Variable weave graft with metal strand reinforcement for in situ fenestration

1. An implantable prosthesis for treatment of a main vessel defect near one or more branch vessels, the prosthesis comprising:

a graft fabric comprising textile strands aligned in a first direction interwoven with textile strands and metal strands aligned in a second direction, the woven strands defining a lumen with a proximal end and a distal end, a main portion having a first area and at least one passage disposed between the proximal and distal end and having a second area smaller than the first area;

where at least some of the metal strands are woven in at least the main portion and bound the at least one passage; and

where, although at least some textile strands traverse the at least one passage, the at least one passage is defined by having a lower weave density than the main portion.

2. The prosthesis of claim 1 , further comprising at least two stents attached to the graft fabric, one of which is attached between the distal end and the at least one passage, the other of which is attached between the proximal end and the at least one passage.

3. The prosthesis of claim 1 , further comprising metal strands aligned in the first direction interwoven with the textile strands and metal strands aligned in the second direction.

4. The prosthesis of claim 1 , where the textile strands aligned in the first direction comprise warp yarns, and the textile strands and metal strands aligned in the second direction comprise weft yarns.

5. The prosthesis of claim 1 , where at least one of the metal strands at least partially traverses the at least one passage.

6. An implantable prosthesis comprising:

a graft body forming a lumen with a proximal end and a distal end;

where at least a portion of the lumen is defined by a woven fabric comprising textile strands and metal strands aligned in a first direction interwoven with textile strands and metal strands aligned in a second direction;

where the woven fabric further comprises a main portion having a first area and at least one reduced density region disposed between the proximal end and the distal end of the graft body and having a second area smaller than the first area;

where the main portion and the least one reduced density region each have a weave density, where the weave density of the main portion is greater than the weave density of the at least one reduced density region;

where at least some of the metal strands aligned in the first and second directions are interwoven in at least the main portion and bound the at least one reduced density region.

7. The prosthesis of claim 1 , where the at least one reduced density region is round, obround, polygonal, rectangular, square, or freeform, or combinations thereof.

8. The prosthesis of claim 1 , where the lumen has a circumference and the at least one reduced density region comprises a circumferential width which is less than the circumference of the lumen.

9. The prosthesis of claim 1 , where the textile strands and metal strands aligned in the first direction comprise warp strands, and the textile strands and metal strands aligned in the second direction comprise weft strands.

10. The prosthesis of claim 9 , where the main portion comprises between about 50 and about 300 weft textile strands per inch and between about 50 and about 300 warp textile strands per inch and where the at least one reduced density region comprises between about 10 and about 200 weft textile strands per inch and between about 10 and about 200 warp textile strands per inch.

11. The prosthesis of claim 9 , where the main portion comprises 150 weft textile strands per inch and 250 warp textile strands per inch and where the at least one reduced density region comprises between about 20 and about 50 weft textile strands per inch.

12. The prosthesis of claim 1 where the at least one reduced density region has a perimeter and the metallic strands abut the perimeter of the at least one reduced density region and do not traverse the at least one reduced density region.

13. The prosthesis of claim 1 , where at least one of the metal strands at least partially traverses the at least one reduced density region.

14. The prosthesis of claim 1 , further comprising a first stent attached near the graft body proximal end and second stent attached near the graft body distal end.

15. The prosthesis of claim 1 , further configured to include a plurality of indwelling guide wires disposed within and extending through the graft body at the at least one reduced density region.

16. The prosthesis of claim 15 , further comprising a self expanding stent supporting the region of reduced density region, the self expanding stent comprising proximal and distal bends and struts between the proximal and distal bends, the struts being bent into semicircles in the notional cylindrical surface of the stent around and away from exit points of the guide wires thereby providing reinforcement around a fenestration if one is made at the respective exit point.

17. An implantable prosthesis comprising:

a graft body forming a lumen with a proximal end and a distal end;

where at least a portion of the lumen is defined by a woven fabric comprising textile strands and metal strands aligned in a first direction interwoven with textile strands and metal strands aligned in a second direction;

where the woven fabric further comprises a main portion having a first area and at least one reduced density region disposed between the proximal end and the distal end of the graft body and having a second area smaller than the first area;

where the main portion and the least one reduced density region each have a weave density, where the weave density of the main portion is greater than the weave density of the at least one reduced density region;

where at least some of the metal strands aligned in the first and second directions are interwoven in at least the main portion and bound the at least one reduced density region, and

where the at least one reduced density region comprises a perimeter region and a center region within the perimeter region, where the perimeter region comprises a first weave density of interwoven textile strands and the center region comprises a second weave density of interwoven textile strands, where the first weave density is greater than the second weave density.

18. An implantable prosthesis comprising:

a graft body forming a lumen with a proximal end and a distal end;

where at least a portion of the lumen is defined by a woven fabric comprising textile strands and metal strands aligned in a first direction interwoven with textile strands and metal strands aligned in a second direction;

where the woven fabric further comprises a main portion having a first area and at least one reduced density region disposed between the proximal end and the distal end of the graft body and having a second area smaller than the first area;

where the main portion and the least one reduced density region each have a weave density, where the weave density of the main portion is greater than the weave density of the at least one reduced density region;

where at least some of the metal strands aligned in the first and second directions are interwoven in at least the main portion and bound the at least one reduced density region,

where the at least one reduced region comprises a perimeter region and a center region within the perimeter region, where the perimeter regions comprises a first weave density comprising metal strands interwoven with textile strands and the center region comprises a second weave density comprising metal strands interwoven with textile strands, where the first weave density is greater than the second weave density.