Stent delivery systems and methods for making and using stent delivery systems are disclosed. An example stent delivery system may include an inner member having a stent receiving region, a stent disposed along the stent receiving region, a deployment sheath axially slidable relative to the inner member, the deployment sheath having a proximal end region, a handle coupled to the deployment sheath, a rod coupled to the handle, the rod having a distal end region, a proximal end region and a first threaded portion extending from the distal end region to the proximal end region and a coupling member configured to couple the rod to the deployment sheath, the coupling member having an engagement portion. Additionally, the first threaded portion of the rod is designed to engage the engagement portion of coupling member and rotation of the rod is designed to translate the coupling member along the rod.

Various systems, devices, and methods for endovascular implants and accurate placement thereof are disclosed. The disclosed implants include a proximal implant segment, a distal implant segment, connector struts connecting the proximal implant segment to the distal implant segment, and a side opening between the proximal implant segment and the distal implant segment. The disclosed implants can be used to create an arteriovenous fistula or connect one vessel of the body to another by placement of the proximal implant segment and the distal implant segment within the vessels to be connected. The disclosed implants can include one or more anchors for securing the implant in place with respect to the vessels of the body it is connecting. The disclosed implants can also include a continuous strut or ring at a distal edge of the proximal implant segment. Also disclosed are methods for accurate percutaneous placement of the implants disclosed, and a device for percutaneous delivery.

A heart valve prosthesis can be delivered in a serial configuration to a native heart valve using a transcatheter approach. The implantation device can utilize track wires to guide a valve anchor of the prosthesis into a desired position within the native valve. A valve frame of the prosthesis can then be advanced into position and expanded within the valve anchor.

A delivery device includes a handle, a central elongate member extending from the handle, a sheath configured to slide over and relative to the central elongate member, a distal tether retainer at a distal end of the central elongate member, a proximal tether restraining mechanism positioned along the central elongate member distal of the handle and proximal of the distal tether retainer, and a plurality of tethers. The tethers are configured to extend from the proximal tether restraining mechanism to the distal tether retainer.

An endoprosthesis delivery system includes an expandable endoprosthesis including a side branch portal, a first primary sleeve releasably constraining a proximal portion of the expandable endoprosthesis to a collapsed configuration, a second primary sleeve in parallel with the first primary sleeve, the second primary sleeve releasably constraining a distal portion of the expandable endoprosthesis to the collapsed configuration, and a secondary sleeve within the first primary sleeve. Upon release of the first primary sleeve, the secondary sleeve releasably constrains the proximal portion of the expandable endoprosthesis to a partially expanded configuration allowing access to the side branch portal via the partially expanded proximal portion of the expandable endoprosthesis.

Methods, apparatuses and systems are described for expandable stent delivery apparatus to cover an access site. The method may include delivering a stent delivery system through an access site, where the stent delivery system comprises a positioning member with a first portion that is rotatable with respect to a second portion, and where the stent is releasably coupled with the first portion of the positioning member. In some cases, the method may further include withdrawing an outer constrainment member front the stent to deploy a proximal portion of the stent within the body lumen and rotating the proximal portion of the stent away from the access site by withdrawing the positioning member proximally and back through the access site. The method may further include covering the access site with the proximal portion of the stent upon fully deploying the proximal portion from the outer constrainment member.

A stent graft delivery system and method of assembling the same is disclosed. The stent graft delivery system includes a stent graft cover configured to maintain a stent graft in a constricted configuration, and is configured to slide relative to the stent graft to enable the stent graft to expand radially outwardly. The stent graft cover extends along a first central axis. A tapered tip defining an opening therethrough is configured to track along a guidewire. The opening extends along a second central axis that is offset from the first central axis. This provides a delivery system with an opening in a leading edge that is not center relative to the outer stent graft cover.

Various systems, devices, and methods for endovascular implants and placement thereof are disclosed. The implants include a proximal implant segment, a distal implant segment, connector struts connecting the proximal implant segment to the distal implant segment, and a side opening between the proximal implant segment and the distal implant segment. The implants can be used to create an arteriovenous fistula or connect one vessel of the body to another by placement of the proximal implant segment and the distal implant segment within the vessels to be connected. The implants can include one or more anchors for securing the implant in place with respect to the vessels of the body it is connecting. The implants can also include a continuous strut or ring at a distal edge of the proximal implant segment. Also disclosed are methods for percutaneous placement of the implants, and a device for percutaneous delivery.

The present disclosure describes medical devices comprising implantable expandable implants, such as stent-grafts. Such devices can comprise a constraining line. The constraining line can surround the proximal end of the expandable implant, and assist in positioning and deployment of the expandable implant within the body of the patient.

The invention relates to a system for deploying an implant, optionally a TIPS stent graft, the system comprising a handle, a catheter extending from the handle, the catheter being arranged for holding an implant at an implant holding portion at a distal end of the catheter, an implant retaining sheath, the implant retaining sheath being arranged so as to surround the implant holding portion so as to retain an implant that is arranged at the implant holding portion, a pull tab, the pull tab being connected to the implant retaining sheath so that a proximal pull on the pull tab pulls back the implant retaining sheath so as to release an implant arranged at the implant holding portion, the pull tab further comprising a engagement feature that is arranged on the pull tab and that is moved proximally as the pull tab is moved proximally, the engagement feature being arranged to engage with a first interference feature arranged at a first fixed longitudinal position on the system for deploying the implant, wherein an engagement between the engagement feature and the first interference feature provides tactile feedback to a user of the system that the implant retaining sheath has been pulled back a pre-set distance.