Abstract: A fenestrated implantable medical device, such as a stent graft (10) is provided with a plurality of zigzag stents (12) of which two or more form fenestrations (34, 36) using part of the stents (12) as a support frame (30, 32) for the fenestrations (34, 36). The frames (30, 32) are preferably covered by radiopaque wire (44) coiled around the stent structures. The radiopaque coil (44) provides easy reference to the fenestrations (30, 32) for imaging purposes.

Abstract: A modular stent graft system and methods of assembly are disclosed. The stent graft assembly comprises a first stent graft having an interface region at its distal end and a first locking stent secured to an internal surface of the interface region. A second stent graft having an interface region at its proximal end is configured to at least partially overlap with the interface region at the distal end of the first stent graft. The second stent graft comprises a second locking stent secured to an external surface of the interface region. The first and second locking stents are configured to be engaged such that the second locking stent is nested between the first locking stent and an internal surface of the interface region of the first stent graft thereby interlocking the first and second stent grafts to each other.

Abstract: Composite stent grafts can include separate components that are capable of being repositioned relative to each other in situ. In some examples, a stent and a graft that are attached to each other in an insertion package do not overlap each other. The graft and stent are moved relative to each other in situ.

Abstract: The present invention embodies an endovascular graft having an attachment frame connection mechanism that allows placement of the main body component in vasculature in combination with limb components. Various limb component-to-main body component attachment mechanisms are provided which ensure a reliable bond while facilitating a smaller delivery profile.

Abstract: An endoluminal vascular repair system includes an aorta stent graft having a fenestration with a first reinforcement around the fenestration. The fenestration aligns with a branch vessel when deployed. A branch vessel stent graft has a flaring portion at a proximal end of the branch vessel prosthesis that has a second reinforcement around its circumference to engage the reinforcement around the fenestration, and a tubular portion. When deployed, the flaring portion retains the proximal end within the aorta stent graft, and the tubular portion extends through the fenestration and into the branch vessel.

Abstract: Assemblies, devices, and methods for positioning the same proximate a target site within a body lumen are provided. The assembly includes first and second components that can function independently of one another to address a patient's vascular abnormalities or can cooperate to form an assembly. The assembly is designed to address aortic pathologies near clusters of arterial branches in a way that allows blood to continue flowing to the arterial branches during the procedure while providing an adequate landing zone for the adjoining component. One of the components may include a tapered portion near one end that can be received by a corresponding end of the other component. Alternatively, one of the components may include an invaginated end that is able to receive a corresponding end of the other component such that the position of each component is substantially fixed with respect to the other.

Abstract: A stent/graft assembly includes a tubular graft connected in substantially end-to-end relationship with a generally tubular stent. Free ends of the stent and graft extend in opposite directions from the end-to-end connection during a pre-deployment orientation of the assembly. However, the graft is inverted during deployment so that free ends of the graft and the stent extend in substantially the same direction from the end-to-end connection in a post-deployment orientation. Thus, at least a portion of the stent is disposed within at least a portion of the graft in a post-deployment orientation of the assembly.

Abstract: The invention relates to an endoprosthesis (1), in particular a vascular or cardiac endoprosthesis (1), having a body (2) and also one or more thrombogenic elements (3) that are fixed to the endoprosthesis (1) and that are able to extend a distance away from the body outside the latter. The endoprothesis comprises means (33) for selectively retaining the thrombogenic elements near the body (2). The release of the one or more thrombogenic elements, after the endoprosthesis has been fitted in place by a conventional method via a sheath, promotes thrombosis.

Abstract: A vascular bypass graft having a primary member and a secondary member is disclosed. The secondary member extends from a distal second end of the primary member and has a common fluid pathway there between. The secondary member may have a flared or diffused proximal first end that facilitates low pressure fluid return and may be integrally formed with the primary member. An adjustable or fixed stenosis is provided in the secondary member which allows the fluid flow through the vascular bypass graft to be modified. The stenosis may be adjusted either manually or by way of a controller. The primary member is surgically connected to a patient's vascular system to provide an alternate route for blood flow around a vascular occlusion. The secondary member is surgically connected to another point in the vascular system to allow continuous circulation of blood through the graft thereby preventing clotting and graft failure.

