Methods and apparatuses to place a prosthesis within a receiving structure are provided. A delivery apparatus includes an elongated support member including a support member distal end. A stop cap is disposed at the support member distal end and includes a stop cap transverse dimension larger than an inner diameter of a receiving lumen of the receiving structure. An elongated prosthesis-positioning member extends along the support member and stop cap so a distal surface of the prosthesis-positioning member is disposed at a position longitudinally coincident with a portion of the stop cap. A sheath comprises a sheath lumen receiving the prosthesis-positioning member so the sheath translates longitudinally relative to the prosthesis-positioning member. The delivery apparatus has a loaded configuration in which the prosthesis is received in the sheath lumen with a proximal end of the prosthesis abutting the prosthesis-positioning member distal surface.

Methods and apparatuses to place a prosthesis within a receiving structure are provided. A delivery apparatus includes an elongated support member including a support member distal end. A stop cap is disposed at the support member distal end and includes a stop cap transverse dimension larger than an inner diameter of a receiving lumen of the receiving structure. An elongated prosthesis-positioning member extends along the support member and stop cap so a distal surface of the prosthesis-positioning member is disposed at a position longitudinally coincident with a portion of the stop cap. A sheath comprises a sheath lumen receiving the prosthesis-positioning member so the sheath translates longitudinally relative to the prosthesis-positioning member. The delivery apparatus has a loaded configuration in which the prosthesis is received in the sheath lumen with a proximal end of the prosthesis abutting the prosthesis-positioning member distal surface.

A modular handle assembly comprises a stationary main handle having proximal and distal ends. A first handle extends proximally from the main handle and is rotationally moveable relative to the main handle, the first handle having proximal and distal ends, wherein a rotational interface is located at the distal end. A second handle extends distally from the main handle and is rotationally moveable relative to the main handle, the second handle having proximal and distal ends, wherein a rotational interface is located at the proximal end. The proximal end of the main handle comprises a first rotational interface that is configured to engage with a rotational interface at the distal end of the first handle and wherein the distal end of the main handle comprises a second rotational interface that is configured to engage with the rotational interface at the proximal end of the second handle.

A stent system may include a stent including a first leg having a first end fixedly attached to the distal end of a main body portion and extending distally from the distal end of the main body portion in a deployed configuration, and a second leg having a first end fixedly attached to the distal end of the main body portion and extending distally from the distal end of the main body portion in the deployed configuration. The second leg may extend proximally from the distal end of the main body portion in a delivery configuration. A stent system may include a bifurcated delivery sheath and two guidewires for delivery of two stents at the same time. A method of treating a body lumen may include delivering a contrast fluid including an anti-gas agent while implanting a stent in the body lumen.

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 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.

Devices, systems, and methods for implanting a patient-specific prosthesis at a treatment site in a patient are disclosed herein. In some embodiments, a patient-specific prosthesis includes a tubular graft and a coupling member. A fenestration can be disposed in the tubular graft, the fenestration corresponding to a predicted branch blood vessel location. The coupling member can be disposed about the fenestration. The coupling member can include a coil configured to expand from a first configuration to a second configuration in response to the application of an expanding force. The coil can be configured to contract to a third configuration upon removal of the expanding force.

Devices, systems, and methods for implanting a patient-specific prosthesis at a treatment site in a patient are disclosed herein. In some embodiments, a patient-specific prosthesis includes a tubular graft and a coupling member. A fenestration can be disposed in the tubular graft, the fenestration corresponding to a predicted branch blood vessel location. The coupling member can be disposed about the fenestration. The coupling member can include a coil configured to expand from a first configuration to a second configuration in response to the application of an expanding force. The coil can be configured to contract to a third configuration upon removal of the expanding force.

An endoluminal prosthesis includes a stent-graft and a temporary aortic valve, typically combined in an integrated assembly suitable for transfemoral or other endoluminal placement in a patient's ascending aorta, aortic root, and aortic valve. The stent-graft has a base end configured to be positioned into over the patient's aortic root and over the aortic annulus. The temporary aortic valve assembly is attached to the base end of the stent-graft and comprises a scaffold configured to be anchored in the patient's aortic annulus and valve leaflets configured to function temporarily after the endoluminal prosthesis has been implanted. At least one fenestration suitable for receiving a guidewire and/or a coronary stent graft is located near a junction between the base end of the stent graft and the temporary aortic valve, wherein said at least one fenestration is disposed on the endoluminal prosthesis to be aligned with one of the patient's coronary ostia after the endoluminal prosthesis has been implanted.