Abstract: The present invention relates to medical techniques, more particularly, to methods and apparatus for delivery of endovasular devices, such as grafts or stent-grafts, and their oversew fixation to the walls of blood vessels in direction from inside these vessels to their outer surface. There is proposed an apparatus for delivery and oversew fixation of grafts or stent-grafts. the apparatus comprises a tubular body with an expandable working head at the free end having eight cartridges, each of them being provided by one basic and at least one standby fastener means, substantially U-shaped staples, a control mechanism, as well as first and second connecting means. The apparatus is also provided with means for positioning inside a blood vessel. Besides, there is proposed a method for delivery and fixation of a graft or stent-graft to the wall of a blood vessel, substantially the aorta, from inside the latter.

Abstract: The present invention relates to a stent (10) for the positioning and anchoring of a valvular prosthesis (100) in an implantation site in the heart of a patient. Specifically, the present invention relates to an expandable stent for an endoprosthesis used in the treatment of a narrowing of a cardiac valve and/or a cardiac valve insufficiency. So as to ensure that no longitudinal displacement of a valvular prosthesis (100) fastened to a stent (10) will occur relative the stent (10) in the implanted state of the stent (10), even given the peristaltic motion of the heart, the stent (10) according to the invention comprises at least one fastening portion (11) via which the valvular prosthesis (100) is connectable to the stent (10). The stent (10) further comprises positioning arches (15) and retaining arches (16), whereby at least one positioning arch (15) is connected to at least one retaining arch (16) via a first connecting land (17).

Abstract: The present invention relates to a stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient. Specifically, the present invention relates to an expandable stent for an endoprosthesis used in the treatment of a narrowing of a cardiac valve and/or a cardiac valve insufficiency. So as to ensure that no longitudinal displacement of a valvular prosthesis fastened to a stent will occur relative the stent in the implanted state of the stent, even given the peristaltic motion of the heart, the stent according to the invention comprises at least one fastening portion via which the valvular prosthesis is connectable to the stent. The stent further comprises positioning arches and retaining arches, whereby at least one positioning arch is connected to at least one retaining arch via a first connecting web.

Abstract: The invention relates to a stent for insertion into and placement inside a body cavity of a human being or an animal, said stent being intended for having a first configuration during insertion into the cavity and said stent, after having been placed in the cavity, being intended for having a second configuration. In an aspect of the invention, an expandable part is constituted by at least one first section of at least one helical winding in a clockwise direction and at least one second section of at least one helical winding in a counter-clockwise direction, each of said first and second at least one section being radially expandable so that during expansion, and where the at least one first section will be rotating in counter-clockwise direction and the at least one second section will be rotating in clockwise direction.

Abstract: A medical prosthesis for implantation within the body of a patient comprises a support structure and an anchoring element that comprises a basal portion and at least one barb extending from the basal portion. The anchoring element may be slidably attached to the strut and the strut may include a first stop and a second stop that define a longitudinal zone of movement for the anchoring element. Other devices and methods are described.

Abstract: A delivery system for delivery of an implantable stented device to a body lumen, the device having a plurality of structures at its proximal end, wherein the delivery system comprises a first body portion removably attached to a second body portion and wherein the second body portion includes a plurality of attachment components at its distal end for attachment to the plurality of structures at the proximal end of the device.

Abstract: Medical devices for implantation in a body vessel, and methods of using and making the same, are provided. A medical device can include a frame with one or more projections each having at least one edge extending from the surface of the frame, and a biocompatible, water-soluble removable material coated over at least a portion of the at least one edge. The projections can be barbs positioned to engage the interior wall of a body vessel or to attach a material, such as a valve leaflet or graft, to the frame. The removable material can be dissolved within a body vessel upon implantation, thereby exposing the at least one edge. Methods of making an implantable medical device and methods of treating a subject are also disclosed.