Abstract: An arrangement for temporarily retaining a side arm (36) of a stent graft (30) in a selected position during loading thereof onto a deployment device, the side arm extending from an ostium (38) in the tubular body (32) and substantially helically around and along the tubular body to an open end (40). A first tie down wire (48) is stitched through the tubular body and through the side arm and then through the biocompatible graft material of the tubular body at the open end of the side arm. The stent graft can then be loaded into a sheath of a deployment device for the stent graft. There can be a second tie down wire (50) stitched through the biocompatible graft material of the tubular body and through the side arm and then through the biocompatible graft material of the tubular body at the ostium end of the side arm. The first and/or second tie down wires can be withdrawn after the stent graft is loaded into the sheath or left in place until delivery.

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 system is provided for stenting a bifurcated vessel structure having a parent vessel and a daughter vessel. The stent system has a parent vessel stent and a daughter vessel stent. The parent vessel stent has a substantially tubular body that is configured to be deployed into the parent vessel. This body has an angular flap that is openable to extend into the daughter vessel. The daughter vessel stent has a substantially tubular body that is configured to be deployed through the flap in the parent vessel stent into the daughter vessel. The daughter vessel stent has an angled tail portion that is configured to overlap with the flap of the parent vessel stent when both stents are deployed in the vessel structure. A method of stenting using this system is also provided.

Abstract: A stent graft has a cylindrical wall, an internal lumen within the cylindrical wall and a fenestration in the wall. The fenestration is closed off by a valve arrangement to prevent the flow of liquids from within the internal lumen to outside of the wall. The valve arrangement is a tube of graft material which can be closed off by pressure on its outside surface. The end of the tube remote from the fenestration can be held shut by having its periphery fastened to a flattened resilient ring. Fluid pressure on the tube of graft material causes the tube to close off to prevent fluid flow therethrough and by resilient deflection of the resilient ring the end of the tube of graft material can be opened to enable the passing of a medical device therethrough.

Abstract: One aspect of the present disclosure relates to a branched vessel prosthesis for repair of a failed stent graft. The branched vessel prosthesis can include a main stent graft body having a proximal end portion, a distal end portion, and a frusto-conical midsection that tapers to the distal end portion. The main stent graft body can include a tubular wall that defines a main lumen. The midsection can include a fenestration in the tubular wall and a collapsible internal limb that extends from the fenestration into the main lumen. The internal limb can be configured to receive an iliac limb extension.

Abstract: A stent graft has a tubular side arm which can be angled proximally and distally and from side to side. The wall of the stent graft in the vicinity of the side arm has a loose fold of the graft material and the side arm is fastened to the loose fold of graft material. The tubular side arm has an inner end and an outer end and is fastened into the loose fold of graft material by a circumferential fastening around the tubular side arm between the inner end and the outer end so that the tubular side arm extends partially within the tubular body of the stent graft and partially outside the tubular body of the stent graft. The loose fold of graft material can be formed by the graft material defining a recess in the wall of the stent graft. To enable movement or angulation proximally and distally and from side to side the loose fold of graft material is provided both proximally and distally of the tubular side arm and circumferentially to each side of the tubular side arm.

Abstract: A method for treating a body conduit/lumen having an undesired reduced diameter includes determining a target diameter of the conduit/lumen in a target location of the conduit/lumen, and delivering a self-expanding metal stent in a contracted configuration to the target location. In a fully expanded configuration, the stent has a diameter that is more than 50% larger than the target diameter over an entire length of the self-expanding stent.

Abstract: A thoracic arch stent graft (1) has a tubular body of a biocompatible graft material (3) and at least one fenestration (13, 15) in the wall on one side thereof. A combination guide and tubular side arm assembly (20, 22) is mounted into the or each fenestration. The combination guide and tubular side arm assembly comprises a tubular portion (24) and a funnel portion (26) extending from a distal end of the tubular portion. The funnel portion has an angled open end. The tubular portion and the funnel portion are formed from a biocompatible graft material wall and have a lightweight space frame (38 40) formed from a resilient wire and supporting the graft material and defining the combination guide and tubular side arm assembly.

