Abstract: An endovascular prosthesis includes a tubular body and a mobile external coupling. The tubular body includes a graft material and stents coupled thereto, and forms a lumen therethrough. The mobile external coupling includes a graft material, extends outwardly from the tubular body, and is generally frustoconically shaped. The mobile external coupling includes a base coupled to the tubular body, a top spaced from the tubular body, and a coupling lumen disposed between the base and the top that is in flow communication with the body lumen. An annular support wireform is coupled to the mobile external coupling, and is formed into a sinusoidal configuration having a plurality of opposing first crowns and second crowns, the first crowns of the support wireform extending around of the top of the mobile external coupling. The coupling graft material extending between the second crowns of the support wireform and the tubular body is unsupported.

Abstract: A method of deploying an eversible branch stent-graft includes deploying the eversible branch stent-graft into a main vessel such that a collateral opening in a main stent-graft of the eversible branch stent-graft is aligned with an ostium of a branch vessel emanating from the main vessel. A branch stent ring suture threaded though outer exposed crowns of an outer stent ring of the branch stent-graft is grasped and pulled through the collateral opening to evert the branch stent-graft into the branch vessel as a branch anchor suture is removed to release a protruding end of a branch stent-graft from a proximal end of the main stent-graft.

Abstract: A variable zone high metal to vessel ratio stent includes a proximal high metal to vessel ratio zone, a central low metal to vessel ratio zone, and a distal high metal to vessel ratio zone. The proximal high metal to vessel ratio zone is deployed with fixation and sealing to healthy tissue of a main vessel superior to branch vessels and an aneurysm. The central low metal to vessel ratio zone is deployed directly on ostai of the branch vessels. However, as the central low metal to vessel ratio zone is highly permeable, blood flows from the main vessel through the central low metal to vessel ratio zone and into branch vessels.

Abstract: A method of deploying an eversible branch stent-graft includes deploying the eversible branch stent-graft into a main vessel such that a collateral opening in a main stent-graft of the eversible branch stent-graft is aligned with an ostium of a branch vessel emanating from the main vessel. A branch stent ring suture threaded though outer exposed crowns of an outer stent ring of the branch stent-graft is grasped and pulled through the collateral opening to evert the branch stent-graft into the branch vessel as a branch anchor suture is removed to release a protruding end of a branch stent-graft from a proximal end of the main stent-graft.

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 method of deploying an eversible branch stent-graft includes deploying the eversible branch stent-graft into a main vessel such that a collateral opening in a main stent-graft of the eversible branch stent-graft is aligned with an ostium of a branch vessel emanating from the main vessel. A branch stent ring suture threaded though outer exposed crowns of an outer stent ring of the branch stent-graft is grasped and pulled through the collateral opening to evert the branch stent-graft into the branch vessel as a branch anchor suture is removed to release a protruding end of a branch stent-graft from a proximal end of the main stent-graft.

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 sheath introducer system with exchangeable hemostatic valve modules is disclosed. A first valve module includes a single entry port to ensure hemostasis during the introduction of an interventional device, such as a main graft delivery system for treatment of an abdominal aortic aneurysm (AAA). A second valve module includes multiple entry ports to ensure hemostasis during the simultaneous introduction and manipulation of multiple interventional devices, such as multiple guiding catheters for use in delivering various intravascular graft components for completion of branch perfusion, for instance, during treatment of the AAA.

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 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 variable zone high metal to vessel ratio stent includes a proximal high metal to vessel ratio zone, a central low metal to vessel ratio zone, and a distal high metal to vessel ratio zone. The proximal high metal to vessel ratio zone is deployed with fixation and sealing to healthy tissue of a main vessel superior to branch vessels and an aneurysm. The central low metal to vessel ratio zone is deployed directly on ostai of the branch vessels. However, as the central low metal to vessel ratio zone is highly permeable, blood flows from the main vessel through the central low metal to vessel ratio zone and into branch vessels.

Abstract: An endovascular prosthesis includes a tubular body and a mobile external coupling. The tubular body includes a graft material and stents coupled thereto, a forms a lumen therethrough. The mobile external coupling extends outwardly from the tubular body. The mobile external coupling includes a graft material and is generally frustoconically shaped. The mobile external coupling includes a base coupled to the tubular body, a top spaced from the tubular body, and a coupling lumen disposed between the base and the top, wherein the coupling lumen is in flow communication with the body lumen. The coupling graft material is a woven fabric with warp yarn which run generally parallel to a longitudinal axis of the mobile external coupling including a shape memory material.

