Abstract: A radially expandable stent graft 10 for placement in a lumen of a patient is disclosed. The stent graft 10 comprises: a prosthetic trunk 100 comprising a trunk lumen 110 there-through; a prosthetic branch 300 comprising a branch lumen 310 extending there-through, wherein the branch lumen 310 is in fluid communication with the trunk lumen 110 through a lateral opening 115 in the trunk lumen 110; a valve 150 comprising a fenestration 152 for providing temporary lateral access into the trunk lumen 110, the valve 150 positioned opposite the lateral opening 115 in the trunk lumen 110; and a valve actuator. The valve actuator closes the fenestration 152 as the stent graft 10 expands.

Abstract: The present invention provides apparatus and methods for a conduit, such as an implantable conduit for a vessel. The conduit may comprise a main member and a side-branch member. The conduit may be implanted with the side-branch member initially disposed within the main member. When positioned, the side-branch member may then be extended from within the main member and into a vessel side-branch. The materials for the conduit may include circumferentially distensible and/or low recoil materials. The materials for the conduit may be constructed by various techniques and may include materials with enhanced flexibility and kink resistance.

Abstract: An endovascular graft, which is configured to conform to the morphology of a vessel to be treated, includes a tubular ePTFE structure; an inflatable ePTFE structure disposed over at least a portion of the ePTFE tubular structure; and an injection port in fluid communication with the inflatable ePTFE structure for inflation of the inflatable ePTFE structure with an inflation medium. The inflatable ePTFE structure may be longitudinally disposed over the tubular ePTFE structure. The ePTFE structure may be a bifurcated structure having first and second bifurcated tubular structures, where the inflatable ePTFE structure is disposed over at least a portion of the first and second bifurcated tubular structures.

Abstract: An embolic filter is disclosed and can include a head. A plurality of bent legs can extend from the head. Each bent leg can be configured to engage an inner wall of a vein and prevent the embolic filter from migrating in a cranial direction. A plurality of straight legs can also extend from the head. Each straight leg can be configured to prevent the embolic filter from migrating in a caudal direction.

Abstract: A medical system including an elongate member and an elongate element associated with the elongate member so that a shape of the elongate member can be altered upon applying energy to the element.

Abstract: An endoprosthesis includes a stent structure having an elongate member longitudinal portions of which overlap to define the crossover structures. The stent structure may also include loop structures, which are contiguous with the crossover structures, through which a filament extends. A guard structure is secured to the stent structure and located adjacent to the crossover structures to obstruct displacement of the filament between the longitudinal portions of the elongate member of the crossover structures. A method for operating the endoprosthesis includes displacing the loop structures toward one another along the filament to displaced positions relative to the suture structure for reducing the respective profiles of the stent structure and patch structure.

Abstract: A system to deliver a prosthesis for repair of a transected body vessel is described herein. The system can have a prosthesis and a plurality of distinct strands. A releasable loop can be formed at a distal end of each strand and positioned to retain one of a plurality of portions of the prosthesis in a compressed configuration. Each portion of the prosthesis can be independently movable between the compressed configuration and an expanded configuration. Retraction of the proximal end or severing the loop of any one of the strands can cause the corresponding loop to release to allow the corresponding portion of the prosthesis to expand from the compressed configuration to the expanded configuration. The prosthesis can couple two vessel portions of the transected vessel together to allow for blood perfusion and maintain hemostasis.

Abstract: Non-occlusive modeling catheters including a dilation device for expanding an endoprosthesis implanted in a vessel are disclosed. In an embodiment, a modeling catheter includes a device comprising a plurality of compliant wires braided in a double overlapping pattern and having a length spanning between a proximal end of the device and a distal end of the device, wherein the device is positioned in at least a portion of an endoprosthesis implanted in a vessel, wherein, when the device is in a relaxed state, a plurality of spaces are formed between the plurality of wires to allow fluid to move freely through the plurality of spaces, and wherein, when the device is in a dilated state, the plurality of wires are sufficiently designed to exert a radial force on the endoprosthesis while continually allowing the fluid to move freely through the plurality of spaces.