Abstract: The present invention provides a modular stent-graft system. In one embodiment, a prosthesis comprises a first tubular graft comprising a layer of graft material, one lumen extending therein, and a first fenestration extending through the layer of graft material. A layer of fenestration covering material attaches to the layer of graft material. The layer of fenestration covering material is disposed in the lumen of the first tubular graft and partitions the first fenestration from the lumen of the first tubular graft. A first non-stented opening is disposed proximal to the first fenestration and communicates with the first fenestration between the layer of graft material and the fenestration covering material. In use, a proximal end of a second tubular graft sealably engages the first non-stented opening, and the second tubular graft further extends through the first fenestration and into a branch vessel.

Abstract: A tandem modular endograft includes a main elongate tubular graft body having at least one circumferential inflatable channel disposed towards a proximal portion of the graft body wall and a plurality of circumferential inflatable channels disposed towards a distal portion of the graft body wall. A proximal expansion anchor is disposed at or secured to a proximal neck portion of the graft body wall. First and second elongate tubular stent-graft extensions may be percutaneously disposed into a distal end of the tubular graft body. In combination, proximal portions of the first and second stent-graft extensions are conformable to a shape of the open lumen of the main graft body.

Abstract: A system for deploying a prosthesis over a Carina between an ipsilateral lumen and a contralateral lumen includes a guidewire, a guidewire capture catheter, a self-expanding tubular prosthesis, and a delivery catheter. The guidewire is first placed in the ipsilateral lumen. The guidewire capture catheter is then advanced from the contralateral lumen to a position at or above the ipsilateral lumen. The guidewire is typically advanced through an occlusion, which may be a total occlusion, and captured by a capture element on the guidewire capture catheter. The guidewire capture catheter pulls the guidewire out through the contralateral side, and the guidewire is used to advance a delivery catheter from the ipsilateral side. The delivery catheter delivers a first segment of the tubular prosthesis in the ipsilateral lumen and a second segment of the prosthesis in the contralateral lumen.

Abstract: A system for treating a bifurcation includes first and second delivery catheters, each having an expandable member and a stent. The stent on the second delivery catheter has a side hole. A portion of the first delivery catheter is disposed under a portion of the stent on second delivery catheter. The first delivery catheter is slidable relative to the second delivery catheter, and the first delivery catheter passes through the side hole.

Abstract: A modular prosthetic conduit system such as a stent or stent graft system tailored for the repair of aneurysms or other compromised vessel walls. The stent or stent graft system incorporates various means to interlock the multiple modular components used in the repair procedure. The present invention further provides a modular stent graft system tailored for the repair of aneurysms or other compromised vessel walls that cross or are adjacent to a branch or bifurcation in a vessel.

Abstract: The present disclosure relates to an endoluminal prosthesis, such as a stent graft that includes one or more fenestrations to accommodate endovascular disease, such as an aneurysm in cases where one or more side branches is involved. In one aspect, the prosthesis includes fenestrations that are pivotable to accommodate the dynamic geometry of the aortic branches. In another aspect, the pivotable fenestrations include a first perimeter, a band of flexible material attached and surrounding the first perimeter, and a second perimeter attached to and surrounding the band of flexible material. The first perimeter, band of flexible material, and second perimeter have a geometric shape. In one aspect, the prosthesis includes at least three pivotable fenestrations.

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

Abstract: A branched stent graft comprises a main body portion and a branch portion. Each of the main body portion and the branch portion includes a stent and a tubular graft. The stent of the main body portion includes a plurality of stent segments, at least one of which is a varying-height stent segment (102). The stent of the branch portion includes one or more stent segments, at least one of which is a varying-height stent segment (103). The distance between the proximal-most stent segment of the branch portion and the main body portion is in the range of 2-8 mm. A positioning ring (105) may be used at a side opening which connects the branch portion and the main body portion, and the positioning ring (105) can be sutured inside the graft of the main body, between the graft of the main body and the graft of the branch, or outside the graft of the branch.

