Apparatus and method of placement of a graft or graft system

Abstract

An endoluminal prosthesis system deployable in a region of a patient's vasculature having one or more branch vessels, having a main graft body having a first opening in a wall portion of the main graft body and a pre-loaded guidewire positioned inside the main graft body and advanced through the first opening. One or more branch grafts can be attached to the main graft body to cover one or more openings in the main graft body.

What is claimed is: 
     
         1 . An endoluminal prosthesis system, comprising:
 a delivery catheter having a flexible catheter body, a proximal end, and a distal end;   an endoluminal prosthesis comprising:
 a first main graft body having a first lumen extending axially therethrough; 
 a first lateral opening extending through a wall portion of the first main graft body, the first lateral opening defining a first dimension; 
 a second lateral opening extending through the wall portion of the first main graft body, the second lateral opening positioned opposite the first lateral opening and defining a second dimension; 
   a first hollow guidewire extending from the proximal end of the flexible catheter body through at least a portion of the flexible catheter body, through at least a portion of the first lumen of the first main graft body, and through the first lateral opening in the wall portion of the first main graft body when the first main graft body is in a collapsed, pre-delivery state within the flexible catheter body; and   a second hollow guidewire extending from the proximal end of the flexible catheter body through at least a portion of the flexible catheter body, through at least a portion of the first lumen of the first main graft body, and through the second lateral opening in the wall portion of the first main graft body when the first main graft body is in the collapsed, pre-delivery state within the flexible catheter body.   
     
     
         2 . The endoluminal prosthesis system of  claim 1 , wherein the second dimension is approximately four times larger than the first dimension. 
     
     
         3 . The endoluminal prosthesis system of  claim 2 , wherein when the endoluminal prosthesis is in a deployed state, the first lateral opening is approximately axially aligned with a first vessel and the second lateral opening is axially offset from a second vessel. 
     
     
         4 . The endoluminal prosthesis system of  claim 3 , further comprising:
 a second main graft body positioned within the first lumen, the second main graft body having a second lumen extending axially therethrough;   a third lateral opening extending through a wall portion of the second main graft body, the third lateral opening defining a third dimension;   a fourth lateral opening extending through the wall portion of the second main graft body, the fourth lateral opening positioned approximately one hundred eighty degrees opposite the third lateral opening and defining a fourth dimension larger than the third dimension;   a third hollow guidewire advanced from the proximal end of the flexible catheter body through at least a portion of the flexible catheter body, through at least a portion of the second lumen of the second main graft body, and through the third lateral opening in the wall portion of the second main graft body when the second main graft body is in a collapsed, pre-delivery state within the flexible catheter body; and   a fourth hollow guidewire advanced from the proximal end of the flexible catheter body through at least a portion of the flexible catheter body, through at least a portion of the second lumen of the second main graft body, and through the fourth lateral opening in the wall portion of the second main graft body when the second main graft body is in the collapsed, pre-delivery state within the flexible catheter body.   
     
     
         5 . The endoluminal prosthesis of  claim 4 , wherein the fourth dimension is approximately four times larger than the third dimension. 
     
     
         6 . The endoluminal prosthesis of  claim 5 , wherein when the endoluminal prosthesis is in the deployed state, the third lateral opening is approximately axially aligned with the second vessel, and the fourth lateral opening is axially offset from the first vessel. 
     
     
         7 . The endoluminal prosthesis of  claim 6 , wherein the first lateral opening and the fourth lateral opening are axially offset and are configured to receive an expansion device. 
     
     
         8 . The endoluminal prosthesis of  claim 6 , wherein the first lateral opening and the fourth lateral opening are axially offset and are configured to receive an expansion device. 
     
     
         9 . The endoluminal prosthesis of  claim 7 , wherein the expansion device comprises a balloon. 
     
     
         10 . The endoluminal prosthesis of  claim 7 , wherein the expansion device comprises a stent. 
     
