Methods for placing a stent in a branched vessel

1. A method of placing a stent at a target site within vasculature comprising a main vessel and at least one side branch vessel in fluid communication with the main vessel, the stent comprising a main lumen and a at least one side branch lumen, the method comprising:

creating an incision within the vasculature;

advancing a catheter through the vasculature from the incision to the target site;

deploying the stent from the catheter at the target site wherein the stent is in a reduced dimension inside the catheter and expands to an expanded dimension in the vasculature, where deploying the stent comprises selectively tensioning the main lumen and the side branch lumen independently from one another such that the main lumen and the side branch lumen are independently repositionable in the main vessel and the side branch vessel, respectively,

Where the main lumen and side branch lumen are independently repositionable in the main vessel and side branch vessel, respectively, by expanding and reducing a diameter of the main lumen and side branch lumen.

2. The method of claim 1 further comprising allowing graft material on the stent to integrate the stent into the target site.

3. The method of claim 1 wherein the stent is deployed without completely disrupting blood flow in the main vessel.

4. The method of claim 1 further comprising viewing at least one of the acts of the method using an imaging system.

5. The method of claim 4 wherein the imaging system comprises use of radiographic dye or fluoroscopy.

6. The method of claim 4 further comprising injecting a visualization material into the vessel.

7. The method of claim 4 wherein the imaging system comprises intravascular ultrasound.

8. The method of claim 7 further comprising employing a guidewire to implant the stent wherein the distal tip of the guidewire comprises at least one intravascular ultrasonic transducer.

9. The method of claim 1 wherein only a single incision is made.

10. The method of claim 1 , where the main lumen and the side branch lumen are independently repositionable in the main vessel and the side branch vessel, respectively, by applying and releasing tension on the main lumen and the side branch lumen.

11. The method of claim 1 , where the main lumen is releasably coupled to a first deployer and the side branch lumen is releasably coupled to a second deployer, and where at least a portion of the second deployer is within the first deployer.

12. A method of treating an aortic aneurysm of a human patient, comprising:

creating a first incision in a first location of a vessel leading to an aneurysm in a patient's aortic artery;

creating a second incision in a second location of a vessel leading to the aneurysm;

moving a stent to a target site at the aneurysm using a first line connected to the stent and exiting the first incision and using a second line connected to the stent and exiting the second incision; and

deploying the stent from the catheter at the target site wherein the stent is in a reduced dimension inside the catheter and expands to an expanded dimension in the vessel, and further wherein the stent comprises a main lumen and at least one side branch lumen where deploying the stent comprises selectively tensioning the main lumen and the side branch lumen independently from one another such that the side branch lumen is independently repositionable in the side branch vessel by increasing and decreasing a size of the side branch lumen independently of a size of the main lumen.

13. The method of claim 12 , further comprising:

imaging the interior of a vessel while moving the stent to the target site.

14. The method of claim 12 , further comprising:

tensioning the first and second lines and thereby reducing an outer dimension of the stent.

15. The method of claim 12 , further comprising:

placing a graft material around at least a portion of the stent prior to placing the stent in a vessel.

16. The method of claim 15 , further comprising:

allowing the graft material to integrate the stent into the main vessel wall at the target site.

17. The method of claim 12 , further comprising selectively tensioning the main lumen and the side branch lumen independently from one another such that the main lumen is independently repositionable in the main vessel by increasing and decreasing the size of the main lumen independently of the size of the side branch lumen.

18. The method of claim 12 , where the main lumen is releasably coupled to a first deployer and the side branch lumen is releasably coupled to a second deployer, and where the second deployer is within the main lumen during at least a portion of the selectively tensioning step.