Abstract: An example stent delivery system is disclosed. The example stent delivery system includes an outer shaft having a distal end region, an inner surface and a lumen extending therein. The delivery system also includes an inner shaft extending within the outer shaft lumen, the inner shaft having a stent receiving region disposed along a distal end region thereof. Additionally, the delivery system includes a stent disposed along the stent receiving region and a braided member positioned radially outward from an outer surface of the stent and radially inward from the inner surface of the outer shaft, the braided member being attached to an outer surface of the inner member proximal of the stent. Additionally, the delivery system includes a plurality of tether members coupled to the braided member, wherein longitudinal retraction of the outer shaft relative to the inner shaft exposes the stent from the braided member.

Abstract: Systems and methods of adjusting the diameter of an endoluminal prosthesis that allows for controlled radial deployment of the endoluminal prosthesis and the ability to revise the positioning of the endoluminal prosthesis after unsheathing. The endoluminal prosthesis includes a stent graft having a tubular graft wall, a stent, a main strand, a proximal strand, and a distal strand.

Abstract: Delivery devices, systems, and methods for delivering implantable leadless pacing devices are disclosed. An example delivery device may an outer tubular member and an inner tubular member slidably disposed within the lumen of the outer tubular member. A distal holding section may extend distally of a distal end of the inner tubular member and define a cavity therein for receiving an implantable leadless pacing device. The device may further include a hub portion including at least a first hub portion affixed adjacent to the proximal end of the outer tubular member and a second hub portion affixed adjacent to the proximal end of the inner tubular member. A first locking mechanism configured to releasably couple the outer tubular member and the inner tubular member may be disposed within the hub portion.

Abstract: A catheter and tissue cutting system percutaneously permits the creation of an anastomosis between a first and second anatomical structure, such as a vein and an artery. The system comprises a catheter having a main body with a lumen and tapered distal tip, configured to be moved distally into the first anatomical structure over a primary guidewire. A cutting electrode is nested in the main body, with a lumen which tracks over a secondary guidewire, and is insertable into the secondary anatomical structure. An energy supply is operative to energize the cutting electrode in order to cut a tissue wall defining the first anatomical structure.

Abstract: A delivery device (1) for an endoprosthesis (2). The endoprosthesis (2) is preferably an endoprosthesis for treating an aneurysm. The delivery device (1) comprises an outer sheath (3) and an inner tube (4). The inner tube (4) is arranged within the outer sheath (3) and at least one restraining tube (5, 30). The restraining tube (5, 30) is for holding the endoprosthesis (2) in a compressed configuration. The restraining tube (5, 30) is arranged between the outer sheath (3) and the inner tube (4). The outer sheath (3), the inner tube (4) and at least one restraining tube (5, 30) are coaxial. The restraining tube (5, 30) includes at least one axial elongation (6) extending from a distal end portion of the restraining tube. The at least one axial elongation (6) is adapted to be laced through portions of the endoprosthesis (2).

Abstract: A prosthetic device for sealing a native heart valves to prevent or reduce regurgitation comprises a spacer having one or more anchors. The spacer may also have atrial support structures, ventricular support structures, or both atrial and ventricular support structures In some cases, the spacer has anchors that attach to the leaflets as well as atrial and ventricular support. In some cases, the spacer straddles the annulus and is located by anchors, and in some cases the support structures can be implanted within the native heart valve. In some cases, the prosthetic device reduces the annulus diameter when implanted within the native heart vasculature. In some cases, the prosthetic device cinches the annulus when implanted within the native heart vasculature.

Abstract: A method of delivering a catheter to a location of interest in the vasculature, the method including positioning a self-expanding sheath within a lumen of the catheter; advancing the catheter and the self-expanding sheath in tandem over a guidewire; and distally moving a distal end of the self-expanding sheath out from the lumen of the catheter thereby causing the self-expanding sheath to move from a collapsed state within the catheter to an expanded state outside the catheter, wherein when the self-expanding sheath is in the expanded state both the self-expanding sheath and the catheter are distally advanceable in tandem.

Abstract: An implantable medical device may comprise an elongated tubular body having a scaffolding forming a plurality of cells. A polymeric covering may be disposed over at least a portion of the stent. The covering may include a plurality of voids formed in an outer surface thereof. An extracellular matrix material coating may be disposed over the polymeric covering and within the plurality of voids.

