Delivery systems and methods of endoluminal delivery of branched vascular endoprosthetic devices

1 . A delivery system comprising:

a delivery catheter having a leading end and a trailing end;

a medical implant carried by the delivery catheter between the leading end and the trailing end of the delivery catheter, the medical implant having a proximal end and a distal end, with a main lumen extending between the proximal and distal ends, a middle portion between the proximal and distal ends, and a plurality of proximal branch portals and a plurality of distal branch portals located distal to the plurality of proximal branch portals, each of the proximal and distal branch portals being disposed proximate to the middle portion of the medical implant;

a first constraint configured to releasably maintain at least a proximal portion of the medical implant in a delivery configuration;

a second constraint configured to releasably maintain at least the middle portion at a diameter that is less than a fully deployed diameter of the medical implant following release of the first constraint;

a plurality of removable tubes, at least one of the plurality of removable tubes positioned through at least one of the plurality of proximal branch portals or at least one of the plurality of distal branch portals for cannulation thereof and extending into the proximal end of the medical implant, through the main lumen of the medical implant, and through the proximal and distal branch portals of the medical implant;

a multi-lumen catheter having a distal end and a proximal end, the multi-lumen catheter defining a first lumen and a second lumen extending between the distal end and the proximal end;

a first guidewire configured to extend through the first lumen of the multi-lumen catheter and a delivery lumen of the delivery catheter; and

a second guidewire configured to extend through the second lumen of the multi-lumen catheter and along at least a portion of the removable tubes,

wherein the multi-lumen catheter and the delivery catheter are displaceable together along and guided by the first guidewire and the second guidewire to deliver the medical implant.

2 . The delivery system of claim 1 , wherein the first lumen has a first diameter and the second lumen has a second diameter different from the first diameter.

3 . The delivery system of claim 1 , wherein the first lumen has a first cross-sectional shape and the second lumen has a second cross-sectional shape different from the first cross-sectional shape.

4 . The delivery system of claim 1 , further comprising a third guidewire and the multi-lumen catheter has a third lumen configured to receive the third guidewire.

5 . The delivery system of claim 4 , wherein the multi-lumen catheter defines a length, and the first, second, and third lumens extend parallel to one another along the length of the multi-lumen catheter.

6 . The delivery system of claim 1 , wherein the multi-lumen catheter further includes a multi-lumen catheter olive disposed at the distal end thereof through which each of the first and second lumens extends.

7 . The delivery system of claim 1 , wherein the multi-lumen catheter further includes a plurality of radiopaque markers.

8 . The delivery system of claim 1 , wherein the delivery catheter further includes a delivery catheter olive disposed at the leading end thereof and through which the delivery lumen extends.

9 . The delivery system of claim 1 , wherein the leading end of the delivery catheter is operable to be engaged with the proximal end of the multi-lumen catheter when the multi-lumen catheter and the delivery catheter are positioned together along the first guidewire and the second guidewire.

10 . The delivery system of claim 1 , wherein the second guidewire extends externally along the delivery catheter such that a first portion of the second guidewire extends within the medical implant, and a second portion of the second guidewire extends externally along the medical implant.

11 . A method of delivering a medical implant to a vasculature of a body, the method comprising:

routing a first guidewire through a first lumen of a multi-lumen catheter extending between a distal end and a proximal end of the multi-lumen catheter;

providing a delivery catheter having a leading end and a trailing end, the delivery catheter carrying a medical implant that includes a plurality of branch portals between the leading end and the trailing end of the delivery catheter, such that the leading end of the delivery catheter is disposed adjacent to the proximal end of the multi-lumen catheter, the medical implant being constrained by a first constraint and a second constraint;

positioning at least one of a plurality of removable tubes through at least one of the branch portals for cannulation of the branch portals;

extending a second guidewire through a second lumen and along at least a portion of the removable tubes, the second lumen extending between the distal end and the proximal end of the multi-lumen catheter;

inserting the multi-lumen catheter into the vasculature through a first access site of the body;

inserting the first guidewire through a delivery lumen of the delivery catheter;

inserting the delivery catheter into the vasculature through a second access site of the body that is different from the first access site;

abutting the delivery catheter against the multi-lumen catheter inside the vasculature such that the leading end of the delivery catheter abuts with the proximal end of the multi-lumen catheter, and the multi-lumen catheter and the delivery catheter are displaced together along and guided by the first guidewire and the second guidewire to deliver the medical implant;

positioning the medical implant at a treatment site within the vasculature by adjusting a location of the multi-lumen catheter and the delivery catheter while the multi-lumen catheter and the delivery catheter remain abutted;

releasing the first constraint that maintains at least a proximal portion of the medical implant in a delivery configuration to partially deploy the medical implant; and

releasing the second constraint that maintains at least a middle portion of the medical implant at a diameter that is less than a fully deployed diameter of the medical implant following the release of the first constraint to fully deploy the medical implant.

12 . The method of claim 11 , wherein the first lumen through which the first guidewire is routed has a first diameter and the second lumen through which the second guidewire is routed has a second diameter different from the first diameter.

13 . The method of claim 11 , wherein the first lumen through which the first guidewire is routed has a first cross-sectional shape and the second lumen through which the second guidewire is routed has a second cross-sectional shape different from the first cross-sectional shape.

14 . The method of claim 11 , further comprising routing a third guidewire through a third lumen of the multi-lumen catheter.

15 . The method of claim 14 , wherein the multi-lumen catheter defines a length, and the first, second, and third lumens extend parallel to one another along the length of the multi-lumen catheter.

16 . The method of claim 11 , further comprising disposing a multi-lumen catheter olive at the distal end of the multi-lumen catheter through which each of the first and second lumens extends.

17 . The method of claim 11 , further comprising disposing a plurality of radiopaque markers on the multi-lumen catheter.

18 . The method of claim 11 , further comprising disposing a delivery catheter olive at the leading end of the delivery catheter and through which the delivery lumen extends.