Abstract: A stent delivery and deployment system for use primarily with self-expanding stents, incorporating a traction tube extending over the length of the diametrically compacted and constrained stent and everting back over itself, with the outer everted portion of the traction tube preferably extending to the proximal end of the delivery system. A constraining sleeve is provided between the inner, non-everted portion and outer, everted portion of the traction tube, the constraining sheath extending over the length of the constrained stent prior to deployment and diametrically constraining the diametrically compacted self-expanding stent. The application of tension to the proximal end of the traction tube causes the constraining sheath to move in a proximal direction, freeing the constrained stent as it moves and allowing the stent to deploy against the wall of the body conduit within which it is located during the deployment process.

Abstract: An apparatus and method of deploying a stent graft having a proximal anchor stent ring includes restraining proximal apexes of the proximal anchor stent ring between a spindle body of a spindle and a control release sleeve of a tapered tip. The control release sleeve is advanced relative to the spindle to release a first proximal apex through an opening in the control release sleeve while the remaining proximal apexes remain restrained by the control release sleeve. The control release sleeve is further advanced relative to the spindle to release the remaining proximal apexes from the control release sleeve. In another example, a stent capture fitting has variable length stent capture fitting arms. As the stent capture fitting is retracted, the proximal apexes of the proximal anchor stent ring are sequentially exposed from and released by the variable length stent capture fitting arms.

Abstract: A catheter device having a shaft that extends from a proximal end to a distal end to carry on its distal end a self-expanding implant for intraluminal advance on a guidewire and delivery of the implant to an implant site by proximal withdrawal of a sheath that lies radially outside the implant in the catheter, the catheter including a first shaft element to pull the sheath proximally and a second shaft element to push the implant distally to prevent the implant moving proximally with the sheath when the sheath is pulled proximally, wherein the second shaft element carries a stopper for abutting the implant, the stopper comprising proximal and distal portions having different radiopacities.

Abstract: Medical systems and related methods are disclosed. In some embodiments, the medical systems include an inner tubular member defining an aperture and an outer tubular member at least partially surrounding the inner tubular member. The inner and outer tubular members can be arranged such that an implantable medical endoprosthesis can be disposed therebetween.

Abstract: An endoluminal prosthesis includes an expandable stent graft that includes a cannula extending through a lumen of the stent graft. A suture is threaded along the perimeter of the graft through openings therein, with an inner end of the suture mounted to the cannula. The cannula is rotatable relative to the graft to wind or unwind the suture around the cannula and cause the graft to become compressed when wound or allow the graft to expand when unwound. The cannula includes an attachment member for retaining an inner end of the suture, and the attachment member can release the inner end of the suture when adjustment of the graft diameter is no longer desired.

Abstract: A stent graft delivery system including a tip assembly, a middle member tube, a sheath assembly, and a unitary front grip. The sheath tube is axially slideable within the distal front grip lumen, the threaded assembly distal end is disposed in the proximal front grip lumen and fixed to the unitary front grip, and the first threaded tube portion and the second threaded tube portion are radially compressed together by the unitary front grip. The sheath handle engages the exterior thread of the threaded assembly in a first configuration to move the sheath tube axially relative to the middle member tube and tip tube through rotation of the sheath handle and disengages the exterior thread of the threaded assembly in a second configuration to move the sheath tube axially relative to the middle member tube and tip tube through axial motion of the sheath handle.

Abstract: A system for improving cardiac function is provided. A foldable and expandable frame having at least one anchoring formation is attached to an elongate manipulator and placed in a catheter tube while folded. The tube is inserted into a left ventricle of a heart where the frame is ejected from the tube and expands in the left ventricle. Movements of the elongate manipulator cause the anchor to penetrate the heart muscle and the elongate manipulator to release the frame. The installed frame minimizes the effects of an akinetic portion of the heart forming an aneurysmic bulge.

Abstract: A catheter assembly may include a main balloon arranged to reside within the main vessel, and a branch balloon configured to extend from the main vessel into the branch vessel. A stent may be situated around the main balloon and may include a branch aperture at a location between proximal and distal open ends of the stent. The branch balloon may extend from within the stent, through the branch aperture, and into the branch vessel. The branch balloon, when inflated, may extend into the branch vessel. The main balloon, when inflated, may also expand the stent within the main vessel. In some arrangements, the branch balloon, when inflated, can function as an anchor within the branch vessel that resists radial and axial movement of the stent relative to the branch vessel and main vessel during expansion of the stent by the main balloon.

