An elongate delivery shaft assembly (30) includes an outer covering shaft (38) and an inner support shaft (40). When the delivery shaft assembly (30) is unconstrained and a stent-graft (20) is removably constrained in a radially-compressed delivery state along a distal end portion (34) of the delivery shaft assembly (30), radially between the outer covering shaft (38) and the inner support shaft (40): (a) the delivery shaft assembly (30) is shaped so as to define a self-orienting portion (50), which (i) is shaped so as to define at least proximal and distal curved portions (52A, 52B), the proximal curved portion (52A) disposed more proximal than the distal curved portion (52B), and (ii) at least one point of inflection (53) on a central longitudinal axis (36) of the delivery shaft assembly (30) longitudinally between the proximal and the distal curved portions (52A, 52B), and (b) respective smallest radii of curvature of the proximal and the distal curved portions (52A, 52B), measured at the central longitudinal axis (36), are each between 2.5 and 12 cm.

A stent-graft prosthesis includes a graft material having a tubular construction, a frame coupled to the graft material, and a port or opening disposed between a proximal end and a distal end of the graft material. The port or opening is open during deployment of the stent-graft prosthesis to enable blood flow from a graft lumen within the graft material to exit the graft lumen, and the port or opening is blocked upon full deployment of the stent-graft prosthesis to prevent blood flow from within the graft lumen from exiting the graft lumen through the port or opening.

Apparatus and methods are described including implanting an aortic pressure-loss-reduction device (20) in a subject's ascending aorta. While the device is inside a catheter (42), a distal end of the catheter is placed within the ascending aorta. A proximal covering sheath (44) of the catheter is retracted such as to uncover at least a portion of a downstream anchor (31), such that the uncovered portion of the downstream anchor includes a portion of the frame that does not have material coupled thereto. Subsequently, a distal covering sheath (45) of the catheter is advanced, such as to cause an upstream anchor (33) to anchor an upstream end device (20) to the subject's ascending aorta, by the upstream anchor radially expending against an inner wall of the ascending aorta. Other applications are also described.

A stent graft for treating an arterial aneurysm includes loops fixed to struts of stents, wherein the struts define distal and proximal apices. The ends of a ligature can be linked by a wire in a stent graft delivery system that threads anchor loops longitudinally spanning ends of the ligature to maintain the stent in a radially constricted position during delivery to the aneurysm. A delivery system and method for implanting a stent graft prosthesis includes and employs a torque component at a distal end of the stent graft prosthesis, whereby following advancement of the stent graft to a surgical site in a constrained or partially constrained configuration, torque is applied to the torque component to rotationally align the stent graft about a longitudinal axis of the stent graft, followed by deployment of the stent graft in correct rotational alignment. A delivery system and method of its use includes an apex capture assembly, a leg clasp, and a leg stop for capturing a stent graft during orientation and stabilization at an implantation site of a surgical site.

Various aspects of the present disclosure are directed toward apparatuses, systems, and methods that include an implantable medical device and a constraining line conduit arranged around a circumference of the implantable medical device. The apparatuses, systems, and methods may also include a constraining line arranged through the constraining line conduit.

A stent delivery apparatus includes a guide catheter through which a guide wire is inserted, a pusher catheter including a first lumen through which the guide catheter is inserted and a first communication hole communicating with the first lumen, a stent including a second lumen through which the guide catheter is inserted and a second communication hole communicating with the second lumen and disposed on a distal side of the pusher catheter, and a thread that connects the stent and the pusher catheter to each other in a releasable manner, wherein the thread has a first end portion that through the first communication hole, an intermediate portion that through the second communication hole, and a second end portion that extends around a part of the guide catheter located between a proximal end of the stent and a distal end of the pusher catheter.

A stent graft delivery system includes a handle, a guidewire catheter extending distally from the handle, at least one tube, and at least one wire extending through the at least one tube, wherein each wire of the stent graft delivery system is configured as a loop at the distal end of the tube. The stent graft delivery system can be employed to implant stent grafts in a patient to thereby treat, for example, an aortic aneurysm spanning a region of an aorta that includes at least one arterial branch.

An endovascular system includes an elongate delivery shaft assembly, which, when a stent-graft is removably constrained in a radially-compressed delivery state along a distal end portion of the delivery shaft assembly, is shaped so as to define a self-orienting portion, which is shaped so as to define (a) at least proximal and distal curved portions, the proximal curved portion disposed more proximal than the distal curved portion, and (b) at least one point of inflection on a central longitudinal axis of the delivery shaft assembly longitudinally between the proximal and the distal curved portions. Upon positioning of a distal tip of the system near a bifurcation of a brachiocephalic artery from an aortic arch, the self-orienting portion automatically rotationally orients itself in the aortic arch to a rotational orientation in which an inferior lateral opening of the stent-graft faces upstream in the aortic arch. Other embodiments are also described.

A vascular graft deployment tool may include a grip, an elongated mandrel positioned distal of the grip, a vascular graft, at least part of which is disposed coaxially about the mandrel, a sheath assembly including a distal sheath portion and a proximal sheath potion, wherein the distal sheath portion and the proximal sheath portion are configured to constrain the vascular graft against the mandrel in an insertion diameter and a actuator that is moveable relative to the grip and engages the sheath assembly, wherein operation of the actuator causes at least one of the distal sheath portion and the proximal sheath portion to separate longitudinally to free at least a portion of the vascular graft. Further, a vascular graft is expandable from an insertion state to a deployed state and at least two suture cuffs are located between opposed ends of the vascular graft.

A stent delivery system can include a core assembly sized for insertion into a corporeal lumen and configured for advancing a stent toward a treatment location in the corporeal lumen. The core assembly can include a proximal restraint having a bumper section, a distal section distal to the bumper section, a lumen extending through the bumper and distal sections, and an undercut section including a recess at least partially surrounding the lumen. The recess can abut and/or be formed in the bumper and/or distal sections.