APPARATUS AND METHOD OF PLACEMENT OF A GRAFT OR GRAFT SYSTEM
Some embodiments of the present disclosure are directed to a method of deploying a graft in a patient's blood vessel having at least a first and a second branch blood vessel, comprising advancing a delivery catheter into a blood vessel, the delivery catheter supporting a fenestrated prosthesis therein, wherein the prosthesis comprises a main graft body, exposing at least one branch sheath, the branch sheath being positioned within the delivery catheter so as to project from a main lumen of the prosthesis through a first opening formed through a wall of the prosthesis, and advancing an angiographic catheter into the branch sheath and cannulating a first target branch vessel before expanding the main graft body of the prosthesis.
1 . A method of deploying a graft in a patient's blood vessel having at least a first branch blood vessel, comprising:
advancing a delivery catheter into a blood vessel, the delivery catheter supporting a fenestrated prosthesis comprising a main graft body therein;
exposing at least one branch sheath, the branch sheath being positioned within the delivery catheter so as to extend from a main lumen of the prosthesis through a first opening formed through a wall of the main graft body; and
advancing an angiographic catheter into the branch sheath and cannulating a first target branch vessel before expanding the main graft body of the prosthesis.
2 . The method of deploying a graft of claim 1 , further comprising advancing the branch sheath over the angiographic catheter and into the first target branch vessel before expanding the main graft body of the prosthesis.
3 . The method of deploying a graft of claim 1 , wherein exposing at least one branch sheath comprises at least partially retracting an outer sheath of the delivery catheter.
4 . The method of deploying a graft of claim 1 , further comprising expanding at least a portion of the main graft body of the prosthesis.
5 . The method of deploying a graft of claim 4 , wherein expanding the main graft body of the prosthesis comprises at least partially retracting an outer sheath of the delivery catheter.
6 . The method of deploying a graft of claim 4 , wherein expanding the main graft body of the prosthesis comprises removing a peelable sheath from the main graft body of the prosthesis.
7 . The method of deploying a graft of claim 4 , further comprising approximately aligning the first opening formed through the wall of the main graft body with an ostium of the first target branch vessel.
8 . The method of deploying a graft of claim 7 , further comprising deploying a flareable stent in the first opening and the first target branch vessel.
9 . The method of deploying a graft of claim 3 , further comprising approximately aligning a second opening formed through the wall of the main graft body with an ostium of a second target branch vessel.
10 . The method of deploying a graft of claim 1 , wherein at least a portion of the main graft body defines a cross-sectional size approximately 30% larger than a cross-sectional size of the target vessel.
11 . The method of deploying a graft of claim 1 , further comprising deploying a proximal portion of the graft by axially advancing a distal sheath off of the proximal portion of the graft.
12 . A method of deploying a fenestrated prosthesis in a patient's blood vessel having at least a first branch blood vessel, comprising:
advancing a delivery catheter into a blood vessel;
wherein:
the delivery catheter supports the fenestrated prosthesis having a main graft body and at least one fenestration extending through the main graft body;
a first restraint restrains a proximal portion of the prosthesis; and
a second restraint restrains a distal portion of the prosthesis, the distal portion of the prosthesis being closer to a proximal portion of the delivery catheter than the proximal portion of the prosthesis;
exposing at least one guide sheath, the guide sheath being positioned within the delivery catheter so as to extend from a main lumen of the prosthesis through a first opening formed through a wall of the prosthesis; and
advancing an angiographic catheter through the guide sheath and cannulating a first target branch vessel before completely removing the second restraint.
13 . The method of deploying a fenestrated prosthesis of claim 12 , wherein at least a portion of the main graft body defines a cross-sectional size approximately 30% larger than a cross-sectional size of the target vessel.
14 . The method of deploying a fenestrated prosthesis of claim 12 , further comprising approximately aligning the fenestration extending through the main graft body with an ostium of the first target branch vessel.
15 . The method of deploying a fenestrated prosthesis of claim 12 , further comprising deploying a proximal portion of the fenestrated prosthesis by axially advancing the first restraint off of the proximal portion of the prosthesis.
16 . A method of deploying a fenestrated prosthesis in a patient's blood vessel having at least a first branch blood vessel, comprising:
advancing a delivery catheter into a blood vessel;
wherein:
the delivery catheter supports the fenestrated prosthesis having a main graft body and at least one fenestration therein;
a first restraint restrains a proximal portion of the prosthesis; and
a second restraint restrains a distal portion of the prosthesis, the distal portion of the prosthesis being closer to a proximal portion of the delivery catheter than the proximal portion of the prosthesis;
exposing at least one guide sheath, the guide sheath being positioned within the delivery catheter so as to extend from a main lumen of the prosthesis through a first opening formed through a wall of the prosthesis; and
advancing the guide sheath into a first target branch vessel before completely removing the second restraint.
17 . A delivery system for deploying an endoluminal prosthesis, comprising:
a first restraint configured to restrain a first portion of the prosthesis;
a second restraint configured to restrain a second portion of the prosthesis;
a first opening through a wall of the prosthesis, the first opening being positioned between the first and second portions;
a first guide sheath extending from a proximal end of the delivery system into a main lumen of the endoluminal prosthesis and through the first opening in the wall of the prosthesis;
a first stent configured to support the first portion of the endoluminal prosthesis; and
a second stent configured to support the second portion of the endoluminal prosthesis;
wherein the guide sheath is moveable before removing the first and second restraints.