Abstract: A method is provided for treating a cardiovascular disease, such as pulmonary arterial hypertension, an arrhythmia, or heart failure. One step of the method includes providing an apparatus. The apparatus includes an expandable support member having oppositely disposed proximal and distal end portions and a main body portion extending between the end portions. The proximal end portion includes a plurality of wing members extending from the main body portion. At least a portion of the expandable support member is treated with at least one therapeutic agent for eluting into a blood vessel. The expandable support member is inserted into the pulmonary vasculature and then advanced to a bifurcation in the pulmonary vasculature. The bifurcation includes the intersection of a first pulmonary vessel, a second pulmonary vessel, and a third pulmonary vessel. The expandable support member is secured at the bifurcation to treat pulmonary arterial hypertension, for example.

Abstract: An implantable device having a composite weave graft is disclosed. The device comprises a graft body forming a lumen defining a longitudinal axis and comprising proximal and distal ends. The graft body comprises a composite of low dernier yarns and polymeric yarns configured for low profile delivery and radial elongation relative to the longitudinal axis during use. The graft body has a first portion and a second portion extending from the first portion. The first portion comprises at least one expandable stent radially attached thereto for support and the second portion having corrugations for enhanced kink resistance.

Abstract: Stent-valves (e.g., single-stent-valves and double-stent-valves), associated methods and systems for their delivery via minimally-invasive surgery, and guide-wire compatible closure devices for sealing access orifices are provided.

Abstract: An implantable graft device is disclosed. The device comprises a graft body forming a lumen defining a longitudinal axis and comprising proximal and distal ends. The graft body comprises a woven fabric having warp yarns aligned in a first direction and weft yarns aligned in a second direction. The weft yarns are woven with the warp yarns. A portion of the warp yarns along the longitudinal axis of the graft body are not interwoven with the weft yarns, defining floating yarns having loops aligned in one of the first direction and the second direction. The device further comprises an expandable stent disposed circumferentially about the longitudinal axis and received through the loops of the floating yarns to attach the stent to the graft body.

Abstract: A stent constructed from at least two individual monolithic stent units is provided. The stent includes at least two individual stent units. Each individual stent unit has, as a monolithic structure, a first strut, a second strut, and a third strut. A first apex adjoins the first and second struts, and a second apex adjoining the second and third struts, where the second apex is disposed in a direction generally opposite the first apex. The monolithic stent unit includes an attachment mechanism at the end of at least the first strut. The first strut of each monolithic stent unit is joined at an attachment point to the third strut of an adjacent monolithic stent unit. The attachment mechanism is bent to form an angle relative to the attachment point. A method of manufacturing the same stent also is provided.

Abstract: An implantable graft device having treated yarn is disclosed. The device comprises a graft body forming a lumen defining a longitudinal axis and comprising proximal and distal ends. The graft body comprises a woven fabric having warp yarns aligned in a first direction and a weft yarns aligned in a second direction. At least one of the weft yarns and the warp yarns has an agent applied thereto defining treated yarns of the graft body.

Abstract: The present invention relates to methods of treating tissue of the human body, specially, methods of promoting cell proliferation and ingrowth around implantable medical devices. The methods include inserting an apparatus comprising asperities adapted to injure native tissue at a desired anchoring location, injuring the native tissue at the desired anchoring location with the apparatus to initiate an injury response in the native tissue to thereby promote cell proliferation and ingrowth; and implanting the medical device at the treatment location.

Abstract: A supplemental elasticity device is attached to an artery in the knee to replace lost elastic behavior. The supplemental elasticity device is attached near both ends of the vessel section which it is intended to compress. In this case, the vessel section extends from the adductor canal to below the knee joint. Supplemental elasticity device fixation can be achieved by tabs, spikes or hooks extending from the supplemental elasticity device or increased friction between the supplemental elasticity device and vessel wall, or a combination of both. To assist with maintaining hemostasis, the fixation points may include fabric patches on the supplemental elasticity device surface. The supplemental elasticity device can be deployed in an un-stretched or nominal length when the leg is bent. It is also possible to deploy when the leg is straight if the supplemental elasticity device is in an elongated configuration during deployment.

Abstract: The present embodiments provide a barbed stent having at least one integrally-formed barb. In one embodiment, the barbed stent comprises a stent having at least one segment forming a strut. A slit is formed in the strut, preferably such that the slit is disposed partially but not entirely through the strut. A barbed portion is formed extending from the strut, whereby the slit separates the barbed portion from a remainder of the strut. The barbed portion then may be bent at an angle with respect to the strut, and a sharpened tip suitable for engaging tissue may be formed, for example, by grinding an end region of the barbed portion.