Abstract: A stent body having a frame having a plurality of openings. A first cover overlies and is attached to the frame to cover a first portion of the frame and has a free floating end unattached to the frame. A second cover overlies and is attached to the frame to cover a second portion of the frame, the second cover having a free floating end unattached to the frame. The first cover overlaps a first region of the second cover.

Abstract: Methods for delivering a replacement heart valve include advancing a delivery system through a femoral vein and into the atrium of a heart, wherein the delivery system includes an outer sheath assembly, a mid shaft assembly and an inner assembly. The outer sheath assembly and the mid shaft assembly are adapted to retain the replacement heart valve in a radially compacted state over the inner assembly. The outer sheath assembly is retracted to allow a plurality of distal anchors to self-expand while a portion of the replacement heart valve remains retained in a compacted state by the mid shaft assembly. The distal anchors are positioned to engage one or more native leaflets and the retained portion of the replacement heart valve is then released and allowed to fully expand for implanting the replacement heart valve within the native valve.

Abstract: A method of occluding an aneurysm includes positioning a braided implant within an aneurysm sack such that an outer non-inverted layer contacts a wall of the aneurysm and an inverted layer apposes the outer non-inverted layer to form a double layer of braid across a neck of the aneurysm. A radiopaque end of the braided implant can be positioned centrally within the aneurysm so that the radiopaque end extends adjacent or across a plane defined by a fold between the outer non-inverted layer and the inner inverted layer. Embolic coils can be inserted into the aneurysm sac and inhibited from exiting the aneurysm at the neck by the double layer braid across the aneurysm neck.

Abstract: An apparatus for treating an aneurysm in a blood vessel includes an occlusion element including a first tubular mesh having a first end and a second end coupled together at a proximal end of the occlusion element such that an intermediate portion of the first tubular mesh between the first end and the second end includes a substantially 180 degree turn, the intermediate portion of the first tubular mesh extending distally from the proximal end of the occlusion element, wherein the intermediate portion of the first tubular mesh has a collapsed configuration and is configured to expand to an expanded. In some embodiments, the apparatus further includes a second tubular mesh having a first end and a second end coupled to the proximal end of the occlusion element such that an intermediate portion of the second tubular mesh between the first end and the second end includes a substantially 180 degree turn.

Abstract: Stent delivery systems and methods for making and using stent delivery systems are disclosed. An example stent delivery system may include an inner member having a stent receiving region. A stent may be disposed along the stent receiving region. The system may also include a deployment sheath axially slidable relative to the inner member. The deployment sheath may have a proximal end region. A rack may be coupled to the proximal end region of the deployment sheath. An outer shaft may be disposed along at least a portion of the deployment sheath. The deployment sheath may be rotatable relative to the inner member, the outer shaft or both.

Abstract: Aspects of the present invention relate to a delivery device for locating an expandable implant for treating BPH within the prostatic urethra of a patient. The delivery device comprises an inner tube and an outer sleeve movable relative to the inner tube between a stored position and a deployed position. The outer sleeve surrounds the inner tube to define an annulus therebetween and the expandable implant is retained within the annulus when the outer sleeve is in the stored position.

Abstract: A medical implant including an expandable framework configured to shift between a collapsed configuration and an expanded configuration, the expandable framework comprising a plurality of interconnected struts defining a plurality of cells; and an occlusive element connected to the expandable framework and having an inner surface and an outer surface. The expandable framework may include a plurality of securement members projecting from the plurality of interconnected struts. One of the inner surface or the outer surface of the occlusive element may be in contact with the plurality of interconnected struts, and the other of the inner surface and the outer surface not in contact with the plurality of interconnected struts may lie against an opposing surface of each of the plurality of securement members. A tip portion of the plurality of securement members may not extend radially outward of the plurality of interconnected struts.

Abstract: An implant delivery device includes a holder, a guide rod, and a sliding handle. One end of the guide rod is connected to the holder, and the other end of the guide rod penetrates the sliding handle. Multiple first engagement structures axially spaced apart from each other are disposed on an outer surface of the guide rod. The delivery device also includes a position locking device disposed in the sliding handle. The position locking device includes a tooth block) and an elastic component. The tooth block is sleeved on the guide rod and is provided with a second engagement structure. The elastic component and the tooth block cooperate to allow the first engagement structures and the second engagement structure to engage with each other allowing an implant to be in a release-locked state. These and other elements allow for the implant to be gradually released or release-locked.