Abstract: An endovascular prosthesis includes a tubular body and a flexible springy mobile external coupling. The tubular body includes a graft material and stents coupled thereto with a forms a lumen therethrough. The mobile external coupling extends outwardly from the tubular body. The mobile external coupling includes a graft material and is generally frustoconically shaped. The mobile external coupling includes a base coupled to the tubular body, a top spaced from the tubular body, and a coupling lumen disposed between the base and the top, wherein the coupling lumen is in flow communication with the body lumen. A helically shaped stent may be coupled to the coupling graft material to make it flexible and springy.

Abstract: One or more markers or sensors are positioned in the vasculature of a patient to facilitate determining the location, configuration, and/or orientation of a vessel or certain aspects thereof (e.g., a branch vessel), determining the location, configuration and/or orientation of a endovascular devices prior to and during prosthesis deployment as well as the relative position of portions of the vasculature and devices, generating an image of a virtual model of a portion of one or more vessels (e.g., branch vessels) or devices, and/or formation of one or more openings in a tubular prosthesis in situ to allow branch vessel perfusion when the prosthesis is placed over one or more branch vessels in a patient (e.g., when an aortic abdominal artery stent-graft is fixed to the aorta superior to the renal artery ostia).

Abstract: A method of prosthesis delivery comprises advancing first, second and third guidewires through a first vessel, positioning the second guidewire in a second vessel that branches from the first vessel, positioning the third guidewire in a third vessel that branches from the first vessel, advancing a prosthesis over the first, second, and third guidewires to the vicinity of one of the second and third vessels, and deploying the prosthesis. The prosthesis can comprise a tubular stent-graft having a first eyelet adapted to receive a guidewire and a second eyelet adapted to receive a guidewire.

Abstract: An endovascular prosthesis includes a tubular body and a mobile external coupling. The tubular body includes a graft material and stents coupled thereto which forms a lumen therethrough. The mobile external coupling extends outwardly from the tubular body. The mobile external coupling includes a graft material and is generally frustoconically shaped. The mobile external coupling includes a base coupled to the tubular body, a top spaced from the tubular body, and a coupling lumen disposed between the base and the top, wherein the coupling lumen is in flow communication with the body lumen. A coupling deployment device is coupled to the coupling graft material to provide an extension force to extend the mobile external coupling from a collapsed configuration against the tubular body to an extended position wherein the mobile external coupling extends from the tubular body.

Abstract: An endovascular prosthesis includes a tubular body and a mobile external coupling. The tubular body includes a graft material and stents coupled thereto, a forms a lumen therethrough. The mobile external coupling extends outwardly from the tubular body. The mobile external coupling includes a graft material and is generally frustoconically shaped. The mobile external coupling includes a base coupled to the tubular body, a top spaced from the tubular body, and a coupling lumen disposed between the base and the top, wherein the coupling lumen is in flow communication with the body lumen. A cylindrical sealing cuff of graft material is attached to and extends from the top of the mobile external coupling towards the tubular body within the coupling lumen. The sealing cuff is configured to contact a portion of a branch vessel prosthesis and thereby provides an elongated interference seal between the branch vessel prosthesis and the mobile external coupling.

Abstract: A method includes covering an ostium of a branch vessel emanating from a main vessel with a proximal landing zone of a high metal to vessel ratio landing zone stent-graft, wherein a metal to vessel ratio of the proximal landing zone when deployed is sufficiently high to encourage tissue ingrowth around the proximal landing zone yet is sufficiently low to ensure perfusion of the branch vessel through the proximal landing zone. The method further includes covering an aneurysm of the main vessel with an exclusion zone of the high metal to vessel ratio landing zone stent-graft, the exclusion zone being formed of graft material. By forming the exclusion zone of graft material, excellent exclusion of the aneurysm is achieved.

Abstract: A sheath introducer system with exchangeable hemostatic valve modules is disclosed. A first valve module includes a single entry port to ensure hemostasis during the introduction of an interventional device, such as a main graft delivery system for treatment of an abdominal aortic aneurysm (AAA). A second valve module includes multiple entry ports to ensure hemostasis during the simultaneous introduction and manipulation of multiple interventional devices, such as multiple guiding catheters for use in delivering various intravascular graft components for completion of branch perfusion, for instance, during treatment of the AAA.

Abstract: An endovascular prosthesis includes a tubular body and a mobile external coupling. The tubular body includes a graft material and stents coupled thereto, and forms a lumen therethrough. The mobile external coupling includes a graft material, extends outwardly from the tubular body, and is generally frustoconically shaped. The mobile external coupling includes a base coupled to the tubular body, a top spaced from the tubular body, and a coupling lumen disposed between the base and the top that is in flow communication with the body lumen. An annular support wireform is coupled to the mobile external coupling, and is formed into a sinusoidal configuration having a plurality of opposing first crowns and second crowns, the first crowns of the support wireform extending around of the top of the mobile external coupling. The coupling graft material extending between the second crowns of the support wireform and the tubular body is unsupported.