An integrated valve prosthesis includes an anchor stent, a tether component, and a valve component. The anchor stent includes a self-expanding tubular frame member configured to be deployed in the annulus of an aortic valve or the aorta. The valve component includes a valve frame and a prosthetic valve coupled to the valve frame, and is configured to be deployed within the anchor stent. The tether component includes a first end coupled to the anchor stent and a second end coupled to the valve frame. In the delivery configuration, the tether component extends in a first direction from the anchor stent to the valve component, and in the deployed configuration, the tether component extends in a second direction from the anchor stent to the valve component. The second direction is generally opposite the first direction. The tether component may set the location of the valve component relative to the anchor stent.

A delivery device can include several different features including, at least: a shuttle and trigger retraction of an outer sheath; an interlock device to prevent actuation of the trigger; a retraction override switch and lock; and an inner shaft adjuster to ensure correct alignment of the inner shaft and the outer sheath prior to device deployment. The inner shaft adjuster may include, at least: a proximal portion of the handle housing having slots therethrough: pins operatively fixed to the inner shaft and extending through and slidable within the slots: and a cap having an inner helical groove that mates with the pins. Rotation of the cap may push the pins and the inner shaft in a proximal-distal direction. The cap may have a distal lip configured to accept a proximal extension of the interlock and retain it in a locked position until the inner shaft has been adjusted or moved.

A stent graft for placement in a vessel of a patient, the stent graft that has a tubular body of graft material, the tubular body having a proximal inflow end, a distal outflow end, a main lumen therethrough, a longitudinal access, and a sidewall from the first end to the second end. At least one stent is along the length of the tubular body. One or more shaped recesses are formed of a concave or recessed portion of graft material that extends into the lumen of the stent graft. A fenestration is in the recessed portion with a fenestration and an internal branch extends from the or each fenestration toward the proximal end of the tubular body of graft material. The internal branch may have a tubular portion and a funnel portion, wherein the tubular portion extends into the main lumen and the enlarged funnel portion is attached to sidewall and forms the at least one shaped recess.

Described herein are radially self-expanding stents. The disclosed stents can be used to widen arteries and/or veins of a patient to counteract or combat narrowing of the arteries and/or veins associated with certain congenital diseases, such as aortic coarctation. As an example, the disclosed stents are configured to be placed at or near a narrowed portion of the aorta where the stent produces a radial outward force on the aorta. The radial force produced by the stent widens the aorta and causes the stent to expand with the aorta. The disclosed stents can be crimped to relatively small sizes for placement in small patients (e.g., less than about 10 kg in size) and can be configured to expand to widen the aorta and to accommodate growth in the patient.

A plaque tack can be used for holding plaque against blood vessel walls such as in treating atherosclerotic occlusive disease. The plaque tack can be formed as a thin, annular band for holding loose plaque under a spring or other expansion force against a blood vessel wall. Focal elevating elements and/or other features, such as anchors, can be used to exert a holding force on a plaque position while minimizing the amount of material surface area in contact with the plaque or blood vessel wall and reducing the potential of friction with the endoluminal surface. This approach offers clinicians the ability to perform a minimally invasive post-angioplasty treatment and produce a stent-like result without using a stent.

A stent includes a cylindrical main body portion, a linkage portion, and a marker attachment portion. The main body portion extends in an axial direction. The linkage portion extends from an end of the main body portion in the axial direction. The marker attachment portion is linked to the main body portion through the linkage portion. The linkage portion includes a bent portion tilting the marker attachment portion outward in a radial direction of the main body portion.

A stent graft for placement in a vessel of a patient, the stent graft that has a tubular body of graft material, the tubular body having a proximal inflow end, a distal outflow end, a main lumen therethrough, a longitudinal access, and a sidewall from the first end to the second end. At least one stent is along the length of the tubular body. One or more shaped recesses are formed of a concave or recessed portion of graft material that extends into the lumen of the stent graft. A fenestration is in the recessed portion with a fenestration and an internal branch extends from the or each fenestration toward the proximal end of the tubular body of graft material. The internal branch may have a tubular portion and a funnel portion, wherein the tubular portion extends into the main lumen and the enlarged funnel portion is attached to sidewall and forms the at least one shaped recess.

A plaque tack can be used for holding plaque against blood vessel walls such as in treating atherosclerotic occlusive disease. The plaque tack can be formed as a thin, annular band for holding loose plaque under a spring or other expansion force against a blood vessel wall. Focal elevating elements and/or other features, such as anchors, can be used to exert a holding force on a plaque position while minimizing the amount of material surface area in contact with the plaque or blood vessel wall and reducing the potential of friction with the endoluminal surface. This approach offers clinicians the ability to perform a minimally invasive post-angioplasty treatment and produce a stent-like result without using a stent.

An endoluminal device can be configured for precise positioning during deployment within a vessel. The endoluminal device can be a tack, stent, vascular implant or other type of implant. The endoluminal device can have circumferential member with an undulating configuration having multiple inward and outward apexes and struts extending therebetween. Two of the struts can be used to establish a foot for the precise positioning of the device during deployment. A method of placing the endoluminal device can include withdrawing an outer sheath such that a portion of the endoluminal device is expanded prior to the rest of the endoluminal device.

A prosthetic assembly configured for endovascular placement within an aortic arch and method of use thereof. The prosthetic assembly includes a proximal aortic stent-graft prosthesis configured to be positioned within a proximal portion of the aortic arch adjacent to the brachiocephalic artery, a distal aortic stent-graft prosthesis configured to be positioned within a distal portion of the aortic arch adjacent to the left subclavian artery, a first branch stent-graft prosthesis configured to be positioned within the brachiocephalic artery and a second branch stent-graft prosthesis configured to be positioned in one of the left common carotid and the left subclavian artery. When deployed, a proximal end of the first branch stent-graft prosthesis is disposed within a lumen of the proximal aortic stent-graft prosthesis to proximally displace the ostium of the brachiocephalic artery. When deployed, a proximal end of the distal aortic stent-graft prosthesis is disposed within the distal end of the proximal aortic stent-graft prosthesis to form an overlap between the proximal and distal aortic stent-graft prostheses. The overlap is relatively increased by the first branch stent-graft prosthesis proximally displacing the ostium of the brachiocephalic artery.