Universal endovascular grafts are provided for evaluation and repair of damaged or aneurismal blood vessels. More particularly, the present invention relates to universal fenestrated and universal branched endografts for repair of blood vessels with branches, methods for implanting the endografts in the vessel and for making connection with one or more branches. The universal fenestrated endografts have a body with a first end, a second end, a first wall, a second wall, and an interior passage or lumen. The body further includes openings in communication with the passage at the first and second ends and one or more lateral fenestrations in communication with the lumen. The body further has a necked portion between the ends and a cannulation member. The universal branched endografts have a tubular body with a main lumen and four branch lumens. A large branch extends from the body. The four lumens are positioned about a circumference of the tubular body.

A visceral double-barreled main body stent graft and methods for its use, the stent graft comprises, a main body stent graft having distal and proximal ends, the main body stent graft's length ranges from about 100-120 mm and diameter at the proximal end ranges from about 30-45 mm, first and second lumens defined at the main body stent graft's distal end, the first lumen's diameter ranges from about 18-20 mm, the second lumen's diameter ranges from about 16-18 mm, the first and second lumens have about the same length from about 50-70 mm, the first lumen is secured to the second lumen along a shared length, and the main body stent graft defines a tubular wall that is contiguous with the first and second lumens such that any fluid entering the main body must exit through one of the first or second lumens.

A stent graft includes a tubular aortic component that defines a lumen and a fenestration with a pocket at the fenestration. At least one proximal tunnel graft extends proximally within the lumen from the proximal opening of the pocket and is secured at a proximal end to the tubular component, and at least one distal tunnel graft extends distally within the lumen from the distal opening of the pocket and is secured at a distal end to the tubular aortic component. The stent graft can further include at least one branch stent graft, each of which extends through the fenestration and within at least one of the proximal tunnel graft or the distal tunnel graft. The stent graft can be implanted in a patient to thereby treat an aneurysm, such as a suprarenal or thoracoabdominal aortic aneurysm.

A stent graft system (1) with a first stent graft (2) expandable in respect of a diameter, and with at least a second stent graft (3). The first stent graft (2) at least in some areas has a tubular net structure (4) which, in an expanded mode, has a net structure (4) with substantially round annular meshes (5). The at least second stent graft (3) has, at a distal end (6), outwardly extending barbs (7) via which the at least second stent graft (3) can be coupled to the first stent graft (2) in the expanded mode. The distal end (6) of the at least second stent graft (3) passes through a round annular mesh (5) of corresponding diameter and, with its outwardly extending barbs (7), engages on the round annular mesh (5). Also, a method for coupling stent grafts as a stent graft system.

The vascular prosthesis includes a luminal graft component having at least one fenestration. At least one fenestration ring borders the at least one fenestration and is fixed to the luminal graft component. The fenestration ring includes a main component with two opposing ends and a connecting component. The diameter of the fenestration ring can expand upon insertion of a branch prosthesis through the fenestration ring during implantation at a surgical site. The vascular prosthesis can be implanted in a patient to thereby treat, for example, an arterial aneurysm, spanning a region of an aneurysm that includes at least one arterial branch.

Provided are a tubular therapeutic implement, a tubular therapeutic implement set, and a tubular therapeutic implement indwelling device, all of which enable appropriate indwelling at a branching portion in a tubular tissue. This stent graft 30 is provided with: a frame portion (32) having a plurality of frame pieces (321-325); and a tubular graft portion (33) which is provided along the frame portion, wherein the tube wall of the graft portion is provided with a lateral opening (through-hole 36 of a branching section 35) that is connected with an inner cavity of the graft portion, and when the region between one end and the other end of the graft portion is compartmented into a first region (P) that includes the lateral opening and a second region (Q) that dose not include the lateral opening, the frame pieces are not situated in the first region, but are in the second region.

A first positional information derivation unit derives first positional information indicating at least one first position related to the insertion of an insertion structure into a target structure in a subject from a preoperative image acquired before a medical procedure for the subject. A second positional information derivation unit derives second positional information indicating at least one second position on the insertion structure from an intraoperative image acquired during the medical procedure for the subject. A display control unit displays, on a display unit, a positional information screen including at least one of a distance between the first position and the second position or an angle related to the first position and the second position on the basis of the first positional information and the second positional information in a coordinate system common to a coordinate system of the preoperative image and a coordinate system of the intraoperative image.

A heart valve assembly includes an inner frame comprising a graft covering housing a prosthetic heart valve, wherein the graft covering extends around the prosthetic heart valve for providing sealing to the heart valve, an outer frame formed from a metallic material and defining a gridded configuration, and being secured to the graft covering by a plurality of stitches, and a sealing material positioned externally to the outer frame for providing sealing between the outer frame and a patient's anatomical wall to prevent paravalvular leaks. The sealing material includes a plurality of radially extending fibers that extend outwardly of the outer frame. The graft covering is made of polyester, polytetrafluoroethylene, expanded polytetrafluoroethylene, or a polymer.

A transcatheter valve includes an outer seal made of outwardly extending fibers and is configured for transfemoral delivery within a patient.

Branched stent grafts and a stent graft delivery system for, and methods of, endovascular repair of abdominal and/or thoracic aortic aneurysms are disclosed. Embodiments of the branched stent grafts include, but are not limited to, branched aorto-uni-iliac (AUI) stent grafts, branched bifurcated stent grafts, and branched thoracic stent grafts. In some embodiments, the branched stent grafts comprise one or more retrograde internal branches. In other embodiments, the branched stent grafts comprise one or more external branches. The stent graft delivery system comprises a larger directional sheath for positioning the branched stent grafts and one or more smaller sheaths for the delivery of, for example, covered stents for the complete exclusion of juxtarenal/pararenal abdominal aortic aneurysms. Methods of using the stent graft delivery system to deploy the branched stent grafts are provided.