiments provide a stent graft having a tubular configuration defining a lumen therethrough, the stent graft having a proximal section and a distal section. A folded section is positioned between the proximal section and the distal section. The folded section includes a first fold directed toward the distal end and engaged with the proximal section and a second fold directed toward the proximal end and engaged with the distal section. A valve arrangement is positioned in at least one of the first and second folds providing access from an exterior of the graft to the interior of the stent graft for insertion of an additional device.