Abstract: A marker and pushing member are provided with lateral extensions connected to a connecting portion. The connecting portion connects the marker/pushing member to a proximal or distal end of the stent. The lateral extensions distribute forces applied to the marker/pushing member so that part of the force is applied to the connecting member and part of the force is applied to a portion of the stent structure that is not directly connected to the connecting member.

Abstract: A narrowing intraluminal stent is disclosed and comprises a hollow body and a flow passage therethrough, the hollow body designed for intraluminal placement and having “at least one portion of an inner cross sectional dimension smaller than the cross sectional dimension of the lumen, so as to artificially narrow a passage through the body lumen. A method of artificially narrowing a passage through a body lumen using the stent is also disclosed.

Abstract: Minimally invasive techniques are utilized in bypass grafting to implant an end portion of a graft in the body of a patent by (i) advancing a medical instrument within a circulatory system of the body, (ii) guiding a distal end of the medical instrument out of the circulatory system through an opening defined in the circulatory system, (iii) advancing the end portion of the graft within the medical instrument toward a surgical site, and (iv) securing the end portion of the graft to a blood vessel at the surgical site, wherein the graft includes resilient arms confined within the medical instrument that expand outwardly within the blood vessel following positioning of a graft end through an aperture in the blood vessel.

Abstract: Scaffold-supported metal or pseudometallic film covers suitable for use as medical devices are disclosed together with methods of fabricating the devices. Methods for making the medical devices consist of either providing or forming a scaffold, then depositing a metallic or pseudometallic film cover onto the scaffold in such a manner as to form an integral, substantially monolithic junction between the deposited cover material and the scaffold.

Abstract: An anastomotic device includes a tube and anastomotic coupler rings having vessel openings attached to each end of the tube. In an embodiment, the diameters of the vessel openings are different.

Abstract: This is directed to methods and devices suited for maintaining an opening in a wall of a body organ for an extended period. More particularly devices and methods are directed maintaining patency of channels that alter gaseous flow within a lung to improve the expiration cycle of, for instance, an individual having chronic obstructive pulmonary disease.

Abstract: An endoluminal prosthesis is disclosed and comprises a first generally tubular stent, a second generally tubular stent, and a generally tubular graft member concentrically disposed between the first and second stents. One or more of the first and second stents may have a body portion and a flaring portion. The first and second stents each may have a recoil force such that the combined application of the first and second recoil forces secures the graft member between the first and second stents.

Abstract: A fiber-optic endoscopic instrument (Fistuloscope) is used to visualize anorectal fistula, and to accurately identify the course through the fistula. The instrument can be used to flush the fistula, to close the fistula tract by means of injecting sealants or placing grafts in the tract of the fistula or to pass setons, micro-instruments or other means to treat and seal the tract.

Abstract: The present invention relates to stent structures having improved migration resistance. In particular, the invention relates to mesh stents, such as braided or twisted stent designs, where at least a portion of the stent is folded back over itself to form a multi-layered stent device. Such multi-layered portions provide for migration resistance, among other advantages.

Abstract: Blood flow restrictors are discussed. In some examples, a restrictor apparatus includes a converging entry portion, a diverging exit portion, and optionally a narrowed portion therebetween to restrict the flow of blood through an arteriovenous graft from a subject's artery to a vein. The structure of the restrictor apparatus decreases the pressure and volume of blood flow between the artery and vein to reduce or prevent hyperplasia or stenosis on the venous side, an increased load on the heart, or blood steal, among other things. The restrictor apparatus can be separate from, but couplable to, the arteriovenous graft. The restrictor apparatus can be integral with the arteriovenous graft. In some examples, the restrictor apparatus can be inserted into the arteriovenous graft in a compressed size and shape, and subsequently be allowed to expand to an uncompressed size and shape. Methods of forming and using the restrictor apparatus are also discussed.

