A vascular system includes a delivery apparatus and an endovascular device. The delivery apparatus including a catheter and a control lead. The control lead extends through a lumen of the catheter and is configured to be manipulated by a user. The endovascular device is releasably coupled to the delivery apparatus and includes an implant body, a seal extending radially outwardly from the implant body, and one or more tissue engaging elements. The seal is configured to contact native vascular tissue to reduce leakage between the native vascular tissue and the implant body. The tissue engaging elements are pivotable relative to the seal from a compressed state to an expanded state. In the compressed state, the tissue engaging elements are positioned so as to disengage the native vascular tissue. In the expanded state, the tissue engaging elements extend outwardly from the seal and are configured to engage the native vascular tissue.

An anastomotic coupler is provided. A ring can include a plurality of receiving portions. A fixation device includes a cartridge. The cartridge includes a plurality of fasteners. The ring is aligned with the cartridge such that the receiving portions are aligned with the fasteners. Upon actuation of the fixation device, the fasteners puncture the tubular structure and are received by the receiving portions such that the tubular structure is coupled with the ring.

An anastomotic coupler is provided. A ring can include a receiving portion. A fixation device includes a cartridge. The cartridge includes a plurality of fasteners. Upon actuation of the fixation device, the fasteners puncture the tubular structure. The fasteners are received by the receiving portions such that the tubular structure is coupled with the ring.

A method of implanting a prosthetic medical device at a target implantation site is provided. The method first comprises advancing a first prosthetic medical device through a subject's vasculature to a target implantation site. The first prosthetic medical device comprises a coil having an inflow end portion, an outflow end portion, and a central longitudinal axis extending from the inflow end portion to the outflow end portion. The method further comprises expanding the first prosthetic medical device from a compressed state to an expanded state to engage native vascular tissue at the target implantation site. The method subsequently comprises docking a second prosthetic medical device within the first prosthetic medical device.

A surgical stapler includes a proximal end and a distal end and an anvil at the distal end for providing resistance to staples during the stapling operation of the surgical stapler. The anvil may include a number of segments arranged end-to-end. The anvil is elongated in the collapsed state, the anvil being elongated generally in a first direction D1. The anvil is configured such that the segments rotate about a rotation axis along a perpendicular second direction D2 when the anvil is actuated between the deployed and the collapsed states. The anvil is configured such that adjacent segments pivot relative to each other about a pivot axis along a third direction D3 when the anvil is actuated between the deployed and collapsed states. The stapler also includes an actuator mechanism, wherein the actuator mechanism is configured to be controlled from a location on the surgical stapler towards the proximal end.

A surgical stapling apparatus includes a staple cartridge assembly, an anvil assembly operatively associated with the staple cartridge assembly, and a surgical buttress releasably coupled to the staple cartridge assembly or the anvil assembly. The staple cartridge assembly includes a tissue facing surface having staple retaining slots defined therein, each staple retaining slot housing a staple therein, and a circular knife disposed radially inwardly of the tissue facing surface. The anvil assembly includes an anvil member including a tissue facing surface and an anvil shaft extending from the anvil member. The surgical buttress has a circular configuration defining a central aperture therethrough. The surgical buttress includes an inner concentric portion having a therapeutic coating disposed thereon and an outer concentric portion free of the therapeutic coating.

An anastomotic coupler is provided. A ring can include a plurality of receiving portions. A fixation device includes a cartridge. The cartridge includes a plurality of fasteners. Upon actuation of the fixation device, the fasteners puncture the tubular structure. The fasteners are received by the receiving portions such that the tubular structure is coupled with the ring.

An apparatus for forming an anastomosis between adjacent intestinal sections of tissue includes an anastomosis device having an anvil and a tubular body portion, wherein the anvil is selectively attachable to the tubular body portion by a shaft; and a support structure for deposition between the intestinal sections of tissue. The support structure includes a body defining an aperture therein for receiving the shaft. The body has an outer terminal edge. The support structure includes at least one layer of expandable material disposed at the outer terminal edge of the body.

An end effector assembly for use with a circular stapler apparatus permits alignment of the staple forming pockets of the anvil assembly and the staples of the staple cartridge assembly regardless of the relative orientation of the components. The end effector assembly includes a cartridge housing, a staple retainer having a plurality of staples arranged in a circular array, a staple pusher at least partially disposed within the cartridge housing and configured for movement through a firing stroke to eject the staples from the staple retainer, an anvil rod configured for coupling relative to the cartridge housing, and an anvil head including at least one continuous circular staple forming pocket. The staple forming pocket is in registration with the staples for at least partial reception of the staples during the firing stroke. The staple forming pocket is configured for at least partially deforming the staples.

An apparatus for forming an anastomosis between adjacent intestinal sections of tissue includes an anastomosis device having an anvil and a tubular body portion, wherein the anvil is selectively attachable to the tubular body portion by a shaft; and a support structure for deposition between the intestinal sections of tissue. The support structure includes a body defining an aperture therein for receiving the shaft. The body has an outer terminal edge. The support structure includes at least one layer of expandable material disposed at the outer terminal edge of the body.