Abstract: Modular pre-loaded implant subassemblies that can be packaged separately from a handle, which allows using any one of a plurality of separately packaged modular pre-loaded implants with a common handle.

Abstract: The present disclosure relates to a braid for treating an aneurysm. The braid can include a proximal expandable portion for positioning inside the aneurysm and sealing across a neck of the aneurysm. The braid can also include a distal expandable portion distal of the proximal expandable portion, the distal expandable portion for filling the aneurysm.

Abstract: A trackable guidewire apparatus and method for use are described. Longitudinally spaced proximal and distal guidewire ends are separated by a guidewire body. A plurality of longitudinally spaced position sensors are configured to provide signals corresponding to a three-dimensional position of at least one position sensor in a coordinate system of an associated tracking system in response to an electromagnetic field/stimulus. At least one retention mechanism is provided for maintaining the medical device in a predetermined retention position longitudinally along the guidewire body. At least one stop structure is provided in a predetermined stop position longitudinally along the guidewire body.

Abstract: A method for constructing a braided implant delivery system and treating an aneurysm can include attaching a braided implant having a band attached thereto to a delivery tube, positioning the braided implant within the aneurysm, and releasing the band from the delivery tube, thereby releasing the braided implant. The band can include movable extensions that can press into an outer surface of the delivery tube to secure the band to the delivery tube then move away from the outer surface of the delivery tube to release the band. A pull wire can be engaged to the band to secure the band to the delivery tube then be pulled proximally to release the band from the delivery tube. At least a portion of the braid of the braided implant can be positioned within a lumen of the delivery tube.

Abstract: A deployment device for lining a vessel having a housing having a proximal end and a distal end opposite the proximal end, the housing defining a guidewire channel, a tube elongated along a longitudinal axis, the tube having a proximal end and a distal end spaced from the proximal end of the tube along the longitudinal axis, a sheath assembly having a hub removably coupled to the distal end of the housing, and a mesh removably coupled to the tube and positioned along the tube. The tube and the sheath assembly are configured to move along the guidewire and into the vessel through a puncture and release the mesh inside the vessel when at least one of the tube and the mesh is actuated. The device is used as a method of mitigating potential injury or harm to the integrity of the patient's vessel lining.

Abstract: A delivery device for percutaneously delivering a stented prosthetic heart includes a sheath, a handle, and adjustment device including a fine adjustment mechanism, and an outer stability shaft. The sheath defines a lumen and is configured to compressively constrain the stented prosthetic heart valve. The handle is coupled to the proximal portion of the sheath and includes an actuator mechanism coupled to a proximal portion of the sheath that is configured to selectively move the sheath relative to the housing to release the stented prosthetic heat valve. The adjustment device is coupled to the handle and includes an adjustment lumen through which the sheath and the handle slidably extend. The outer stability shaft is coupled to the adjustment device. The fine adjustment mechanism is configured to selectively move the handle and the sheath relative to the adjustment device and the outer stability shaft.

Abstract: Features for a restraint to facilitate delivery and deployment of an implantable cardiac device are described. The restraint may include a series of circumferential engagements for securing inwardly corresponding portions of the implant. The restraint may be located inside the implant and provide a radially inward force on the implant. The restraint may include a center shaft having a series of grooves configured to cooperate with corresponding splines of the implant. Distal or proximal advance of the restraint disengages the restraint from the implant. The implant may include a tubular frame configured to contract and be secured by the restraint in a contracted configuration and to expand upon disengagement from the restraint. The restraint may provide for a smaller overall cross-sectional profile of a transcatheter delivery system, for instance by negating the need for a distal delivery sheath.

Abstract: The disclosure relates to transcatheter stented prosthesis delivery devices including transition elements that route, constrain, support and reduce damage to tension member wear as tension in the tension members is varied to adjust the compression of a stented prosthesis loaded onto the delivery device. Various disclosed tension elements include inserts, edge treatments and guides proximate a distal portion of the delivery device upon which the stented prosthesis is loaded. In some embodiments, the transition feature is positioned proximate a location where at least one tension member transitions from a first orientation that is not parallel to the distal portion to a second orientation that is generally parallel to the distal portion. Further embodiments disclose configurations and methods of selectively locking and unlocking a longitudinal and/or rotational position of the stent frame with respect to the distal portion of the delivery device.