Abstract: A stent includes a first portion including first and second bands of cells that flare outwardly when the stent is expanded from a contracted to a flared condition, and a second portion connected to the first portion by flexible connectors. During use, the stent is introduced into a main vessel in the contracted condition and positioned with the first portion adjacent an ostium and the second portion within a branch vessel extending from the ostium. The first portion is flared, causing first struts of the first set of cells to move from an axial towards a radial and partial circumferential orientation and causing second struts of the second set of cells to move from an axial towards a radial orientation. The stent is expanded further such that the second portion expands within the branch body lumen, and the first and second struts move towards a more circumferential orientation.

Abstract: Endoprosthesis, such as a stent, includes at least one annular element defined by a first set of strut members interconnected to define apices proximate opposite sides of the annular element. The annular element further includes a foot extension extending between at least one pair of circumferentially-adjacent strut members. The foot extension has first and second foot portions extending circumferentially from corresponding ends of the circumferentially-adjacent strut members, and are contoured to provide at least two areas of flexure. The first and second foot portions are joined at a toe portion of the foot extension, and define a circumferentially-directed apex between the pair of circumferentially-adjacent strut members. Preferably, at least one or more additional annular elements, each defined by interconnected strut members, are provided. The annular elements are generally expandable between a delivery configuration and a deployed configuration.

Abstract: The present examples provide a stent for use in a medical procedure that comprises at least one apex having first and second generally straight portions and a curved portion disposed between the first and second straight portions. The curved portion may comprise at least one region having a cross-sectional area that is less than a cross-sectional area of the first and second straight portions, which may facilitate compression of the stent and insertion of the stent into smaller vessels. The stent may be used alone, or in conjunction with a stent-graft, and may comprise one or more barbs configured to engage an inner wall of a vessel or duct.

Abstract: A rapid exchange stent delivery catheter includes an inner tubular member having a proximal portion, a distal portion, a stent holding portion located adjacent the distal portion of the inner member, and a guide wire lumen extending from a proximal guide wire opening disposed distal of the proximal portion of the inner member to a distal guide wire opening disposed at a distal end of the inner member. The proximal guide wire opening has a first length. An outer tubular member is slidably disposed about the inner member. The outer member has a proximal portion, a distal portion, and a guide wire opening disposed distal of the proximal portion of the outer member. The guide wire opening of the outer member has a second length that is shorter than the first length and a guide wire ramp extends into, and is movable along the first length.

Abstract: A vascular graft incorporating a stent into a portion of its length. While various materials may be used for the vascular graft, the graft is preferably an ePTFE graft. The stent is preferably a self-expanding stent, although it may alternatively be a balloon expandable stent. The vascular graft preferably has a continuous inner tubular liner that extends between the opposing ends of the graft and provides a continuous luminal surface for blood contact that is uninterrupted by seams or joints. The length portion of the graft that does not include the stent has a greater wall thickness than does the portion including the stent.

Abstract: A dual taper stent protector having a first stent covering region configured to cover a stent without substantially engaging the stent, a second covering region, and an engagement region for engaging a product mandrel removably disposed within a catheter shaft, and first and second tapered regions connecting the first stent covering region and the second stent covering region and the second covering region and the engagement region respectively, and to methods of making and using the same.

Abstract: An implantable, flat-woven multi-petaled graft includes (i) a hollow tubular woven portion having opposed first and second tubular ends, the woven portion having a number of warp yarns interlaced with a number of fill yarns in a flat-woven tubular woven pattern to define a flat-woven tubular diameter, and (ii) a bulbous woven portion having opposed first and second ends, the first bulbous end having a greater number of warp yarns interlaced with the fill yarns in a flat-woven tubular bulbous pattern contiguously woven from the second tubular end to provide a seamless woven, wherein the greater number of warp yarns are threadingly engaged with the fill yarns to define a flat-woven bulbous diameter; wherein the second end of the bulbous portion is scalloped with a plurality of petal-like projections seamlessly woven from the first bulbous end. The graft may include three petal-like projections. The bulbous woven section may be truncated, i.e., hemispherically or hemibulbously shaped.