Abstract: Disclosed is a stent assembly for expanding in vivo vessels, the assembly comprising first and second radially expandable mesh stents, wherein the first stent is separated by a predetermined distance from the second stent and a stent jacket spans the predetermined distance such that a first end of the jacket is operatively associated with the first stent and a second end of the jacket is operatively associated with the second stent.

Abstract: A multi-component stent-graft system (10) comprises first, second, and third generally tubular stent-grafts (20, 22, 24), which are configured to assume radially-expanded states. The first (20) is shaped so as to define a first lateral opening (34) when radially-expanded. The second (22) is shaped so as to define a second lateral opening (44) when radially-expanded. The first and second (20, 22) are configured such that the second (22) forms a blood-impervious seal with the first (20) around the first lateral opening (34) when the second stent-graft (22) is disposed therethrough, and the first and the second (20, 22) are radially-expanded. The second and the third (22, 24) are configured such that the third (24) forms a blood-impervious seal with the second (22) around the second lateral opening (44) when the third (24) is disposed therethrough, and the second and third (22, 24) are radially-expanded. Other embodiments also described.

Abstract: A side catheter branch of a catheter assembly is oriented with respect to the main or side balloons of a catheter assembly. In some examples, the orientation is accomplished by connecting the side catheter branch to the main and/or side balloons or waist portions thereof. In other examples, the side catheter branch is positioned within the folds of the main or side balloons during assembly of the catheter assembly. In this manner, the side catheter branch remains in a known orientation with respect to the main and/or side balloons prior to and/or after deployment.

Abstract: Some embodiments of the present disclosure are directed to endoluminal prostheses having one or more reinforced fenestrations therein. The one or more reinforced fenestrations can have improved sealing capabilities with respect to branch grafts deployed within the fenestrations, improved tear resistance and expandability, and improved pull-out resistance for branch grafts. In some embodiments, the endoluminal prosthesis can have a main graft body defining a flow lumen therethrough, a first opening passing through a wall of the main graft body, and a first support member supported by the main graft body and overlapping an edge of the first opening, the first support member being configured to at least increase the tear resistance of the main graft body adjacent to the first opening. The support member can be stitched or otherwise attached to the main graft adjacent to the fenestration.

Abstract: The present embodiments provide a branch vessel prosthesis for placement at least partially between a main vessel and a branch vessel of a patient. The branch vessel prosthesis has a graft including a generally tubular body of a biocompatible material. At least one stent is coupled to a proximal region of the graft, and at least one stent is coupled to a distal region of the graft. The proximal region of the graft includes a generally straight configuration in an expanded deployed state that is substantially parallel to a longitudinal axis of a main vessel. The distal region of the graft includes a generally straight configuration in the expanded deployed state that is substantially parallel to a branch vessel. A curvature of a central region varies an angle in which the distal region of the graft is disposed relative to the proximal region.

Abstract: A device and method for endovascular repair of a patient's aorta is disclosed. The device includes a frame component that has a balloon-expandable frame and a self-expanding frame secured to the balloon-expandable frame. The device also includes a valve element positioned at the proximal end of the frame component. The device may include another prosthetic component that may be secured to the frame component. The prosthetic component may include at least one conduit configured to receive a covered stent.

Abstract: The present invention is directed to balloon folding configurations and methods for catheter devices having dual lumens in radial proximity to the balloon, such as, but not limited to, self-aligning stent delivery systems for treatment of bifurcated lesions. The configuration designs alters the conventional catheter profile by packing balloon materials in otherwise vacant areas located on both sides of the side branch shaft and/or the parent shaft, such that the device takes on more of a round profile instead of the classical elongated egg-shaped profile.

Abstract: A method for treating an aneurysm can include inserting a medical device partially in a first artery and partially in a third artery. The device can be expanded radially outwardly from a first position to a second position to engage an inner surface of the first artery and an inner surface of the third artery, so as to maintain a fluid pathway through said arteries. Further, the device can be positioned such that, when the device is in the second position, a porous membrane of the device is located at a neck of the aneurysm.