Abstract: A method for assembling a stent graft onto a balloon delivery catheter is disclosed. The method includes the steps of: assembling a graft over a stent with attached security rings and inserting the ends of the graft between the stent and the rings; placing the assembled stent graft on the delivery balloon of the delivery catheter; and crimping the stent graft onto the balloon. The stent may include a plurality of axially aligned belts that include a plurality of mid belts, and first and second end belts, where each of the mid belts includes a plurality of circumferentially spaced struts having first and second ends adjoining first sinusoidal-shaped elements, and each of the first and second end belts includes at least about twice the number of circumferentially spaced struts adjoining second sinusoidal-shaped elements. Also disclosed is a stent graft for use in practicing the method.

Abstract: A fitting device (104) for fitting a stent-graft (100) into a lumen of a patient includes a catheter (110), a cannula (112) reciprocably carried in the catheter (110) and a pair of gripper claws (106) in the cannula (112). The gripper claws (106) grip onto a stent (102) at the proximal end (128) of the stent-graft (100) which a suture loop (108) is tied to a stent (102) at an intermediate position along the stent graft (100). The stent-graft (100) can be curved by pulling the end-most stent (102) backwards, that is by retracting the cannula (112) into the catheter (110) while the gripper claws (106) grip onto the stent (102). The proximal end of the stent-graft (100) can also be adjusted position-wise by moving the cannula (112) into and out of the catheter (110). Thus, precise positioning and curving of the stent-graft (100) can be achieved.

Abstract: An apparatus is provided in one example embodiment and includes a body section having an upper surface, a lower surface, and an inner edge circumferentially arranged around at least a portion of an open area. The apparatus also includes a tool extending from the body section into the open area for holding a graft vessel. The lower surface of the body section opposes a receiving vessel when the tool is positioned to transfer the graft vessel to the receiving vessel, such that the graft vessel is axially accessible through the open area to be attached to the receiving vessel. In more specific embodiments, the body section has first and second opposing ends defining a gap sized to permit the vessel to pass through.

Abstract: An endoluminal prosthesis may include a tubular body of a biocompatible graft material having proximal and distal ends and anterior and posterior sides. The prosthesis may include at least a first and a second fenestration. The first and second fenestrations may be spaced from one another circumferentially around the tubular body. The prosthesis may include at least one first diameter reducing tie positioned circumferentially on the posterior side of the prosthesis and engaging at least a circumferential segment of the posterior side to restrain the engaged segment from expansion. The prosthesis may include at least one second diameter reducing tie positioned circumferentially between the first and second fenestrations on the anterior side of the prosthesis and engaging at least a circumferential segment of the anterior side to restrain the engaged segment from expansion.

Abstract: A drainage stent delivery system including a stent, a guide catheter, a push catheter, and an outer sheath. The guide catheter extends through the lumen of the stent and the push catheter is disposed over a portion of the guide catheter proximal of the distal end of the stent. The outer sheath is slidably disposed over the push catheter and surrounding at least a portion of the stent. The outer sheath may be actuated from a first position in which a distal portion of the outer sheath surrounds the stent to a second position in which the distal portion of the outer sheath is proximal of the stent. The stent delivery system may also include a retention mechanism for selectively coupling the stent to the outer sheath which may selectively decouple the stent from the outer sheath through rotational and/or translational motion of the outer sheath relative to the stent.

Abstract: An occlusion device for implantation within a body vessel is provided with a screen member and an associated support member. The occlusion device is radially expandable from a compressed condition, suitable for inserting the device in an introducer, to a deployed or expanded condition within a vessel. The screen member includes a plurality of substantially diamond-shaped openings in the compressed and expanded conditions. The porosity of the screen member is less than the porosity of the support member in the expanded condition.

Abstract: An expandable stent and delivery system are provided for treating body vessel defects, such as partially occluded blood vessels and aneurysms. The delivery system includes a core member having a threaded core member portion configured to interlock with a threaded strut member portion of the expandable stent. The expandable stent is mounted thusly onto the core member for movement within a delivery catheter and deployment to a body vessel defect. The deployment catheter is used to compress the interlocked threaded strut member portion into engagement with the threaded core member portion.