Abstract: An improved medical device for use in the treatment of stenosis of the ostium of tubular organs, such as, but not limited to blood vessels. The improved medical device includes a configuration and design that enables at least one end region of the improved medical device to flare outwardly.

Abstract: An improved medical device for use in the treatment of stenosis of the ostium of tubular organs, such as, but not limited to blood vessels. The improved medical device includes a configuration and design that enables at least one end region of the improved medical device to flare outwardly.

Abstract: The invention relates to a vessel implant for the treatment of an aneurysm, i.e. a dilatation of the cross-sectional area of a blood vessel, comprising an elongate body which has an inlet opening, an outlet opening and a passage connecting the inlet opening to the outlet opening for blood flowing through the blood vessel, with the passage being bounded in the peripheral direction by a blood-impermeable wall, and with the inlet opening having a larger cross-sectional area than the outlet opening.

Abstract: Apparatus, kits and methods for flaring an end of a stent that can then be placed within the ostium of a vessel are disclosed. Areas in which ostial stents with flared ends could be used may include, e.g., the left main artery, renal arteries, sub-clavian artery, right coronary artery, circumflex artery, et al.

Abstract: A medical device for treatment of a stenosed body lumen includes an open-ended cylindrical body movable between a collapsed position and a radially expanded position pressed against the wall of the lumen is carried on a distal end of a catheter for insertion of the device into the lumen and placement at the stenosed site. In one embodiment the body sidewall is an open lattice-like structure, and a cover is attached to its outer surface. In another embodiment, concentric laminated tubes of dissimilar materials, such as, e.g., copper and silver, form the body. In a further embodiment stacked rings of different materials form the body. In a still further embodiment the device is temporarily placed in a body lumen for treatment of a stenosed site, after which the device is withdrawn. In all forms the body may have an outwardly flared inlet end to reduce turbulence.

Abstract: A prosthetic stent graft including a trunk with a vascular graft bifurcated into two flow channels. The flow channels have a first taper angle, decreasing area along its length between the bifurcation point and an outlet. A leg section of the stent graft includes a tubular vascular graft. An inlet of the leg section has a deployed diameter at least about the same size or larger than a deployed diameter of the outlet of the flow channels. The leg section has its own taper angle, preferably less than or about equal to, and more preferably about equal to the taper angle of the flow channel. The deployed diameter of the leg section inlet is preferably about the same size or larger than the deployed diameter of the flow channels adjacent the bifurcation point of the trunk section, and the deployed diameter of flow channel outlets are preferably about the same size or smaller than the deployed diameter of the leg section at an equal distance from the leg section inlet as the outlet is from bifurcation point.

Abstract: A device for treatment of mitral annulus dilatation comprises an elongate body having two states. In a first of these states the elongate body is insertable into the coronary sinus and has a shape adapting to the shape of the coronary sinus. When positioned in the coronary sinus, the elongate body is transferable to the second state assuming a reduced radius of curvature, whereby the radius of curvature of the coronary sinus and the radius of curvature as well as the circumference of the mitral annulus is reduced.

Abstract: An endovascular prosthesis comprising a first end section, a second end section and a midsection. The midsection has a diameter less than the diameter of the first end section and the second end section. At least the first end section and the second end section have lateral support preferably in the form of a stent which may also act as anchoring. The reduced diameter midsection is provided with at least one side port which is adapted to be connected to a branch endograft to provide a connection between the side port and the native branch artery. The side ports are arranged to correspond with the native branch arteries and are provided with radiographic markers at their proximal and distal ends. The side ports with the radiographic markers provide an effective means of making the connection to the native branch by a branch endograft without having to align the side ports exactly to the branch arteries and without kinking of the side ports.

Abstract: An endovascular graft system used to repair aneurysms in arteries which bifurcate such as the aorta which bifurcates at the aortoiliac junction. The graft system includes two legs, each defining a lumen. Each leg comprises an aortic stent, a graft component and an iliac stent. The graft component is affixed at one end to the aortic stent and at the other end to the iliac stent. Each leg of the graft system is preferably a mirror image of the other with the exception of the aortic stents. The graft component of each leg includes a means for allowing in situ adjustment of the length of the leg to accommodate the different sizes required for different patients.