Abstract: An endoluminal prosthesis with a moveable fenestration including a tubular graft body having a proximal end, a distal end, a surface plane at least one fenestration having a perimeter disposed in a sidewall of the tubular body between the proximal end and the distal end, a first biocompatible graft material, and a second biocompatible graft material adjacent to and surrounding the perimeter of the at least one fenestration. The second biocompatible graft material has at least one characteristic different from the first biocompatible graft material and is more flexible than the first biocompatible graft material and is movable relative to the surface plane of the tubular graft body.

Abstract: A small vessel stent graft with a fixation coupling that has a hyperboloid shape positioned at or near the proximal end of the graft. The coupling may be deployed within the fenestration of a fenestrated graft to provide multi-directional movement without compromising the integrity of the sealing zone.

Abstract: A stent graft extends in a flow lumen to span a defective portion of the flow lumen and seal the defective portion from further blood contact. The stent graft includes a pair of apertures, from which extensions project into the renal arteries to seal the passage of blood into the renal arteries from the abnormality. The apertures are larger than the opening of the renal arteries, such that the apertures need not be centered with the renal arteries to enable placement of the extensions. The aperture opening and side branch extensions contain hook and loop structures to provide a variably positionable seal of the aperture opening.

Abstract: A self expanding stent (10) formed from a resilient wire. The resilient wire comprises a zig zag form including an odd number of struts (12) such as seven struts and a bend (14) between each strut. There is first loop (18) of the resilient wire at the terminal end of a first strut and a second loop (18) of the resilient wire at the terminal end of a last strut. The stent as formed is substantially planar but in use is formed into a substantially cylindrical form (20) by being stitched onto a tubular body of a biocompatible graft material with at least the first strut and the last strut overlapping.

Abstract: A bridging device for supporting occlusive masses within an aneurysm located at a vascular bifurcation.

Abstract: A prosthesis having a tubular body of a biocompatible graft material having a proximal end, a distal end, a lumen therethrough, and a sidewall. The prosthesis includes at least one perfusion branch extending from the sidewall of the tubular body and having a proximal end, a distal end, and a lumen therethrough, where the lumen of the perfusion branch is in temporary fluid communication with the lumen of the tubular body. The perfusion branch comprises a self-sealing component, that after predetermined period of time precludes fluid flow out of the distal end of the perfusion branch.

Abstract: A membrane for covering a peripheral surface of a stent is provided, the membrane including a plurality of line openings formed therein. Each line opening may be a straight line opening, for example in the form of a slit, a curved line opening, or any line opening of a suitable shape or curvature, e.g. U-shaped or V-shaped. Blood pressure opens the slits to allow blood to flow through the membrane, while curved line openings create a flap in the membrane that can open to allow blood to pass through. According to further embodiments of the present invention, a method of forming a membrane on a stent and a device for use in a blood vessel are provided.

Abstract: A tubular implant having an axial end to which is attached a ring of spoons of a material different from that of the implant. In another aspect, the invention provides a method of attaching elements to an axial end of a tubular implant comprising the steps of providing said elements on one end of a support tube having a radius substantially that of the implant in its unexpanded configuration, abutting the implant and elements end-to-end, fixing the elements to the implant, and parting the elements from the support tube. In a third aspect, the invention provides an implant carrying an element of another material, the element and implant having complementary tapered mating surfaces for achieving a taper form-fit of the element onto the implant.

Abstract: Each arterial bifurcation lesion has a fingerprint-like pattern related to varying amounts of plaque and degree of obstruction in the main vessel proximal to, within the bifurcation itself, and the distal limbs of the main branch and side branch(es) and related to the angle of the bifurcation. A new device and with it a new technique is described to optimize treatment of bifurcation (and trifurcation) lesions. The invention and related method use a catheter capable of delivering two or more guide wires exiting at the distal end of the catheter allowing treatment of lesions more safely and efficaciously. Safety is increased by allowing both guide wires to remain in place throughout the entire procedure. Efficacy is increased, particularly in the long-term, by providing a result that maximizes vessel coverage and normal flow dynamics in the entire bifurcation area.