Abstract: Apparatus for permanent placement across an ostium of a left atrial appendage in a patient, which includes a filtering membrane configured to extend across the ostium of the left atrial appendage. The filtering membrane has a permeable structure which allows blood to flow through but substantially inhibits thrombus from passing therethrough. The apparatus also includes a support structure attached to the filtering membrane which retains the filtering membrane in position across the ostium of the left atrial appendage by permanently engaging a portion of the interior wall of the left atrial appendage. The support structure may be radially expandable from a first configuration to a second configuration which engages the ostium or the interior wall of the left atrial appendage. The filtering membrane may define an opening therethrough that is configured to expand from a first size which inhibits the passage of thrombus therethrough to a second size which allows an interventional device, e.g.

Abstract: A stent or stent-graft delivery system includes a handle having a graft cover retractor having a screw gear and a drive and quick release assembly. The drive and quick release assembly includes a proximal portion and a distal portion that are separable. The proximal portion of the drive and quick release assembly rotates in a first rotational direction about the screw gear to retract the graft cover using the screw gear. The drive and quick release assembly transitions from retraction using the engagement with the screw gear to retraction by sliding by the user grasping the distal portion instead of the proximal portion, and sliding the proximal portion only along the screw gear. In transitioning from using the screw gear to sliding along screw gear, it unnecessary to push any button and unnecessary for the user to remove her/his hand from the assembly.

Abstract: A luminal prosthesis comprises a plurality of radially expandable prosthetic stent segments arranged axially. Two or more of the prosthetic stent segments are separable upon expansion from the remaining prosthetic stent segments and a coupling structure connects at least some of the adjacent prosthetic stent segments to each other. The coupling structure permits a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains or forms an attachment between the adjacent prosthetic stent segments in the first group which have been expanded together. A delivery system and methods for deploying the multiple coupled prosthetic stent segments are also disclosed.

Abstract: An external bodily vessel support comprising an elongate body with a longitudinal axis and an interior to be brought into apposition with an exterior of the bodily vessel. The elongate body including a tubular fabric of a plurality of threads, the body when in a relaxed configuration having a relaxed length and being sized and shaped to fit over of the exterior of the bodily vessel, the tubular fabric being longitudinally elastic to maintain the length with an axial stiffness of at least 0.1 N/m.

Abstract: The present invention relates to a delivery system for a self-expanding stent with a hollow cylindrical body and a proximal and a distal end. At least the proximal end thereof has projecting loops pointing alternately in the proximal and distal direction, the loops having a shoulder and straight sections. In addition, there is an outer tube which passes through the stent and an inner tube which passes through the outer tube, the inner tube and the outer tube being designed to move axially with respect to one another. In addition, it is fitted with a locking system for the projecting loops at the proximal end of the stent for introduction of the stent into the body vessel, the locking system having a cap element with pin elements fixed to it which point axially in the proximal direction of the delivery system and a first engagement unit for the pin elements which is positioned proximal with respect to the cap element in the delivery system.

Abstract: A stent graft delivery system including a tip assembly, a middle member tube, a sheath assembly, a threaded assembly, and a unitary endoseal. The tip tube is disposed in and longitudinally slideable within the proximal portion of the endoseal lumen, the middle member proximal end of the middle member tube is disposed in the distal portion of the endoseal lumen and fixed to the longitudinal cylindrical endoseal body, the first cylindrical portion of the transverse cylindrical endoseal body is disposed in the first sidewall port of the threaded assembly, the second cylindrical portion of the transverse cylindrical endoseal body is disposed in the second sidewall port of the threaded assembly, and the longitudinal endoseal cylindrical body is disposed in the threaded assembly lumen.

Abstract: An endovascular delivery system includes a bifurcated and inflatable prosthesis including a main tubular body having an open end and opposed ipsilateral and contralateral legs defining a graft wall therein between. A tether is disposed securably disposed to the contralateral leg, and the contralateral leg is releasably restrained towards the ipsilateral leg tether to prevent undesirable movement of the contralateral leg. A release wire within the endovascular delivery system releasably retains the tether near the ipsilateral leg.