Abstract: A vascular shunt apparatus (10) includes a tubular member having first and second end portions (16, 20) and an aperture extending through the first and second end portions (16, 20). A transducer (64) can be associated with the tubular member to provide a signal in response to the flow of fluid through the tubular member. One or both of the end portions (16, 20) also can be adapted to form respective sealing connections with different parts of a patient's vascular system.

Abstract: A stent in a non-expanded state has a first column expansion strut pair. A plurality of the first column expansion strut pair form a first expansion column. A plurality of second column expansion strut pair form a second expansion column. A plurality of first serial connecting struts form a first connecting strut column that couples the first expansion column to the second expansion column. The first expansion column, the second expansion column, and the first connecting strut column form a plurality of geometric cells. At least a portion of the plurality are asymmetrical geometric cells.

Abstract: The present invention provides for reinforced and drug eluting stent-grafts and related methods of implanting and manufacturing the stent-grafts. A stent-graft of the present invention may include a tubular stent, a biocompatible covering surrounding the stent, and a supporting collar coupled to the proximal end of the stent-graft. A drug agent may be applied to a textured external surface layer of the biocompatible covering, or alternatively to a space between the textured external surface layer and a smooth luminal surface layer of the biocompatible covering, and allowed to elute over time into a wall of a body lumen after the stent-graft is deployed. The collar of the stent-graft absorbs pressure exerted on the stent-graft by fluid flow within the body lumen in order to minimize potential damage to the stent-graft, and may also include barbs to further secure the stent-graft to the body lumen.

Abstract: The present invention comprises a pulmonary valved conduit that permits inflow diameters greater than about 22 mm while still maintaining the advantages of a naturally-formed biological valved conduit. Specifically, the present invention comprises a valved vascular prosthetic having an inflow conduit comprising a manifold formed from the sealed attachment of at least two venous valvular conduits.

Abstract: A conduit is provided to provide a bypass around a blockage in the coronary artery. The conduit is adapted to be positioned in the myocardium or heart wall to provide a passage for blood to flow between a chamber of the heart such as the left ventricle and the coronary artery, distal to the blockage. The stent is self-expanding or uses a balloon to expand the stent in the heart wall. Various attachment means are provided to anchor the stent and prevent its migration. In one embodiment, a conduit is provided having a distal top which is more preferably a ball top, wire top, flare top or flip-down top. These top configurations anchor the shunt at one end in the coronary artery.

Abstract: An arterial graft device and a process for positioning the same, wherein the device provides a first part positioned by conventional techniques within the artery, and a second part which is positioned and fixed on the first part by a segment which is provided on the first part so as to prevent a catheter guidewire—whereby the second part is positioned in place—from deviating and damaging arterial walls.

Abstract: A stent graft device has an upper main tubular portion dividing into two tubular limbs and is adapted for location in an aorta having an aneurysm. The stent graft device is well suited for an aorta having a restricted section having an inner diameter smaller than the sum of the inner diameters of the iliac arteries, which branch from the aorta. The diameters of the two tubular limbs are sufficiently small to allow for both tubular limbs to be deployed side-by-side in a fully expanded state within the restricted section without being constrained by the aorta inner surface. The limbs also have distal end portions having diameters larger than the diameters of limbs at the area near the restricted section for being retained within the iliac arteries.

Abstract: An improved method and devices for preventing restenosis are provided. The method may include delivering a stent configured to contain a stenosis to a body vessel. The method may also include using atherectomy at the site prior to stent delivery. In one embodiment, the stent has a proximal end, a distal end, and a center portion arranged such that the diameters of the proximal and distal ends are greater than the diameter of the center portion. In one embodiment, the atherectomy device includes a housing to prevent injury to the unaffected areas of the body vessels but the cutter is extendible beyond the housing. In one embodiment, the stent may be impregnated with at least one drug after stent deployment.