Abstract: A connector for surgical anastomoses is disclosed. The connector has a sleeve with an inlet and an outlet. The inlet is for fluid connection with a first blood vessel. The inlet is generally co-axial with the first blood vessel. The outlet is for fluid connection with a second blood vessel. The outlet is generally orthogonal to the second blood vessel.

Abstract: A combination of a vascular prosthesis and retaining element, whereby a tubular retaining element (2) is arranged on at least one end of the vascular prosthesis (1), such that the above at least partly extends into the vascular prosthesis (1).

Abstract: Delivery systems and methods for delivering modular endovascular graft devices that allow one portion of the repair device to be deployed while maintaining control of the other portions. One system includes an elongate inner member including an anchor stop ring, the anchor stop ring including a plurality of recesses, each sized to receive a portion of the trunk portion and embedding portion of a respective hook in the delivery configuration, each embedding portion extending radially outwardly at an acute angle relative to the trunk portion in the delivery configuration. The delivery systems are simpler to use, easier to manufacture and facilitate better packing of the repair device.

Abstract: A method for performing a coronary artery bypass graft procedure on a patient to connect a bypass vessel to a target vessel includes the steps of creating an opening in the patient that communicates with the thoracic cavity of the patient; providing a bypass vessel having a lumen and at least one free end; passing the free end of the bypass vessel from the thoracic cavity through the opening to a position outside the body of the patient; attaching a connector to the free end of bypass vessel while the free end of the bypass vessel is outside the body of the patient; passing the free end of the bypass vessel from the position outside the body of the patient through the opening and into the thoracic cavity; and connecting the free end of the bypass vessel to a target vessel with the connector.

Abstract: A cardiac prosthesis fixing device made up of a tubular element that can be accommodated inside a valve annulus of a heart and is provided with a bottom flange and top flange, between which the valve annulus can be accommodated. The bottom flange is bent, or can be bent, reversibly, against a resilient force, from a first outward-pointing position into a second position in which the projection of the bottom flange on a radial transverse surface of the tubular element is located essentially on and/or within the periphery of the tubular element and the bottom flange is fixed or can be fixed in the second position in such a way that the fixing can be released in order to bend back the bottom flange towards the first position under the influence of the resilient force.

Abstract: Described herein are implantable medical devices comprising a biocompatible polymer comprising a triggerable bioadhesive property that allows the device to adhere to body tissue. The triggerable bioadhesive property of the polymer can be triggered or activated by exposure to a stimulus. Also, the present invention pertains to methods of making an implantable medical device comprising a biocompatible polymer comprising a triggerable bioadhesive property that allows the device to adhere to body tissue.

Abstract: Devices, systems, and methods for implanting expandable prostheses in the body lumens rely on stapling or anchoring the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable, and may include a single lumen or more than one lumen. After initial placement, a stapling system is introduced within the expanded prosthesis to deploy a plurality of fasteners to at least one prosthesis end. The stapling system may apply a force to the prosthesis to modify the shape of the prosthesis to conform to the shape of the vessel wall. The stapling system can be deflected in one or more distinct steerable segments. A lumen extension or lumens may be coupled to the prosthesis to extend the reach of the prosthesis within the implantation site. Fasteners may also be applied to the lumen extensions.

Abstract: A hybrid modular endovascular graft wherein a main graft is sized to span at least a portion of a target vessel lesion in a large percentage of patients. Graft extensions may be secured to the main graft to extend the main graft and provide a sealing function for some applications.

Abstract: A vascular graft includes an elongated main body portion, a first sewing ring, a second sewing ring, and a third sewing ring. The elongated main body portion includes a first end defining a first opening, a second end defining a second opening, and an aperture defined by a perimeter. The first sewing ring is securely attached to the perimeter of the aperture. The second sewing ring is securely attached to the first end of the main body portion adjacent the first opening. The third sewing ring is securely attached to the second end of the main body portion adjacent the second opening.