Abstract: A method of temporarily reducing the diameter of a stent graft (10) and a stent graft with its diameter reduced. The stent graft has a tubular body and self expanding stents.

Abstract: A method of temporarily reducing the diameter of a stent graft (10) and a stent graft with its diameter reduced. The stent graft has a tubular body and self expanding stents.

Abstract: An apparatus is provided in one example embodiment and includes a body section having an upper surface, a lower surface, and an inner edge circumferentially arranged around at least a portion of an open area. The apparatus also includes a tool extending from the body section into the open area for holding a graft vessel. The lower surface of the body section opposes a receiving vessel when the tool is positioned to transfer the graft vessel to the receiving vessel, such that the graft vessel is axially accessible through the open area to be attached to the receiving vessel. In more specific embodiments, the body section has first and second opposing ends defining a gap sized to permit the vessel to pass through.

Abstract: A delivery system for a self-expanding stent includes a catheter having a distal end and being configured to retain a self-expanding stent proximate the distal end. The delivery system also includes an inflatable device provided on the catheter and positioned proximate the distal end. The inflatable device, typically a balloon, is configured to selectively assist the self-expanding stent with radial expansion. The catheter includes a tubular member and an outer member coaxially positioned about the tubular member. The outer member can slide relative to the tubular member in an axial direction. The outer member is configured to retain a self-expanding stent in a radially-compressed position and to release the self-expanding stent to a radially-expanded position.

Abstract: Apparatuses and methods for guiding endoluminal devices through body lumens. Several embodiments of the present technology, for example, are directed to flexible tubular sheaths or sleeves configured to provide a smooth, low friction pathway through which an endoluminal device can be delivered to a target site in a human patient. In one embodiment, for example, a flexible sheath or sleeve may comprise an elastomeric body and a plurality of structural elements carried by the elastomeric body. The structural elements may be oriented co-axially along the flexible sheath. The elastomeric body is configured to expand radially to accommodate passage of the endoluminal device through the flexible sheath or sleeve to the target site in the patient.

Abstract: In a device (1) for recanalizing a cavity, organ path or vessel (4) which is at least partially occluded by at least one compressible occlusive object, in particular a thrombus or embolus (3), in the body of a human or animal, using at least one compressible and self-expanding stent (10) having a distal (12) and a proximal end (11), the at least one stent (10) is embodied substantially in a bell shape with a widened distal end (12) and a constricted proximal end (11).

Abstract: An apparatus and associated surgical method for repairing abdominal aortic aneurysms is disclosed. The apparatus includes first and second stent grafts made from a metal form structure in combination with a flexible fabric, and a flexible guidewire detachably attached to the first stent graft. The first stent graft has an upper tubular body which defines an inlet, and a lower bifurcation which includes a first tubular leg defining a first outlet, and a second tubular leg defining a second outlet.

Abstract: A delivery catheter includes a constraining sheath coupled to a distal end of the catheter, and a medical device, such as an embolic protection device (EPD) or a stent, constrained by the sheath. A wire may extend proximally from the constraining sheath and be coupled thereto. A proximal pulling force on the wire causes the wire to tear the constraining sheath, thereby releasing the medical device from a constrained configuration to an expanded configuration.

Abstract: An endoprosthesis cover may be attached to the distal end of a delivery device. The cover may be generally cylindrical in shape and may have a lumen through it. An endoprosthesis may then be covered as it is delivered to a treatment site.

Abstract: Apparatus for performing bypass graft surgery on a patient, between a major blood vessel and an occluded vessel in the patient, the vessel being occluded by a lesion, including a blocking balloon, an endoscopic delivery device, a distal suture structure, a proximal suture structure and a delivery catheter, the blocking balloon for isolating a portion of the major blood vessel, the endoscopic delivery device for grasping a vessel graft and for navigating the vessel graft to the major blood vessel and the occluded vessel, the distal suture structure positioned within the distal end of the vessel graft, for suturing the vessel graft with the occluded vessel at a position distal to the lesion, the proximal suture structure positioned within the proximal end of the vessel graft, for suturing the vessel graft with the major blood vessel and the delivery catheter positioned within the vessel graft, for holding and releasing the distal suture structure and the proximal suturing structure.