Abstract: A bypass graft includes a tubular portion having an internal tubular diameter and a first end and a second end. The tubular portion has a central axis. A flared portion has an adjoining end, wherein the adjoining end of the flared portion is integrally formed on and is substantially concentric with the second end of the tubular portion, and a flared end, wherein the flared end has a flared end internal diameter, such that the internal flared end diameter is greater than the internal tubular diameter. The flared portion includes a circumferential skirt for surgical attachment of the graft to a patient's blood vessel.

Abstract: An inventive flanged graft for end-to-side anastomosis includes a tubular graft member and a flanged section The type and size of the flanged section is determined by various factors such as identity of the receiving artery, position of the arteriotomy on the receiving artery, and luminal diameter of the graft. The graft is preferably anastomosed to the receiving artery using continuous sutures to join the arteriotomy to the peripheral edges flanged section.

Abstract: A stent or other intraluminal medical device may be constructed utilizing a series of split-bridges interposed between a series of fixed bridges to reduce the likelihood of deformation during stent loading and stent deployment without sacrificing overall stent flexibility. The stent comprises a plurality of hoops interconnected by a plurality of fixed bridges. The stent also comprises a plurality of split-bridges, which only make contact when the stent is subjected to compressive axial loading. The stent may also comprise markers formed from housings integral with the stent and marker inserts having a higher radiopacity than the stent. This design provides for more precise placement and post-procedural visualization in a vessel, by increasing the radiopacity of the stent under X-ray fluoroscopy. The housings are formed integral to the stent and the marker inserts are made from a material close in the galvanic series to the stent material and sized to substantially minimize the effect of galvanic corrosion.

Abstract: The vascular prosthesis comprises a flexible duct that is elastically deformable lengthwise. It further comprises adjustable means for fixing the spacing between two distant sections of the length of the flexible duct, the duct extending beyond at least one of the first and second sections so as to form at least one segment that is elastically deformable lengthwise.

Abstract: An inventive flanged graft for end-to-side anastomosis includes a graft with bifurcated flanges. The bifurcated flanges may be symmetrical or asymmetrical relative to one another. The type and size of flange to be used is determined by various factors such as identity of the receiving artery, position of the arteriotomy on the receiving artery, and lumenal diameter of the graft. The graft is preferably anastomosed to the receiving artery using continuous sutures to join the arteriotomy to the peripheral edges of the bifucated flanges. In an alternate embodiment, the inventive bypass graft includes a flared skirt which extends circumferentially about the tubular graft member. The flared skirt has an elliptical shape and is offset from a central longitudinal axis of the graft member.

Abstract: A flexible covered stent includes a stent covered on a first surface by a first layer of biocompatible material and on a second surface by a second layer of biocompatible material, the first and second layers of biocompatible material being bonded to one another through a wall in the stent. The first layer of biocompatible material is longer than the second layer of biocompatible material such that at least a portion of the second surface of the stent is left uncovered, imparting flexibility to the stent. A mid portion of the second surface of the stent can be left uncovered to impart flexibility to the stent similar to that enjoyed by a bare stent.

Abstract: A stent and method for making the stent are provided. The stent comprises regions of differing numbers of braided filaments to provide a stent with different dimensions and/or properties in different regions along the stent length. A preferred stent comprises a first and second plurality of braided filaments each braided together. The second plurality of braided filaments is braided into the first plurality of braided filaments to form a region of different properties than the first. A preferred embodiment is a stent having a narrower diameter along a more flexible region and a broader diameter along a more rigid region. Also included is a method of constructing a braided stent in accordance with the above.