Abstract: Some embodiments are directed to methods and systems for percutaneously treating dissections in a patient's vasculature, such as, without limitation, the aorta. The method can include deploying a catheter containing a collapsed anchoring element, frame, and cover through a first vessel to an entry point of the dissection. The anchoring element can be secured to the second branch vessel. The frame can be expanded in the first branch vessel. The cover can be unfolded over at least a portion of the entry point. The cover then reduces blood flow into the entry point.

Abstract: A multi-element, vascular stent may be used to maintain or enhance patency of a blood vessel. The stent may be used in peripheral blood vessels, which may be long and/or tortuous. By using multiple, separate stent elements that are balloon expandable, the multi-element stent may be stronger than a traditional self-expanding stent but may also be more flexible, due to its multiple-element configuration, than a traditional balloon-expandable stent. The distance between stent elements may be based on characteristics of the stent and the target vessel location such that the stent elements do not touch one another during skeletal movement. Thus, the multi-element, vascular stent described herein may be particularly advantageous for treating long lesions in tortuous peripheral blood vessels.

Abstract: A catheter assembly for delivery of an expandable implant having at least one branch portal, which utilizes a secondary sleeve for releasably constraining a middle portion of the expandable implant after releasing a primary constraining sleeve used for constraining the expandable implant toward a delivery configuration for endoluminal delivery; and methods of using the same.

Abstract: A catheter may include an elongate body extending from a proximal end to a distal end and defining a lumen; a push member mechanically coupled to the proximal end of the elongate body; and a slidable push grip disposed about an outer perimeter of the push member. The slidable push grip is controllably engageable with the push member. When the slidable push grip is in an engaged state with the push member, the slidable push grip transmits an axial force to the push member to enable the push member to transmit the axial force to the elongate body. When the slidable push grip is in a disengaged state with the push member, the slidable push grip is movable axially in at least one direction along a length of the push member while transmitting substantially no axial force to the push member.

Abstract: Delivery systems with telescoping capsules for delivering prosthetic heart valve devices and associated methods are disclosed herein. A delivery system configured in accordance with embodiments of the present technology can include, for example, a delivery capsule having a first housing, a second housing slidably disposed within a portion of the first housing, and a prosthetic device constrained within the first and second housings. The delivery capsule can further include first and second chamber defined in part by the first and second housings. During deployment, fluid is delivered to the first chamber to move the first housing distally over the second housing, thereby releasing a portion of the prosthetic device. Subsequently, fluid is delivered to the second chamber such that the first and second housings move together in the distal direction to release a second portion of the prosthetic device.

Abstract: Described herein are systems and methods from delivering prosthetic devices, such as prosthetic heart valves, through the body and into the heart for implantation therein. The prosthetic devices delivered with the delivery systems disclosed herein are, for example, radially expandable from a radially compressed state mounted on the delivery system to a radially expanded state for implantation using an inflatable balloon of the delivery system. Exemplary delivery routes through the body and into the heart include transfemoral routes, transapical routes, and transaortic routes, among others.

Abstract: A stent with a common connection interface, and a method and platform used to create a stent with a common connection interface is described. A common connection interface used to connect a stent to a pusher is described.

Abstract: A medical tool includes, a deflectable distal end, at least a pull wire, and a coupling element. The at least pull wire has a first end coupled to the distal end of the medical tool, and configured to be moved for deflecting the distal end. The coupling element is coupled to a second end of the pull wire and having at least two boreholes configured to receive at least two respective rods traversing therethrough. The coupling element is configured to be moved along a rotation axis of a rotatable element coupled thereto, and the boreholes and the respective rods are configured to prevent rotation of the coupling element.

Abstract: An apparatus for delivery of a device into a hollow organ and a method of delivery are provided. The apparatus includes an elongated tube having proximal and distal openings and being configured for carrying the device on a distal portion thereof. The apparatus further includes a tubular cover for covering at least a portion of the device when mounted on the elongated tube, the tubular cover being radially elastic and axially non-elastic. The tubular cover is retrievable into the elongated tube through the distal opening, such that when the device is mounted on the elongated tube and covered by the tubular cover, retrieval of the tubular cover into the elongated tube uncovers the device for delivery into the hollow organ.