Abstract: Improved methods, compositions and kits for congenital heart disease surgeries are described. The methods utilize amniotic fluid and/or an allograft comprising a layer of amnion to improve the performance and reduce complications of the surgeries and the allograft has a pre-made size and shape suitable for the application.

Abstract: The present disclosure is directed to a branched endoprosthesis comprising a graft component and at least one support component. In various embodiments, the branched endoprosthesis comprises a body portion and at least two leg portions, wherein at least two legs are in an aligned configuration for ease of cannulation. In various embodiments, at least one leg is in an open configuration for ease of cannulation. Cannulation methods are also taught.

Abstract: Improved methods for coronary artery bypass grafting surgeries are described. The methods utilize an allograft comprising a layer of amnion to improve the performance and reduce complications of the surgeries and the allograft has a pre-made size and shape suitable for the application.

Abstract: Removable cardiac implants, applicators for inserting, repositioning and/or removing them, and methods of using them are described. In particular, removable or repositionable ventricular partitioning devices are described. Systems including removable implants and applicators for inserting and/or removing them are also described.

Abstract: Expandable sealing means for endoluminal devices have been developed for controlled activation. The devices have the benefits of a low profile mechanism (for both self-expanding and balloon-expanding prostheses), contained, not open, release of the material, active conformation to the “leak sites” such that leakage areas are filled without disrupting the physical and functional integrity of the prosthesis, and on-demand, controlled activation, that may not be pressure activated.

Abstract: Some embodiments are directed to a deployment system for deploying a stent graft within a passageway, comprising a delivery catheter having an outer sheath, a proximal end, and a distal end, a stent having a first end and a second end, a graft having a first end and a second end, and at least one connecting element extending from the second end of the stent to the first end of the graft so as to connect the stent to the graft. In some embodiments, the stent can be supported within the outer sheath at a first axial position in a collapsed state, and the graft can be supported within the outer sheath at a second axial position different than the first axial position in a collapsed state, such that the stent does not overlap or substantially overlap the graft in the collapsed state within the deployment system.

Abstract: A catheter for delivering a prosthesis to a treatment site in a body lumen comprises an elongate flexible member and a sheath slidably disposed thereover. A plurality of self-expanding tubular prostheses are carried in axially spaced apart locations along the elongate member, within the sheath. The prostheses may be selectively interlocked with one another and are constrained by the sheath in a radially contracted configuration. The prostheses are separately releasable from the sheath when the sheath is retracted relative to the elongate member. The catheter also has a pusher member slidably disposed along the elongate member within the sheath. The pusher is adapted to move past the prostheses in a first direction without displacing the prostheses, while in a second direction the pusher engages a selected prosthesis so as to move the prosthesis with the pusher to interlock the selected prosthesis with a second prosthesis.

Abstract: A method of loading an article, such as a self-expanding stent, into a structure, such as a delivery catheter, including the steps of chilling the article to a predetermined temperature, reducing article size a predetermined amount, inserting fluid into the article, whereby the fluid forms a substantially solid plug with respect to the article, and moving the frozen article. Also provided is an apparatus for loading an article into a structure including: an article size reduction element, a chiller connected to the size reduction element, a cold source communicatively connected to the chiller, and a fluid supply communicatively connected to the size reduction element.

Abstract: A catheter assembly configured for treatment of a vessel bifurcation. The catheter assembly includes a catheter shaft and first and second balloons. The second balloon extends radially outward relative to the first balloon when expanded. A valve arrangement controls expansion of the second balloon. Portions of the valve arrangement can be positioned at proximal and distal end portions of the catheter shaft. Typically, the first balloon is expanded followed by expansion of the second balloon. A stent having a lateral branch opening is operatively mounted to the first balloon. The second balloon is configured to extend through the lateral branch opening when the second balloon is expanded.

Abstract: Medical devices and related methods are disclosed for delivering an implant into the body of a patient. The devices include a damping assembly having an internal chamber with a varying inner diameter, and a piston slideably disposed therein. The piston is operably connected with a catheter portion such that movement of the piston is associated with concurrent movement of the catheter for implant delivery. The varying inner diameter of the damping assembly results in a decrease in damping force during implant delivery, thus providing a substantially constant velocity of implant delivery.