Abstract: Apparatus and methods utilize an intraluminal fastener applier having a guide body with a longitudinal axis. The guide body is sized and configured for intraluminal deployment in a hollow body organ. An actuated assembly is carried by the guide body that is selectively operable to generate an implantation force to implant at least one fastener into tissue within the hollow body organ. The actuated assembly includes a driven member extending generally along the longitudinal axis, which is sized and configured to engage a selected fastener. The actuated assembly also includes a drive member coupled to the driven member to impart the implantation force to the driven element in a direction that is at an angle to the longitudinal axis of the guide body.

Abstract: Methods and devices for a coupler adapted and configured for use with a device insertable within a mammalian body are disclosed. The devices comprise, for example, an elongate member having a lumen therethrough; and a flange extending from the elongate member at a first end further comprising a tissue engaging surface; an opening along a length of the elongate member having a width less than a diameter of the insertable device and adapted and configured to engage the insertable device within the lumen of the elongate member.

Abstract: A fastening device is provided to be associated with a first object, for the attachment of the object to a second object. The device comprises at least one fastening element having a base portion and at least one securing portion. The fastening element is originally produced with its securing portion having a first orientation relative to the base portion and with a possibility to bring the securing portion into a second orientation relative to the base portion, to allow the at least one securing portion to penetrate the second object being exposed thereto while staying in the second orientation, and being adapted to change the second orientation into the first orientation to provide the attachment.

Abstract: A stent is described and comprises an elongate strut having a first end and a second end, an aperture formed in the strut, and a barb having a base and a distal anchor. The barb base is attached to the strut and the barb extends distally from the base through the aperture. Other devices, systems, and methods are described.

Abstract: Apparatus and methods implant a fastener in a targeted body region, e.g., a hollow body cavity or an intraluminal space. The apparatus and methods deploy in the targeted body region a fastener attachment assembly that carries an actuated member. The actuated member is selectively operable to generate an implantation force to implant a fastener into tissue within the targeted body region. The fastener can be implanted, e.g., to secure a prosthesis, e.g., an endovascular graft. The systems and apparatus apply a resolution force at or near the actuated member, thereby making possible a stable and dependable catheter-based fastening platform.

Abstract: Methods, devices and systems facilitate retention of a variety of therapeutic devices. Devices generally include an anchoring element, which has been designed to promote fibrotic ingrowth, and an anchored device, which has been designed to firmly engage the complementary region of the anchoring element. The anchoring element may be placed in a minimally invasive procedure temporally separated from the deployment of the anchored device. Once enough time has passed to ensure appropriate fixation of the anchoring element by tissue and cellular ingrowth at the site of placement, the anchored device may then be deployed during which it firmly engages the complementary region of the anchoring element. In this manner, a firm attachment to the implantation site may be made with a minimum of required hardware. Some embodiments are delivered through a delivery tube or catheter and while some embodiments may require laparoscopy or open surgery for one or more of the placement procedures.

Abstract: Self-expanding stent delivery systems and methods having an introducer that receives a delivery catheter. The delivery catheter includes an outer body, an inner body and a stent loaded onto a stent bed within the inner body. The outer body receives the inner body with the stent loaded on the stent bed thereof. The outer body helps constrain the stent in its undeployed state in the stent bed until the stent is deployed by retraction of the outer body of the delivery catheter when the stent is identified as positioned across an intended treatment site. At least one anchoring mechanism provided on the inner body helps maintain the undeployed loaded stent appropriately in the stent bed during deployment. The at least one anchoring mechanism can include radiopaque material to increase fluoroscopic visualization of the stent during deployment, and the self-expanding stent can be a bio-absorbable material including drugs or other bio-active agents incorporated therein or provided thereon.

Abstract: To improve radiopacity in a stent, and to reduce trauma while improving stent anchoring, imported beads are mounted To stent precursor matrices. Specially attractive is to provide a ring of such beads on the end rings of stent structures featuring a cylindrical mid length section flanked by outwardly flared ends. The beads can be of the same or different material from that of the stent matrix. The beads can assist in drawing the stent into a sleeve of a delivery system. Beads can be used to reveal features of the stent away from an end ring, such as a fenestration in the cylinder. Beads can be fixed in a position mechanically or by welding.

