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.

Medical devices including vascular access kits and related system and methods are disclosed. In some embodiments, a vascular access system may include a first conduit, a second conduit, and an expandable stent that is coupled to both the first and second conduits such that there is a continuous lumen between the first conduit and the second conduit. Methods of deploying the vascular access system within the body of a mammal, more particularly, a human patient are disclosed. Methods of bypassing a section of vasculature of a mammal, more particularly, a human patient are disclosed. The vascular access system, when implanted and assembled, may be a fully subcutaneous surgical implant.

Apparatus and methods for controlled arterial/venous access are provided. The apparatus and methods may include a section of tubing anastomosed to a bodily lumen. A lumen clamping means may utilize a clamp manipulator to effectively seal the tubing, and the manipulator may be operated by two fingers. A needle receptor may be utilized, and the receptor may utilize a rotating member to guide a needle inserted from outside the body, in order ensure accurate placement into a channel. The channel may be in liquid communication with the tubing. The manipulator and the needle receptor may be palpable from outside the body.

Methods, apparatuses, and systems are described for stent delivery and positioning for transluminal application. The method may include positioning the stent in an undeployed configuration through an access site in a wall of a first body lumen. In some cases, the method may include retracting an outer sheath proximally and past an anchoring component disposed at a distal portion of an inner tubular member based on positioning the stent. A distal portion of the stent may be disposed between the anchoring component and the outer sheath while the stent is in the undeployed configuration. The method may further include deploying the distal portion of the stent from the outer sheath and within the first body lumen and expanding a proximal portion of the stent from within the outer sheath such that upon fully exiting the outer sheath, the proximal portion expands to a deployed configuration within a second body lumen.

Methods, apparatuses, and systems are described for stent delivery and positioning for transluminal application. The system may include a stent that is disposed coaxially onto an inner tubular member. In some cases, the system may include an outer sheath disposed coaxially along at least a portion of the inner tubular member. The system may include a distal cutting element coupled with a distal end of the inner tubular member and an anchoring component disposed at a distal portion of the inner tubular member. The anchoring component may be configured to retain a distal portion of the stent in place along the inner tubular member as the outer sheath is retracted proximally to deploy the stent, wherein upon retraction of the outer sheath, the stent releases from the anchoring component and expands into a deployed configuration within the body lumen.

Aortic root replacement grafts, systems and methods for implanting an aortic root replacement graft are disclosed. The graft includes a tubular portion; a bulged portion with a first end and a second end, wherein the second end of the bulged portion is coupled to a first end of the tubular portion; a cuff portion coupled to the first end of the bulged portion; and at least one side arm coupled to and extending from the bulged portion. Methods for implanting an aortic root replacement graft with two side arms are also disclosed.

Devices and methods divert blood flow from a first vessel to a second vessel and maintain blood flow in the first vessel. The device includes a first segment and a second segment. The first segment is configured to anchor in the first vessel. The first segment includes a window to allow blood to flow into the first segment, through the window, and distal in the first vessel. The second segment is configured to anchor in the second vessel. The second segment is configured to allow blood to flow into the first segment, through the second segment, and into the second vessel.

There is described an arteriovenous fistula stent, having a tubular body comprising a series of sinusoidal shaped struts along the length of the tubular body. A plurality of curvilinear connectors extend between and are attached to adjacent struts wherein a first end of a connector is attached to a distal face of a proximal strut apex and a second end of a connector is attached to a proximal face of a distal strut apex. A pair of unconnected strut apexes are between pairs of connected apexes. When the tubular body is in a stowed configuration a proximal aperture and a distal aperture are circular and when the tubular body is in a deployed configuration the distal aperture is oblong or ovoid. There is also described a method for inserting a stent for use in creation of an arteriovenous fistula by identifying a candidate artery and a candidate vein and dissecting the candidate vein. Next, inserting a stent into the vein and creating a breach in the candidate artery at a desired angle and location. Next, introducing the stent and vein into the candidate artery and forming the stent into a curvature angle selected to minimize turbulent blood flow in an anastomosis formed by the vein and the artery. Optionally, there is a step of fastening a distal portion of the stent to the artery.

A vascular graft incorporating a stent into a portion of its length. While various materials may be used for the vascular graft, the graft is preferably an ePTFE graft. The stent is preferably a self-expanding stent, although it may alternatively be a balloon expandable stent. The vascular graft preferably has a continuous inner tubular liner that extends between the opposing ends of the graft and provides a continuous luminal surface for blood contact that is uninterrupted by seams or joints. The length portion of the graft that does not include the stent has a greater wall thickness than does the portion including the stent.

A method of implanting a device in a heart includes inserting an implant into a blood vessel with a delivery apparatus. The implant includes a stent member and an adjustment member. The stent member is circumferentially expandable and contractible. The adjustment member is coupled to the stent member. The delivery apparatus includes a rotatable shaft and a locking mechanism coupled to an end portion of the shaft. The shaft of the delivery apparatus is releasably coupled to the adjustment member of the implant by the locking mechanism of the delivery apparatus. The method further includes positioning the implant at an implantation location within a heart by manipulating the delivery apparatus, and rotating the shaft of the delivery apparatus relative to the stent member of the implant to actuate the adjustment member of the implant. Actuating the adjustment member results in circumferential expansion or contraction of the stent member.