Introducer for a side branch device

A stent graft delivery system for a branched stent graft including:

• a first introducer, the first introducer comprising:
• a proximal end,
• a distal end,
• a handle,
• a central inner catheter having a proximal end and a distal end and extending from the proximal end of the introducer to the distal end of the introducer, the central inner catheter having a lumen extending therethrough that is configured to receive a guidewire,
• a tapered nose cone dilator, having a proximal tip and a distal end, the tapered nose cone dilator attached to the central inner catheter at the proximal end of the central inner catheter, the tapered nose cone dilator having a lumen communicating with the lumen of the central inner catheter,
• an outer catheter having a lumen and disposed at least partially over the central inner catheter, the outer catheter having a proximal end and a proximal opening at its proximal end, the proximal end of the outer catheter spaced a distance from the distal end of the tapered nose cone dilator;
• a branched stent graft disposed over the central inner catheter, the branched stent graft comprising a main body, a proximal end, a distal end, a main lumen therethrough, a branch extending exteriorly from a sidewall of the main body between the branched stent graft proximal end and the branched stent graft distal end, wherein the branch is disposed more proximate the proximal end of the main body and at an acute angle to the main body, the branch having a proximal end, an open distal end, a branch lumen therethrough in fluid communication with the main lumen, a surface, and a stent attached to the surface of the branch adjacent the open distal end;
• an indwelling lateral catheter disposed at least partially within the lumen of the outer catheter and at least partially parallel to the central inner catheter, the indwelling lateral catheter extending from a distal end of the delivery system to the tapered nose cone dilator;
• and a retractable sheath disposed over the branched stent graft, at least partially over the outer catheter and at least partially over the indwelling lateral catheter, and operatively connected to the handle, wherein, when the retractable sheath is disposed over the branched stent graft, the central inner catheter and the indwelling lateral catheter, the indwelling lateral catheter extends through the lumen of the outer catheter to the proximal end of the introducer, then exits the outer catheter lumen at the proximal opening of the outer catheter, then extends partially along an exterior length of the branched stent graft, then enters the branch open distal end and the main lumen, then extends through the main lumen of the branched stent graft, then exits the proximal end of the branched stent graft, and is disposed adjacent the tapered nose cone dilator.

A system comprising:

• a branched stent graft comprising:
• a main body,
• a proximal end,
• a distal end,
• a main lumen therethrough,
• a branch extending exteriorly from a sidewall of the main body between the branched stent graft proximal end and the branched stent graft distal end, wherein the branch is disposed more proximate the proximal end of the main body and at an acute angle to the main body, the branch having a proximal end, an open distal end, a branch lumen therethrough in fluid communication with the main lumen, a surface, and a stent attached to the surface of the branch adjacent the open distal end of the branch;
• a delivery system comprising:
• a main guidewire catheter extending through the main lumen of the branched stent graft to past the proximal end of the branched stent graft, the main guidewire catheter configured to receive a first guidewire therethrough;
• an indwelling lateral catheter having a portion disposed exteriorly and alongside of the branched stent graft from a location distal of the distal end of the branched stent graft and to the opening of the branch, into the opening of the branch, through the branch, through the main lumen, and to and out of the proximal end of the branched stent graft, wherein a portion of the indwelling lateral catheter within the main lumen is directly adjacent and parallel to the main guidewire catheter;
• and
• a distal retention mechanism configured to maintain the distal end of the branched stent graft to the delivery system, the distal retention mechanism comprising a loop on the distal end of the branched stent graft and a retractable wire extending through the loop.