Stent graft introducer

1. A stent graft introducer comprising a delivery catheter, a nose cone dilator, a region between the delivery catheter and the nose cone dilator for retention of a stent graft therein, a stent graft disposed on the region, a sleeve extending over the delivery catheter and proximally to the nose cone dilator to cover the stent graft when retained in the region and an indwelling auxiliary catheter comprising a pre-curved proximal end, the nose cone dilator comprising an elongate groove thereon and the pre-curved proximal end of the auxiliary catheter having its proximal end in the elongate groove, the indwelling auxiliary catheter comprising a guide wire therethrough, wherein when the sleeve is in a partially retracted position the pre-curved proximal end of the indwelling auxiliary catheter is exposed and in a curved configuration and is not covered by the sleeve and when the sleeve is in an advanced position the precurved proximal end of the indwelling auxiliary catheter is in a straightened configuration, extends along the groove in the nose cone dilator and is covered by the sleeve.

2. A stent graft introducer as in claim 1 wherein the indwelling catheter extends through the stent graft when the stent graft is retained in the region between the delivery catheter and the nose cone dilator.

3. A stent graft introducer as in claim 1 wherein the stent graft when retained in the region between the delivery catheter and the nose cone dilator comprises a fenestration in the stent graft and the indwelling catheter extends through the fenestration.

4. An introduction arrangement in combination with a branched stent graft, the branched stent graft intended for deployment into the lumen of a vessel having a blind vessel extending therefrom; the branched stent graft having a main tubular body having a distal end and a proximal end with a main lumen therethrough, a side arm extending from the main body and having a side arm lumen therethrough and in fluid communication with the main lumen, the introduction arrangement including an introducer, the introducer having a distal end intended to remain outside a patient in use and a proximal end, the proximal end having a nose cone dilator and an arrangement to retain the branched stent graft distally of the nose cone dilator, the nose cone dilator comprising an elongate groove thereon, the branched stent graft being retained on the introducer and a sleeve on the introducer extending over the branched stent graft to the nose cone dilator, an indwelling auxiliary catheter comprising a pre-curved proximal end, the indwelling auxiliary catheter extending from the distal end of the introducer through an introducer lumen in the introducer to the branched stent graft, exiting from the introducer lumen at a distal end of the branched stent graft and entering the distal end of the side arm through the side arm lumen to the main lumen and extending out of the proximal end of the branched stent graft to the groove in the nose cone dilator, wherein when the sleeve is in a partially retracted position the pre-curved proximal end of the indwelling auxiliary catheter is exposed and in a curved configuration and is not covered by the sleeve and when the sleeve is in an advanced position the curved proximal end of the indwelling auxiliary catheter is in a straightened configuration, extends along the length of the groove in the nose cone dilator and is covered by the sleeve, the indwelling auxiliary catheter having a guide wire extending therethrough, whereby the sleeve can be partially withdrawn such that the proximal end of the indwelling auxiliary catheter is in the curved configuration and the guide wire can be extended through the curved end of the indwelling auxiliary catheter before the sleeve is fully withdrawn from the branched stent graft.

5. An introduction arrangement in combination with a branched stent graft as in claim 4 wherein the arrangement to retain the branched stent graft on the introducer comprises trigger wires extending to the distal end of the introducer and a release arrangement for separate release of the proximal end of the stent graft from the introducer.

6. An introduction arrangement in combination with a branched stent graft as in claim 4 wherein the stent graft has a proximal end and a distal end and wherein the indwelling catheter extends outside of the stent graft distally of the side arm and enters the stent graft through the side arm and extends within the stent graft towards the proximal end.

7. An introduction arrangement in combination with a branched stent graft as in claim 4 wherein the side arm extends inside the stent graft towards either the proximal or distal ends thereof.

8. An introduction arrangement in combination with a branched stent graft as in claim 4 wherein the side arm extends outside the stent graft towards either the proximal or distal ends thereof.

9. An introduction arrangement in combination with a branched stent graft as in claim 4 wherein the stent graft has a proximal end and a distal end and the indwelling catheter extends inside of the stent graft distally of the fenestration and through the fenestration out of the stent graft and towards the proximal end thereof.

10. An introduction arrangement in combination with a branched stent graft as in claim 4 wherein the side arm extending from the fenestration extends outside the stent graft towards either the proximal or distal ends thereof.

11. An introduction arrangement in combination with a fenestrated stent graft, the fenestrated stent graft intended for deployment into the lumen of a vessel having a blind vessel extending therefrom; the fenestrated stent graft having a main tubular body having a distal end and a proximal end with a main lumen therethrough, a fenestration in the main body between the distal end and the proximal end, the fenestration being in fluid communication with the main lumen, the introduction arrangement including an introducer, the introducer having a distal end intended to remain outside a patient in use and a proximal end, the proximal end having a nose cone dilator and an arrangement to retain the fenestrated stent graft distally of the nose cone dilator, the nose cone dilator comprising an elongate groove thereon, the fenestrated stent graft being retained on the introducer and a sleeve on the introducer extending over the fenestrated stent graft to the nose cone dilator, an indwelling auxiliary catheter comprising a pre-curved proximal end, the indwelling auxiliary catheter extending from the distal end of the introducer through an introducer lumen in the introducer to the fenestrated stent graft, exiting from the introducer lumen at a distal end of the fenestrated stent graft and entering the fenestration from outside the fenestrated stent graft and entering into the main lumen and extending out of the proximal end of the branched stent graft to the groove in the nose cone dilator, wherein when the sleeve is in a partially retracted position the pre-curved proximal end of the indwelling auxiliary catheter is exposed and in a curved configuration and is not covered by the sleeve and when the sleeve is in an advanced position the curved proximal end of the indwelling auxiliary catheter is in a straightened configuration, extends along the length of the groove in the nose cone dilator and is covered by the sleeve, the indwelling auxiliary catheter having a guide wire extending therethrough, whereby the sleeve can be partially withdrawn such that the proximal end of the indwelling auxiliary catheter is in the curved configuration and the guide wire can be extended through the curved end of the indwelling auxiliary catheter before the sheath is fully withdrawn from the fenestrated stent graft.

12. An introduction arrangement in combination with a branched stent graft as in claim 11 wherein the arrangement to retain the fenestrated stent graft on the introducer comprises trigger wires extending to the distal end of the introducer and a release arrangement for separate release of the proximal end of the stent graft from the introducer.

13. An introduction arrangement in combination with a branched stent graft as in claim 11 wherein the stent graft has a proximal end and a distal end and wherein the indwelling catheter extends outside of the stent graft distally of the fenestration and enters the stent graft through the fenestration and extends within the stent graft towards the proximal end.

14. An introduction arrangement in combination with a branched stent graft as in claim 11 wherein the fenestration includes a side arm extending therefrom.

15. An introduction arrangement in combination with a branched stent graft as in claim 14 wherein the side arm extending from the fenestration extends inside the stent graft towards either the proximal or distal ends thereof.