Abstract: A handle for a catheter having an inner shaft and a retractable shaft. The handle includes a housing, a pull cable and a release button mounted movably on the housing. A sleeve is secured in the housing and a brake hose is guided movably in the longitudinal direction in a continuous opening of the sleeve. The brake hose has a first continuous opening for arrangement of the pull cable and a second continuous opening for arrangement of the inner shaft. The brake hose configured and arranged such that its position relative to the sleeve in a first state is fixed by the release button, and such that the brake hose in a second state is displaceable after actuation of the release button together with the pull cable in the longitudinal direction of the sleeve and relative to the sleeve and the inner shaft in the proximal direction in order to retract the retractable shaft, such that the retractable shaft can be connected to the pull cable.

Abstract: A catheter assembly includes a catheter having a proximal end and a distal end; an expandable device releasably attached to the catheter near the distal end; a generally tubular constraining sleeve extending around and compressing the device to an outer peripheral dimension suitable for endoluminal delivery; a tip fixedly secured to the distal end of the catheter; and a bridge member disposed between the tip and the expandable device so as to fill a gap therebetween as the catheter assembly is bent during endoluminal delivery of the expandable device to a treatment site.

Abstract: A self-expanding braided stent includes at least a distal radial expansion ring added to a distal end of the stent body to increase a radial expansion force of the self-expanding braided stent in deployment of the stent, and to facilitate advancement of the stent through a delivery sheath by a core advancement wire. A proximal radial expansion ring is optionally added to a proximal end of the stent body to allow the stent to be recaptured following partial deployment by retraction of the core advancement wire, prior to full deployment of a proximal portion of the stent body.

Abstract: The disclosure relates to cannulae, delivery systems, methods of making cannulae, and methods of making delivery systems. A delivery system comprises an elongate outer tubular member defining an outer tubular member lumen, a cannula having a circumferential wall extending between a proximal end and a distal end and defining an interior lumen, and an intraluminal medical device disposed within the outer tubular member lumen distal to the cannula and not about the cannula. A pattern of openings arranged in an interrupted spiral extends circumferentially along the cannula.

Abstract: The invention relates to a medical device and a method of using it. The device is a stent which can be percutaneously deliverable with (or on) an endovascular catheter or via other surgical or other techniques and then expanded. The stent is configured to have a central portion defined by “open” cells and at least two end portions, defined by “closed” cells, spaced apart and directly connected to the distal and proximal ends of the central portion of the stent. The stent may also optionally have a covering or a lattice with openings.

Abstract: An expandable introducer sheath provided with a steering mechanism is disclosed. The introducer sheath is configured for providing a prosthesis delivery system percutaneous access to a patient's vasculature. The introducer sheath includes a sheath component defining a central lumen and having a longitudinally-extending, radially-expandable portion. The sheath component also includes a steering wire slidably disposed within a wall thereof that longitudinally extends along the radially-expandable portion. When the steering wire is in a slackened configuration, the steering wire permits a width of the radially-expandable portion to increase. When the steering wire is in a taut configuration, the steering wire permits a distal portion of the sheath component to be manipulated or bent in order to align a distal port of the introducer sheath, for instance, with an ostium of a branch vessel.

Abstract: A delivery system used for vascular implant delivery is described. In some embodiments, the delivery system includes a user-gripped handle used to aid in retracting and advancing an implant. In some embodiments, the delivery system includes a telescoping pusher system to aid in retracting and advancing an implant.

Abstract: Apparatus and methods are provided for flaring a stent deployed within a branch vessel including an ostium communicating with a main vessel, a first end of the stent extending at least partially from the branch. A catheter is provided that includes a balloon having a reinforced region adjacent an unreinforced region. When the balloon is positioned at a desired location, e.g., within a stent, prosthetic valve, or other tubular prosthesis, the balloon may be inflated to a first pressure causing the reinforced and unreinforced regions to expand substantially simultaneously. Upon inflation of the balloon beyond the first pressure, the reinforced region of the balloon remains at the first diameter and the unreinforced region continues to expand, e.g., to flare one or more ends of the prosthesis.

Abstract: Cardiac valve repair devices with annuloplasty features and associated systems and methods are disclosed herein. A cardiac valve repair device configured in accordance with embodiments of the present technology can include, for example, an atrial fixation member configured to engage tissue within a left atrium proximate to a native mitral valve and a spring mechanism coupled to an inferior edge portion of the atrial fixation member. The spring mechanism has an extended state with a first length corresponding to a dimension of the atrial fixation member in a deployed state and a relaxed state with a shorter length corresponding to a desired dimension of the native valve annulus. When implanted, the spring mechanism contracts the atrial fixation member such that the native mitral annulus anchored to the atrial fixation member reduces in a cross-sectional dimension.

