A system includes a core and a catheter for use with (A) a first atrial arm and a first ventricular arm articulatable with respect to each other at a first articulation site to clamp one leaflet of a patient's native heart valve, and (B) a second atrial arm and a second ventricular arm articulatable with respect to each other at a second articulation site to clamp another native leaflet of the native valve. The core tapers in a distal direction toward its smallest perimeter, defining a minimum nonzero angle of the atrial arms with respect to a central longitudinal axis of the core. The catheter advances the core and the arms toward the native valve. The catheter and the core have an advancement configuration in which the smallest perimeter of the core is adjacent to the first and second articulation sites. Other embodiments are also described.

An implant includes a clip and a clip-controller interface. The clip is disposed laterally from a central longitudinal axis of the implant, includes first and second arms articulatably coupled to each other, and sandwiches a leaflet of a heart valve between the first and second arms by articulation between the first and second arms, such that the second arm is disposed laterally from the first arm. The clip-controller interface is reversibly coupled to a clip controller of a delivery tool, and includes first and second portions. The first portion is linearly slidable by the clip controller. The second portion is articulatably coupled to the first portion and to the second arm, such that linear sliding of the first portion causes the second portion to (i) articulate with respect to the first portion, and (ii) push the second arm to articulate toward the axis. Other embodiments are also described.

A medical implant delivery system is described. The system can be used to deliver a variety of implants including stents and/or stent grafts. The delivery system retains the implant during delivery and detaches the implant at a target location.

A method of reducing tricuspid valve regurgitation is provided, including implanting first, second, and third tissue anchors at respective different first, second, and third implantation sites in cardiac tissue in the vicinity of the tricuspid valve of the patient. The geometry of the tricuspid valve is altered by drawing the leaflets of the tricuspid valve toward one another by applying tension between the first, the second, and the third tissue anchors by rotating a spool that (a) winds therewithin respective portions of first, second, and third longitudinal members coupled to the first, the second, and the third tissue anchors, respectively, and (b) is suspended along the first, the second, and the third longitudinal members hovering over the tricuspid valve away from the annulus of the tricuspid valve. Other embodiments are also described.

A method of reducing tricuspid valve regurgitation is provided, including implanting first, second, and third tissue anchors at respective different first, second, and third implantation sites in cardiac tissue in the vicinity of the tricuspid valve of the patient. The geometry of the tricuspid valve is altered by drawing the leaflets of the tricuspid valve toward one another by applying tension between the first, the second, and the third tissue anchors by rotating a spool that (a) winds therewithin respective portions of first, second, and third longitudinal members coupled to the first, the second, and the third tissue anchors, respectively, and (b) is suspended along the first, the second, and the third longitudinal members hovering over the tricuspid valve away from the annulus of the tricuspid valve. Other embodiments are also described.

An endoprosthesis has an expanded state and a contracted state, the endoprosthesis includes a stent having an inner surface defining a lumen, having an outer surface, and defining a plurality of apertures through the outer surface, wherein the apertures are arranged in a micropattern; and a coating (e.g., polymeric coating) attached to the outer surface of the stent. The coating includes a base and a tissue engagement portion including a second surface facing outwardly from the stent, the tissue engagement portion including a structure that defines a plurality of holes extending inwardly from the second surface toward the base. The holes are arranged in a micropattern. When the endoprosthesis is expanded to the expanded state in a lumen defined by a vessel wall, the structure applies a force that may reduce stent migration by creating an interlock between the vessel wall and the endoprosthesis.

An endoprosthesis has an expanded state and a contracted state, the endoprosthesis includes a stent having an inner surface defining a lumen, having an outer surface, and defining a plurality of apertures through the outer surface, wherein the apertures are arranged in a micropattern; and a coating (e.g., polymeric coating) attached to the outer surface of the stent. The coating includes a base and a tissue engagement portion including a second surface facing outwardly from the stent, the tissue engagement portion including a structure that defines a plurality of holes extending inwardly from the second surface toward the base. The holes are arranged in a micropattern. When the endoprosthesis is expanded to the expanded state in a lumen defined by a vessel wall, the structure applies a force that may reduce stent migration by creating an interlock between the vessel wall and the endoprosthesis.

A medical device comprises a substrate (10) defining a major surface (9) defining a plane, including a plurality of first struts (14) along a first direction interconnected with a plurality of second struts (12) extending along a second direction not parallel with the first direction, wherein widths (11) of the second struts as measured along the major surface are larger than thicknesses of the second struts as measured perpendicular to the major surface such that when the substrate is stretched in the first direction, intermediate sections (15) of the second struts (12) rotate relative to the first struts (14) and the intermediate sections of the second struts bend out of the plane of the major surface. The medical device is operable to extend and/or retract elements suitable for a particular purpose. The elements are extended and/or retracted in response to a stress applied by way of stretching and/or retracting the device, among other methods. The elements may remain extended and/or retracted or may recoil back to an initial position upon the removal of the force. In various embodiments, the elements are used to treat or deliver treatment to a target site within a body.

Endovascular systems for deployment at branched arteries include a main tubular graft body deployable within a main artery including a proximal end and an opposed distal end. The proximal and distal ends have a tubular graft wall therein between. A plurality of inflatable channels are disposed along the main tubular graft body, and at least one stent segment is disposed along the tubular graft wall of the main tubular graft body. The plurality of inflatable channels are configured to be inflatable with an inflation medium. The at least one stent segment is disposed between two or more adjacent inflatable channels of the plurality of inflatable channels.

Endovascular systems for deployment at branched arteries include a main tubular graft body deployable within a main artery including a proximal end and an opposed distal end. The proximal and distal ends have a tubular graft wall therein between. A plurality of inflatable channels are disposed along the main tubular graft body, and at least one stent segment is disposed along the tubular graft wall of the main tubular graft body. The plurality of inflatable channels are configured to be inflatable with an inflation medium. The at least one stent segment is disposed between two or more adjacent inflatable channels of the plurality of inflatable channels.