Abstract: A composite prosthesis (19, 99, 199) and method are disclosed herein. This endoluminal prosthesis is constructed by separately deploying a first prosthesis (9, 201) and a second prosthesis (14, 208), wherein the first prosthesis is deployed and secured to the interior surface of a body lumen (260). In a subsequent step, the second prosthesis is deployed substantially within and secured to the first prosthesis. Although additional prostheses may be deployed within the second prosthesis, in a preferred configuration the first and second prostheses combine to provide all of the necessary attributes associated with a functioning endoluminal prosthesis. Thus, one of the first and second prostheses is permeable to blood and exerts sufficient radial force to cause the composite prosthesis to securely engage an interior surface of the body lumen at one or both of the composite prosthesis's proximal and distal ends, while the other of the first and second prostheses is impermeable to blood flow.

Abstract: Apparatus and methods for endoluminally advancing a tubular prosthesis and a plurality of fasteners to a site in a lumen in a human body and passing the fasteners from an inner surface of the prosthesis through the prosthesis and a wall of the lumen to secure the prosthesis to the wall. Embodiments include simultaneous deployment of fasteners using a graft alone or in conjunction with a stent graft. Another arrangement includes guide lines to guide the end of the fixation deployment device to a specific location of the wall of the prosthesis.

Abstract: A stent graft includes at least one aperture extending through the main body thereof, into which an extension portion may be deployed for positioning within an adjacent branch flow lumen. The extension portions include self biasing features, wherein the extension is biased into engagement with the main body to seal the interface thereof. Additionally, the extension portion may be configured for tortuous or deviated anatomy, to enable sealing of the extension portion with the body while extending the extension portion in a substantially non-radial direction from the main body.

Abstract: The present invention discloses an artificial blood vessel stent, which can minimize the diameter of a stent insertion device because the diameter (profile) thereof is uniform and small over the entire length upon being loaded, and accordingly can be easily placed in a branched portion of a blood vessel using a puncture method.

Abstract: Methods and apparatus for making an anastomotic connection between first and second tubular fluid conduits are provided. For example, a connector may be configured for attachment to the first and second tubular fluid conduits and have an interior thereof substantially accessible to the interior of the first tubular fluid conduit. The connector may be configured for annular enlargement. An expandable structure is provided having a first portion configured to annularly enlarge the connector by engaging the interior of the connector. A second portion may be configured to extend through an opening in the medial portion of the first tubular fluid conduit.

Abstract: A tubular tissue graft device is provided comprising a tubular tissue and a restrictive fiber matrix of a bioerodible polymer about a circumference of the tubular tissue. The matrix may be electrospun onto the tubular tissue. In one embodiment, the tubular tissue is from a vein, such as a saphenous vein, useful as an arterial graft, for example and without limitation, in a coronary artery bypass procedure. Also provided is method of preparing a tubular graft comprising depositing a fiber matrix of a bioerodible polymer about a perimeter of a tubular tissue to produce a tubular tissue graft device. A cardiac bypass method comprising bypassing a coronary artery with a tubular tissue graft device comprising a vein and a restrictive fiber matrix of a bioerodible polymer about a circumference of the vein also is provided.

Abstract: Methods and apparatus for occluding an anatomical structure including a device having at least first and second clamp portions adapted to cooperate to move from an open position adjacent an anatomical structure to a closed position engaging and occluding the anatomical structure. A system for delivery of a fluid to affect occlusion of an anatomical structure is provided, as well as an applicator for deploying occlusion devices having different sizes.

Abstract: A medical device for implantation in a vessel is disclosed. The medical device comprises at least one anastomotic member, at least partially interposing a non-woven liner of electrospun fibers and a non-woven cover of electrospun fibers. The at least one anastomotic member is designed for engaging at least one end of the medical device to a wall of the vessel upon implantation of the medical device within the vessel.

Abstract: A system and method for joining an end of a tubular prosthesis to the wall of a vessel wherein an anvil is inserted into the vessel through an opening in the vessel wall produced by a cutting surface on the anvil. The anvil is operated via an anvil handle which may extend through the tubular prosthesis. The tubular prosthesis is guided to the opening in the vessel wall whereupon jaws clamp the prosthesis around the anvil. Staples mounted on the jaws engage the anvil and are bent to thereby staple the end of the tubular prosthesis to the vessel wall. A cutting edge may be mounted to the anvil and utilized to create an enlarged hole to permit blood flow into the tubular prosthesis and to permit removal of the anvil from the vessel.