Abstract: This disclosure relates to systems and methods for compressing reversibly compressible endovascular devices for loading into delivery catheters prior to deployment in lumen of a vessel.

Abstract: A vascular intervention device delivery system includes a catheter with a proximal end attached to a handle, and a distal carrier segment for mounting a vascular intervention device thereon. A retractable sheath is movable from a first position covering the distal carrier segment to a second position retracted proximally uncovering the distal carrier segment. A pull is attached to the retractable sheath and extends proximally from the retractable sheath toward the handle. A majority of the length of the pull has a cross sectional shape with a concave side that faces the longitudinal axis and is opposite to a convex side that faces away from the longitudinal axis. The cross sectional shape has a width that is greater than a thickness.

Abstract: Described here are delivery devices for delivering one or more implants to the body, and methods of using. The delivery devices may deliver implants to a variety of locations within the body, for a number of different uses. In some variations, the delivery devices have a cannula with one or more curved sections. In some variations, a pusher may be used to release one or more implants from the cannula. In some variations, one or more of the released implants may be a self-expanding device. Methods of delivering implants to one or more sinus cavities are also described here.

Abstract: A device for introduction into a body vessel includes a main elongated element, a balloon positioned at the main elongated element distal end, a distal connecting element positioned at the distal end of the balloon to receive a guidewire during use, and a longitudinally movable sheath positioned external to the main elongated element, a position of the sheath distal end with respect to the balloon defining an exposed portion of the balloon that expands when fluid is delivered to the balloon through the inflation lumen.

Abstract: A device for stabilizing catheters such as delivery catheters is disclosed. The device includes a radially expandable structure which extends from a proximal end to an opposing distal end. The expandable structure is secured to a stabilizer catheter at its proximal end. The device includes means to position the delivery catheter relative to the expandable structure. The means may include one or more attachment members arranged to extend distally from the distal end of the expandable structure. Each attachment member is coupleable to a connector projecting near a distal tip of the delivery catheter. The means may alternatively include one or more sleeves, each arranged for the respective one of the delivery catheters to insert therethrough. A retractable catheter sheath is moveable along the longitudinal axis of the expandable structure to extend the expandable structure between a compressed configuration and an expanded configuration. A kit for stabilizing catheters is also enclosed.

Abstract: A multi-element, vascular stent may be used to maintain or enhance patency of a blood vessel. The stent may be used in peripheral blood vessels, which may be long and/or tortuous. By using multiple, separate stent elements that are balloon expandable, the multi-element stent may be stronger than a traditional self-expanding stent but may also be more flexible, due to its multiple-element configuration, than a traditional balloon-expandable stent. Individual stent elements shorten upon expansion creating a space between stent elements. The distance between stent elements when deployed may be based on characteristics of the stent and the target vessel location such that the stent elements do not touch one another during skeletal movement. Thus, the multi-element, vascular stent described herein may be particularly advantageous for treating long lesions in tortuous peripheral blood vessels.

Abstract: A tool for removing non-visually, urinary tract stents placed within the urinary tract of a patient, comprising a distal end, a longitudinally-extending stem, and a handle. The distal end has a conical head with a groove for hooking a stent, stent string or similar stent configuration. The snare head may have a channel for advancing the tool through a urethra over a guide wire. The snare head has a narrow conical front end for dilating urethral strictures. The stem connects the snare head to the snare handle and is made to be flexible or bend on encountering resistance.

Abstract: A system for treating a bifurcated vessel that includes a first delivery catheter and a second delivery catheter. The first delivery catheter carries a proximal first stent and a distal second stent. The first delivery catheter also has a first elongate shaft, a proximal first expandable member with the proximal first stent disposed thereover, and a distal second expandable member with the distal second stent disposed thereover. The proximal first expandable member and distal second expandable member are independently expandable of one another. The second delivery catheter carries a third stent. The second delivery catheter also has a second elongate shaft, and a third expandable member with the third stent disposed thereover. The third expandable member is independently expandable of the proximal first expandable member and the distal second expandable member.