Pararenal stent graft

A stent graft comprising an elongate tubular body of a biocompatible graft material, the tubular body comprising a distal end and a proximal end, the tubular body comprising a proximal portion of a first selected diameter, a distal portion of a second selected diameter, the second selected diameter being less than the first selected diameter and a tapered central portion between the proximal portion and the distal portion, the tubular body comprising a circumference, a notional anterior longitudinal datum line on the tubular body and a notional transverse clock face having 12 o'clock at the notional anterior longitudinal datum line;

• a scalloped cut out in the proximal portion of the tubular body, the scalloped cut out being open at the proximal end of the tubular body;
• a fenestration in the proximal portion distal of the scalloped cut out;
• first and second low profile side arms in the distal end of the tapered central portion, the first and second low profile side arms each comprising an external open end,
• the tapered central portion comprising a asymmetric self expanding zig zag stent, the asymmetric self expanding zig zag stent comprising a plurality of struts and proximal and distal bends between the struts and a circumference and a part of the circumference comprising bends being spaced circumferentially further apart than others of the bends, thereby defining wider void regions between the bends which are spaced circumferentially further apart, the asymmetric self expanding zig zag stent being affixed to the stent graft such that the part of the circumference comprising bends being spaced further apart is in an anterior region of the stent graft and the void regions are longitudinally proximal of the open external ends of the first and second low profile side arms;
• the scalloped cut out being circumferentially centered with respect to the notional transverse clock face at 12:30 o'clock and comprising a circumferential width of about 20 mm and a longitudinal depth of about 20 mm, the fenestration in the proximal portion being circumferentially centered with respect to the notional transverse clock face at 12:00 o'clock and comprising a diameter of 8 mm and being centered at a distance of about 26 mm from the proximal end, the first low profile side arm being circumferentially centered with respect to the notional transverse clock face at 2:15 o'clock and the second low profile side arm being circumferentially centered with respect to the notional transverse clock face at 10:00 o'clock and proximal ends of each being positioned at a space of 55 mm from the proximal end.