     
         11 . An endoluminal prosthesis, comprising:
 a first main graft body having a first lumen extending axially therethrough;   a first lateral opening extending through a wall portion of the first main graft body, the first lateral opening defining a first dimension;   a second lateral opening extending through the wall portion of the first main graft body, the second lateral opening positioned opposite the first lateral opening and defining a second dimension; and   wherein the first main graft body is configured to collapse into a pre-delivery state and receive a first hollow guidewire through at least a portion of the first lumen of the first main graft body, and through the first lateral opening in the wall portion of the first main graft body.   
     
     
         12 . The endoluminal prosthesis of  claim 11 , wherein the first main graft body is configured to receive a second hollow guidewire through at least a portion of the first lumen of the first main graft body, and through the second lateral opening in the wall portion of the first main graft body. 
     
     
         13 . The endoluminal prosthesis of  claim 12 , further comprising:
 a second main graft body positioned within the first lumen, the second main graft body having a second lumen extending axially therethrough;   a third lateral opening extending through a wall portion of the second main graft body, the third lateral opening defining a third dimension;   a fourth lateral opening extending through the wall portion of the second main graft body, the fourth lateral opening positioned approximately one hundred eighty degrees opposite the third lateral opening and defining a fourth dimension larger than the third dimension; and   wherein the second main graft body is configured to collapse into a pre-delivery state and receive a third hollow guidewire through at least a portion of the second lumen of the second main graft body, and through the third lateral opening in the wall portion of the first main graft body.   
     
     
         14 . The endoluminal prosthesis of  claim 13 , wherein the second main graft body is configured to receive a fourth hollow guidewire through at least a portion of the second lumen of the first main graft body, and through the fourth lateral opening in the wall portion of the second main graft body. 
     
     
         15 . The endoluminal prosthesis of  claim 14 , wherein when the endoluminal prosthesis is in a deployed state:
 the first lateral opening is approximately axially aligned with a first vessel;   the second lateral opening is axially offset from a second vessel;   the third lateral opening is approximately aligned with the second vessel; and   the fourth lateral opening is axially offset from the first vessel.   
     
     
         16 . The endoluminal prosthesis of  claim 15 , wherein the second dimension is approximately four times larger than the first dimension and the fourth dimension is approximately four times larger than the third dimension. 
     
     
         17 . An endoluminal prosthesis system, comprising:
 a delivery catheter comprising:
 a flexible catheter body with a proximal end, and a distal end; 
 a first passage extending through at least a portion of the flexible catheter body; 
 a second passage extending through at least a portion of the flexible catheter body; and 
 a third passage extending through at least a portion of the flexible catheter body; 
   an endoluminal prosthesis comprising:
 a first main graft body having a first lumen extending axially therethrough; 
 a first lateral opening extending through a wall portion of the first main graft body, the first lateral opening defining a first dimension; and 
 a second lateral opening extending through the wall portion of the first main graft body, the second lateral opening positioned opposite the first lateral opening and defining a second dimension; and 
   a first hollow guidewire extending through the first passage, through at least a portion of the first lumen of the first main graft body, and through the first lateral opening in the wall portion of the first main graft body when the first main graft body is in a collapsed, pre-delivery state within the flexible catheter body.   
     
     
         18 . The endoluminal prosthesis system of  claim 17 , further comprising:
 a second hollow guidewire advanced through the second passage, through at least a portion of the first lumen of the first main graft body, and through the second lateral opening in the wall portion of the first main graft body when the first main graft body is in the collapsed, pre-delivery state within the flexible catheter body; and   a third hollow guidewire advanced through the third passage, and through at least a portion of the first lumen of the first main graft body when the first main graft body is in the collapsed, pre-delivery state within the flexible catheter body.   
     
     
         19 . The endoluminal prosthesis system of  claim 18 , wherein when the endoluminal prosthesis is in a deployed state, the first lateral opening is approximately axially aligned with a first vessel and the second lateral opening is axially offset from a second vessel. 
     
     
         20 . The endoluminal prosthesis system of  claim 19 , wherein the second dimension is approximately four times larger than the first dimension.