Abstract: An implantable tubular textile prosthesis particularly useful in branched end-to-side anastomoses is provided. The prosthesis includes a first portion including an elongate tubular main wall which defines a fluid passageway therethrough, and a second portion including a tubular branch wall which extends laterally from the tubular main wall and which defines a fluid passageway therethrough. The tubular branch wall includes an elongate tubular extent and a contiguous flared tubular extent. The tubular branch wall is secured to the tubular main wall at the flared tubular extent to establish fluid communication between the passageways of the tubular main wall and the tubular branch wall. The flared tubular extent includes a gradual increase in diameter with respect to the tubular branch extent to provide a seamless and substantially fluid-tight transition between the tubular main wall and the tubular branch wall along the flared tubular extent.

Abstract: The invention provides arteriovenous grafts and methods for implanting the same. In one aspect of the invention, there are provided arteriovenous grafts that have a stepped down venous end. In another aspect, the invention provides arteriovenous grafts having cuffs for attachment to a target vein. The invention also provides methods for implanting arteriovenous grafts that include inserting the venous end of a graft into the target vein for positioning downstream of the venotomy site.

Abstract: A vascular prosthesis configured for direct connection to an artery. The vascular prosthesis may include a tube of material other than autologous vascular tissue, having an end formation, which is configured for surgical connection to an opening formed in the artery, and a narrower portion prior to commencement of the end formation. The end formation may have an enlarged chamber adapted to induce a concave section in said blood vessel upon attachment thereto.

Abstract: A stent includes a cylindrical main body contractible and expandable in a circumferential direction, a cover member coated on inner and/or outer circumference of the main body, and an inverse current preventing member for preventing food or fluid from reversely flowing. The inverse current preventing member is disposed in the main body and includes a fixing layer defining a passage having a diameter capable of allowing food and fluid to pass, the fixing layer being fixed in the main body and a valve layer extending from the fixing layer to a distal end of the main body.

Abstract: Modular endoluminal stent-grafts include at least two different sized stent-grafts which are deployed one within the other. According to one embodiment of the invention, a first stent-graft is provided having a flared end which is expandable to a first diameter and a midsection which is expandable to a second diameter smaller than the first diameter. A second stent-graft is also provided having an end which is expandable to a diameter which engages the midsection of the first stent-graft. The first embodiment of the invention is deployed by expanding the first stent-graft such that its flared end engages a large diameter vessel, then expanding the second stent-graft inside the midsection of the first stent graft and inside a small diameter vessel such that the second stent graft engages the small diameter vessel and the midsection of the first stent-graft.

Abstract: In some embodiments, prosthetic conduits include biocompatible material formed into a generally cylindrical section and an expanded section connected to the generally cylindrical section to form a conduit. The conduit has a lumen extending through the generally cylindrical section and the expanded section. In some embodiments, the biocompatible material is tissue. The biocompatible material can include one segment or a plurality of segments joined together to form the generally cylindrical section and the expanded section. In some embodiments, the prosthetic conduit includes a reinforcement to prevent unwanted dilation or collapse of the conduit. The reinforcement can be placed at or near the junction of a generally cylindrical section and an expanded section and/or at other locations along the conduit. The prosthetic conduit may or may not include a prosthetic heart valve.

Abstract: Continuously flat-woven implantable tubular prostheses have seamless woven sections which gradually change the number of warp yarns to smoothly transition, i.e., taper, from one diameter to another. Multi-diameter endoluminal grafts having a variety of shapes and configurations are made using a seamless weaving process without unacceptable voids or gaps in the tubular wall.

Abstract: A flanged prosthesis (10) comprises a tubular body (18) equipped at one end with an external flange (19) designed for the anastomosis of the prosthesis to a tubular duct equipped with an opening. The flange (19) is made of a textile material and comprises at least one seam (324, 360, 362) shaping it at the end of the tubular body (18).

Abstract: A vascular prosthesis (50) comprises a tube (52) of material other than autologous vascular tissue, the tube having an end formation for surgical connection direct to an opening formed in an artery, the formation comprising an enlarged chamber (54) having a heel (56) and a toe (58) at opposite ends of a first longer diameter parallel to the axis of the tube and a second shorter transverse diameter the enlarged chamber serving to promote localised movement of blood having a non-laminar nature with a shear stress inducing relationship to receiving arterial wall.