A multi-element, vascular stent may be used to maintain or enhance patency of a blood vessel. The stent may be used in peripheral blood vessels, which may be long and/or tortuous. By using multiple, separate stent elements that are balloon expandable, the multi-element stent may be stronger than a traditional self-expanding stent but may also be more flexible, due to its multiple-element configuration, than a traditional balloon-expandable stent. Individual stent elements shorten upon expansion creating a space between stent elements. The distance between stent elements when deployed may be based on characteristics of the stent and the target vessel location such that the stent elements do not touch one another during skeletal movement. Thus, the multi-element, vascular stent described herein may be particularly advantageous for treating long lesions in tortuous peripheral blood vessels.

Methods for crimping a stent on an expandable member of a delivery catheter, and devices and methods for treating a bifurcation are disclosed. A method for crimping includes positioning a stent having a first portion and a second portion over the expandable member, and non-uniformly crimping the stent to the expandable member. The method can include routing an elongate shaft under the second portion of the stent and through the side hole so as to be routed external to the first portion. The stent second portion can be crimped so that the elongate shaft can be slidably disposed relative to the stent second portion prior to deployment of the stent.

A system for treating a bifurcated vessel that includes a first delivery catheter and a second delivery catheter. The first delivery catheter carries a proximal first stent and a distal second stent. The first delivery catheter also has a first elongate shaft, a proximal first expandable member with the proximal first stent disposed thereover, and a distal second expandable member with the distal second stent disposed thereover. The proximal first expandable member and distal second expandable member are independently expandable of one another. The second delivery catheter carries a third stent. The second delivery catheter also has a second elongate shaft, and a third expandable member with the third stent disposed thereover. The third expandable member is independently expandable of the proximal first expandable member and the distal second expandable member.

A branched and fenestrated prosthesis may include a main tubular graft body including a proximal end opening, a distal end opening, a lumen, and a sidewall. A branch may extend from the sidewall and may include a first end opening, a second end opening, and a lumen. A fenestration may be disposed in the sidewall and positioned distal of the second end opening of the branch. The branched and fenestrated prosthesis may include a plurality of branches and a plurality of fenestrations.

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.

An implantable heart valve configured for implantation within an existing prosthetic heart valve includes a frame including struts defining a lattice region and a plurality of arches, and a central lumen extending therebetween, a plurality of protrusions extending radially outward from the plurality of struts, and a valve coupled to the frame and positioned within the central lumen.

A medical implant (20) includes first and second ring members (22, 24), each including a resilient framework (26) having a generally cylindrical form. A tubular sleeve (28) is fixed to the first and second ring members so as to hold the ring members in mutual longitudinal alignment, thereby defining a lumen (32) passing through the ring members. A constricting element (30) is fit around the sleeve at a location intermediate the first and second ring members so as to reduce a diameter of the lumen at the location.

A system for treating a body lumen including a first stent configured to be positioned in a body lumen and a second stent configured to be positioned in the lumen of the first stent prior to removing the first stent from the body lumen. The first stent includes a liner disposed radially inward of the tubular scaffold of the first stent to permit tissue ingrowth within a tissue ingrowth region defined between the liner and the tubular scaffold. The retrieval stent is configured to be expanded within the previously implanted first stent to cause tissue to recede from the tissue ingrowth region to facilitate removal of the first stent from the body lumen.

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 stent delivery system includes a handling device having a housing, a thumbwheel rotatably mounted in the housing, and a winding spool rotating with the thumbwheel. A catheter arrangement includes an inner shaft fixed on the housing. An outer sheath is coaxial to the inner shaft. A stent is received between the inner shaft and outer sheath. A pull member engages the outer sheath and is held on the winding spool to be windable. For release of the stent, the outer sheath is displaceable by winding the pull member on the winding spool. A locking mechanism causes, upon reaching at least one defined angle of rotation of the thumbwheel, a locking state of the rotational mobility of the thumbwheel, and thereby of the proximal displaceability of the outer sheath. An unlocking mechanism is in operative connection to the locking mechanism. The locking state is reversible with the unlocking mechanism.