Abstract: An endovascular stent-graft (10) includes a generally tubular hourglass-shaped body (22), which is configured to assume a radially-compressed delivery configuration and a radially-expanded deployment configuration. The hourglass-shaped body (22) includes a flexible stent member (26), which includes a plurality of structural stent elements (28); and a tubular fluid flow guide (24), which includes a fabric (29), and is attached to the structural stent elements (28). The hourglass-shaped body (22) is shaped so as to define a narrow waist portion (32) longitudinally surrounded by and adjacent to wider first and second longitudinal portions (30, 34). The fabric (29) along the waist portion (32) is shaped so as to define at least first and second lateral apertures (36, 38). Other embodiments are also described.

Abstract: An abdominal aortic stent includes a first sub-stent and a second sub-stent each having a front end. The circumference of the front end of each sub-stent is half of the circumference of the abdominal aorta. When the circumference is gradually reduced to a rear end of each sub-stent, it has entered one side of the bilateral femoral arteries. The rear ends of the sub-stents with full circumference of the cross-sectional area of the femoral artery are included therein. The first and second sub-stents are coated with external removable membrane to compress the sub-stents to generate smaller circumferences. When the removable membrane has been removed, the sub-stents are fully extended to reconstruct the vascular flow path.

Abstract: A hybrid prosthesis for deployment in a body vessel includes a tubular stent body comprising a wire comprising a shape memory alloy, where the tubular stent body has a self-expanding portion comprising a distal portion of the wire and a balloon-expandable portion comprising a proximal portion of the wire. The shape memory alloy comprises an Af of less than 37° C. in the self-expanding portion and an As of greater than 37° C. in the balloon-expandable portion.

Abstract: A stepped balloon catheter prosthesis deployment system is disclosed for placement of a prosthesis across an Os opening from a main body lumen to a branch body lumen. The prosthesis comprises a radially expansible support at one end, a circumferentially extending link at the other end and at least one frond extending axially therebetween. The prosthesis is configured to be deployed from a stepped diameter balloon with the support in the branch body lumen, with the circumferentially extending link in the main lumen and the frond extendable across the Os.

Abstract: Apparatus and methods for stenting are provided comprising a stent attached to a porous biocompatible material that is permeable to endothelial cell ingrowth, but impermeable to release of emboli of predetermined size. Preferred stent designs are provided, as well as preferred manufacturing techniques. Apparatus and methods are also provided for use at a vessel branching. Moreover, embodiments of the present invention may comprise a coating configured for localized delivery of therapeutic agents. Embodiments of the present invention are expected to provide enhanced embolic protection, improved force distribution, and improved recrossability, while reducing a risk of restenosis and thrombus formation.

Abstract: Aneurysms are treated by filling at least one double-walled filling structure with a curable medium within the aneurysm. The filling structures may be delivered over balloon deployment mechanisms in order to shape and open tubular lumens therethrough. Scaffolds are placed into the tubular lumens in order to help maintain the shape, anchor the filling structures in place, and provide improved blood flow transition into and out of the tubular lumens.

Abstract: A bifurcated intravascular stent graft comprises primary stent segments and a primary graft sleeve, forming a main fluid channel and having a side opening therethrough. An external graft channel formed on the primary graft sleeve has a first end communicating with the side opening and an open second end outside the primary graft sleeve, thereby providing a branch flow channel from the main channel out through the side opening and external graft channel. The primary stent segments and graft sleeve engage an endoluminal surface of a main vessel and form substantially fluid-tight seals. The stent graft further comprises a secondary stent graft, which may be positioned partially within the external graft channel, through the open second end thereof, and partially within a branch vessel. The secondary stent graft engages the inner surface of the external graft channel and the endoluminal surface of the branch vessel, thereby forming substantially fluid-tight seals.

Abstract: The present disclosure includes an endoprosthesis comprising a descending stent-graft, an ascending stent-graft, and/or a side-branch stent-graft. In various embodiments, an ascending stent-graft is capable of being coupled to a descending stent-graft, and/or a descending stent-graft can comprise a fenestration capable of being coupled to a side-branch stent-graft. In addition, in various embodiments, a descending and/or ascending stent-graft can comprise a reduced diameter portion that, when implanted within an aortic arch, recedes from a luminal surface of the aortic arch to allow a side-branch stent-graft to be maneuvered within the aortic arch.