Some embodiments are directed to a deployment system for deploying a stent graft within a passageway, comprising a delivery catheter having an outer sheath, a proximal end, and a distal end, a stent having a first end and a second end, a graft having a first end and a second end, and at least one connecting element extending from the second end of the stent to the first end of the graft so as to connect the stent to the graft. In some embodiments, the stent can be supported within the outer sheath at a first axial position in a collapsed state, and the graft can be supported within the outer sheath at a second axial position different than the first axial position in a collapsed state, such that the stent does not overlap or substantially overlap the graft in the collapsed state within the deployment system.
1. A method of deploying a stent graft comprising a stent and a graft in a passageway, comprising:
supporting the stent in a collapsed position in a first position within an outer sleeve of a delivery catheter in a catheter loaded state;
supporting the graft in a collapsed position in a second position within a distal portion of the outer sleeve of the delivery catheter, the second position being different than the first position such that no portion of the graft overlaps the stent when the graft and stent are in a catheter loaded state;
removing a distal portion of said graft material from said outer sleeve of a delivery catheter by everting and retracting at least a portion of the graft so as to overlap at least a portion of the stent with the graft by retracting one or more retraction elements coupled with a distal end of the graft to position the graft so that the graft overlaps at least a portion of the stent; and
expanding the stent against an inside surface of the graft within the passageway.
2. The method of claim 1 , wherein expanding the stent comprises axially retracting the outer sleeve to expose the stent.
3. The method of claim 1 , wherein overlapping at least a portion of the stent with the graft comprises axially moving the stent relative to the graft or the graft relative to the stent.
4. The method of claim 1 , further comprising axially retracting the outer sleeve of the catheter relative to the stent and graft so that at least the stent expands against a wall of the passageway.
5. The method of claim 1 , further comprising expanding a second stent within the graft after the graft has been deployed from the catheter.
6. The method of claim 1 , wherein the graft comprises a main body, a first branch segment, and a second branch segment.
7. The method of claim 6 , further comprising expanding a branch stent in at least one of the first branch segment and the second branch segment of the graft.
8. The method of claim 1 , further comprising inverting and retracting at least a portion of the graft over an outside surface of the outer sleeve of the delivery catheter.
9. The method of claim 1 , further comprising inverting and retracting the graft over an outside surface of the outer sleeve of the delivery catheter until the graft is approximately axially aligned with the stent.
10. The method of claim 1 , further comprising inverting and retracting the graft over an outside surface of the outer sleeve of the delivery catheter until the graft is approximately axially aligned with the stent and, thereafter, withdrawing the outer sleeve of the delivery catheter to deploy the stent within the graft.
11. The method of claim 1 , comprising axially retracting one or more retraction elements coupled with the graft to position the graft so that the graft overlaps at least a portion of an outside surface of the outer sleeve of the delivery catheter.
12. The method of claim 1 , wherein the graft has a first end and a second end, the stent has a first end and a second end, and at least one connecting element extends from the second end of the stent to the first end of the graft so as to connect the second end of the stent to the first end of the graft.
13. The method of claim 12 , wherein the at least one connecting element comprises sutures, wires, strands, or metal or plastic struts.
14. The method of claim 1 , wherein the retraction elements each comprise at least one of a suture, a cable, and a wire.
15. The method of claim 1 , wherein at least a portion of each of the retraction elements extends from the distal end of the delivery catheter to the proximal end of the delivery catheter outside of an outer wall of the outer sleeve of the delivery catheter.