Abstract: An intravascular implantable medical device includes a detachable tether arrangement. In one embodiment, the detachable tether arrangement comprises a tip assembly that includes a break-away joint and a tether portion, and may also include a connector and an extension portion connected to an end of an elongated intravascular implantable medical device. In this embodiment, the break-away joint is disposed between the extension portion and the tether portion. In some embodiments, the extension portion may comprise a housing or other arrangement that includes an antenna for transmitting and receiving data. In other embodiments, the extension portion may also include a lead for defibrillation, pacing, and/or sensing cardiac electrical activity. In certain embodiments, the tether arrangement is designed to be secured within a patient's vasculature with a vascular anchor either in the form of a separate anchor, such as a conventional stent, or by various integrated retention arrangements.

Abstract: Methods and devices are provided for applying retrograde perfusion of blood at various locations within the body. In certain exemplary embodiments, the methods and devices are particularly useful during open or translumenal surgical approaches to apply long-term retrograde perfusion of the myocardium, the neurosystem, or a periphery, such as the arm or leg, thereby treating various medical conditions, such as coronary artery disease, stroke, renal failure, etc.

Abstract: An apparatus for facilitating securement of a vascular graft within a blood vessel, includes a shaft dimensioned for passage within a blood vessel and having an expansion member movable between a contracted condition and an expanded condition and a fastener array comprising at least one fastener disposed about a peripheral portion of the expansion member. The one fastener is deployable into a wall of the blood vessel upon movement of the expansion member to the expanded condition thereof, to thereby engage the vascular graft to secure the vascular graft to a wall of the blood vessel. The fastener array preferably includes a plurality of fasteners. The fasteners may be operatively connected to each other and releasably secured to the peripheral portion of the expansion member.

Abstract: An implantable shunt for the repair of a blood vessel, which is capable of remaining in place temporarily or for extended periods, which comprises a hollow tube, and flanges positioned at regular intervals along the tube's length, ending at both ends. The shunt is made of non-coagulative material. In operation, damaged vessels are severed and bridged by this implantable shunt, which is secured in place inside a vessel by applying ligatures to flanges on its end.

Abstract: An anchoring device for incorporation into an endoluminal prosthesis to prevent migration thereof in a reliable way without the problems associated with intraluminal delivery of the prosthesis. The anchoring device allows smooth, efficient delivery of the prosthesis by providing an anchoring system that does not engage the delivery catheter or sheath upon deployment of the prosthesis within a body lumen.

Abstract: A device is provided for piercing a graft and artery wall in order to retain the graft on the artery. The device has a central section with an abutment surface for contacting the inner wall of the graft and two elongate members with distal ends for contacting the outer wall of the artery when the device is pierced through the graft and artery. The elongate members are biased so as to urge the abutment surface into the graft and retain the graft on the artery.

Abstract: The present invention relates generally to a surgical instrument. In particular, the present invention relates to a fastener remover for use during the repair of abdominal aortic aneurysms. The fastener remover, in accordance with an embodiment of the present invention, comprises an outer catheter, an inner sheath, and a gripping member. The outer catheter comprises a hollow passage with a proximal end and a distal end. The inner sheath is disposed within the hollow passage of the outer catheter, extending from the outer catheter's proximal end to the distal end. The gripping member is located within the inner sheath, extending from the outer catheter's proximal end to the distal end. The gripping member comprises a connector portion connected to an elongated stem.

Abstract: A stent is provided for an endoprosthesis having a main body portion and two leg portions, particularly suitable for treatment of an abdominal aortic aneurism. The stent includes barbs that are twisted and shaped set to point radially outward. Each barb, as formed, points substantially perpendicular relative to the longitudinal axis of the stent, even when in a non-deployed configuration. The motion to move the barb into a deployed configuration for gripping tissue is a twisting motion which moves the barb from being substantially aligned with the circumference of the stent to extending radially outwards from the stent.