Systems and methods are provided for extravascularly bypassing an occlusion within a patient's blood vessel. An upstream bypass stent may be implanted at an implant site upstream of the occlusion and a downstream bypass stent may be implanted at an implant site downstream of the occlusion, wherein an outlet of the upstream stent and an inlet of the downstream stent are coupled extravascularly to permit blood to extravascularly bypass the occlusion. The upstream stent further may include an additional outlet that directs blood to flow through the occluded blood vessel. A kit including a percutaneous tumescence tunneler for implanting the extravascular bypass system is also provided.

Expandable devices are disclosed herein. Several of the embodiments are directed towards an expandable device comprising a mesh configured to be expanded at a blood vessel bifurcation of a human patient. The mesh may comprise a tubular body portion and one or more circumferentially discontinuous articulating portions. The mesh may be expanded such that the one or more articulating portions are positioned at an angle to the tubular body portion.

The techniques of this disclosure generally relate to a modular assembly including first and second stent-grafts. The first stent-graft includes a body portion having a first diameter and a waist portion having a second diameter less than the first diameter. The waist portion is at a distal end of the first stent-graft. The second stent-graft includes a captured proximal portion configured to be located within the first stent-graft. The captured proximal portion includes a seated portion configured to be located proximal to the waist portion. The seated portion has a third diameter greater than the second diameter to form a mechanical interlock between the first stent-graft and the second stent-graft.

Apparatus for progressively dilating the lumen of a narrow natural vessel such as an iliac artery and implanting a tubular device enabling access through the dilated lumen to conduct subsequent procedures via the dilated lumen, includes an inflatable integrated balloon locatable at least partially within the tubular device, the tubular device having a length L1 providing a self-expanding tubular body having at least a portion including stents, so that when the integrated balloon is removed the dilated lumen of the natural vessel remains dilated and supported by the tubular device.

Systems and methods for repairing aneurysms (e.g., abdominal aneurysm) are provided. The systems and methods provide stent-graft systems having a first stent and a main graft body wherein the main graft body is configured to be inserted through a blood vessel located above a diaphragm of the patient into a target blood vessel. In some instances, the first stent and the main graft body can be in a substantially end-to-end configuration. In some instances, the stent-graft systems and methods are configured for use in a single arterial puncture or incision in, for example, a blood vessel with a diameter less than or equal to the diameter of a femoral artery from the same patient or subject.

Controlled deployable medical devices that are retained inside a body passage and in one particular application to vascular devices used in repairing arterial dilations, e.g., aneurysms. Such devices can be adjusted during deployment, thereby allowing at least one of a longitudinal or radial re-positioning, resulting in precise alignment of the device to an implant target site.

A method of fabricating a casting, the method including applying a substrate to a sacrificial mold, the sacrificial mold including a shaped non-planar receiving surface to receive the substrate and provide a casting of the substrate having a shaped structure corresponding to the receiving surface; and subjecting the sacrificial mold and casting to freeze drying conditions and sublimating the sacrificial mold from the casting to form a cast article including the shaped non-planar structure.

A medical appliance or prosthesis may comprise one or more layers of rotational spun nanofibers, including rotational spun polymers. The rotational spun material may comprise layers including layers of polytetrafluoroethylene (PTFE). Rotational spun nanofiber mats of certain porosities may permit tissue ingrowth into or attachment to the prosthesis. Additionally, one or more cuffs may be configured to allow tissue ingrowth to anchor the prosthesis.

Bifurcated endoprosthetic devices, systems and methods are disclosed herein for treating disease of human vasculature. In various embodiments, a bifurcated endoprosthesis includes a trunk portion and a plurality of legs, where the legs are constrained such that they maintain alignment with one another. In some examples, the legs and bifurcation of an endoprosthetic device may be formed by cutting a tubular graft component along a portion of less than its entire circumference in a longitudinally central region, and then folding the tubular graft component along the uncut portion to define two legs, where the uncut portion defines the bifurcation. In some such examples, the folded tubular graft component can be coupled with a tubular trunk component to form the bifurcated endoprosthetic device.

A compressible and expandable stent assembly for implantation in a body lumen such as a mitral valve, the stent assembly including at least one stent barrel that is shaped and sized so that it allows for normal operation of adjacent heart structures. One or more stent barrels can be included in the stent assembly, where one or more of the stent barrels can include a cylinder with a tapered edge.