A stent graft for placement in a vessel of a patient, the stent graft that has a tubular body of graft material, the tubular body having a proximal inflow end, a distal outflow end, a main lumen therethrough, a longitudinal access, and a sidewall from the first end to the second end. At least one stent is along the length of the tubular body. One or more shaped recesses are formed of a concave or recessed portion of graft material that extends into the lumen of the stent graft. A fenestration is in the recessed portion with a fenestration and an internal branch extends from the or each fenestration toward the proximal end of the tubular body of graft material. The internal branch may have a tubular portion and a funnel portion, wherein the tubular portion extends into the main lumen and the enlarged funnel portion is attached to sidewall and forms the at least one shaped recess.

A method for implanting a prosthesis centrally within a curved lumen includes loading a prosthesis into a delivery sheath, advancing the sheath in a patient towards the curved lumen to place at least the proximal end of the prosthesis within the curved lumen, and centering the proximal end of the prosthesis and/or the distal end of the sheath within the curved lumen. In a first advancing step, the outer catheter containing the inner sheath is advanced together towards the curved lumen to a location proximal of the curved lumen and, in a second advancing step, the inner sheath containing the prosthesis is advanced into the curved lumen to place at least the proximal end within the curved lumen while the outer catheter substantially remains at the location. After centering, the proximal end of the prosthesis is deployed centered within the curved lumen.

A support ring for an aortic prosthesis includes a helical coil extending in an arc and defining a space between a helical coil first end and helical coil second end in opposing relation to each other. A wire extending through the lumen defined by the helical coil includes a wire first end and a wire second end that are fixed to each other, and a length between the wire first end and the wire second end that traverses the space between helical coil first end and the helical coil second end. A branch sleeve assembly includes a graft sleeve having a proximal end that defines a plane that intersects a plane defined by the distal end of the graft sleeve, and a support ring fixed to the graft sleeve wall that is closer to the proximal end of the graft sleeve than to the graft sleeve distal end.

A prosthetic graft assembly (40, 120) is disclosed for placement of a patient's aortic arch and repair of the descending aorta in a procedure which requires only a sternotomy. The assembly includes a descending graft element (40) which includes an eversible cuff (52) which can be wrapped over a cut end (26) of the descending aorta (18). Distal perfusion can be re-established prior to aortic arch replacement. A second prosthetic element (120), optimised to the patient, is fitted with a replacement for the aortic arch and attached to the descending aorta graft (40). An introducer assembly (30) having a transparent or translucent sheath (70) enables the descending aortic graft element (40) to be deployed without the use of x-rays.

An aortic graft assembly includes a tubular component that defines a wall aperture having a proximal end that extends perpendicular to a major longitudinal axis of the tubular aortic component, and a tunnel graft connected to the wall of the tubular aortic component and extending from the wall aperture toward a proximal end of the tubular aortic component. The aortic graft assembly is delivered to a patient through the wall aperture and into interfering relation with the tunnel graft to treat aortic aneurysms.

Examples of prostheses are provided having an internal branch. A tubular graft body of the prosthesis defines a main lumen extending between an inflow end and an outflow end of the graft body. A stent structure is coupled along the graft body. A trough is at least partially defined by a trough wall extending into the main lumen from a sidewall of the graft body. A side branch defines a branch lumen and extends from the trough within the main lumen towards one of the inflow or outflow ends of the graft body. A branch lumen facing surface of the trough wall is a continuous surface with an outer surface of the sidewall of the graft body. A boundary of the trough may be configured to provide a smooth transition surface between the trough and the sidewall.

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.

A membrane body for a tubular treatment device includes a tubular membrane portion (12). The membrane portion forms a multi-layer structure having a first layer (21) formed of a fiber and a second layer (22) having liquid permeability lower than that of the first layer.

The invention relates to an endoprosthesis (60), in particular a vascular stent or a heart stent, comprising a graft (2) with a graft surface (3). The endoprosthesis (60) further comprises at least one fiber (1) which is arranged on the graft surface (3). The graft surface is adapted to directly attach the fiber (1).

The invention relates to an endoprosthesis (60) which comprises a graft (2), a stent structure (5), a fiber (1) and a suture (3). The suture (3) fixedly attaches the stent structure (5) to the graft (2). The fiber is attached to the endoprosthesis (60) via the suture (3).