Methods and apparatus for intraluminal placement of a bifurcated intraluminal garafat

An intraluminal prosthesis comprising:

• a trouser graft having a trunk and two legs diverging in a downstream direction from the trunk at a septum region which is locatable upstream from an aortic bifurcation, the trouser graft being formed of a graft body having an external surface and an internal surface and comprising one or more expandable wireforms at its upstream end and attachable to an aorta;
• and
• at least one balloon-expandable wireform connected primarily to the external surface of the graft body at the distal end of the trunk upstream from the septum region;
• and
• a tubular extension connected to a downstream end of at least one of the two legs;
• wherein the diameter of at least one of the tubular extensions is over-sized with respect to the balloon-expandable wireforms in the at least one of the tubular extensions.

An intraluminal prosthesis of comprising:

• a trouser graft having a trunk and two legs diverging in a downstream direction from the trunk at a septum region which is locatable upstream from an aortic bifurcation, the trouser graft being formed of a graft body having an external surface and an internal surface and comprising one or more expandable wireforms at its upstream end and attachable to an aorta;
• and
• at least one balloon-expandable wireform connected primarily to the external surface of the graft body at the distal end of the trunk upstream from the septum region;
• wherein the diameter of the trunk of the trouser graft is over-sized with respect to the at least one balloon-expandable wireform.

An intraluminal prosthesis comprising:

• a trouser graft having a trunk and two legs diverging in a downstream direction from the trunk at a septum region which is locatable upstream from an aortic bifurcation, the trouser graft being formed of a graft body having an external surface and an internal surface and comprising one or more expandable wireforms at its upstream end attachable to an aorta;
• and
• at least one self-expanding wireform connected primarily to the external surface of the graft body at the septum region and having a radiopaque marker attached thereto;
• wherein the radiopaque marker points to the location at the septum region where the two legs diverge.

An intraluminal prosthesis comprising:

• a trouser graft having a trunk and two legs diverging in a downstream direction from the trunk at a septum region which is locatable upstream from an aortic bifurcation, the trouser graft being formed of a graft body having an external surface and an internal surface and comprising one or more expandable wireforms at its upstream end attachable to an aorta;
• and
• at least one self-expanding wireform connected primarily to the external surface of the graft body at the septum region and having a radiopaque marker attached thereto;
• wherein the self-expanding wireform at the septum region includes at least one crimp, and wherein the radiopaque marker is provided on the crimp.

An intraluminal prosthesis comprising:

• a trouser graft having a trunk and two legs diverging in a downstream direction from the trunk at a septum region which is locatable upstream from an aortic bifurcation, the trouser graft being formed of a graft body having an external surface and an internal surface and comprising one or more expandable wireforms at its upstream end attachable to an aorta;
• at least one self-expanding wireform connected primarily to the external surface of the graft body at the septum region and having a radiopaque marker attached thereto;
• and
• at least one self-expanding wireform connected to the graft body in each of the two legs;
• wherein one of the legs of the trouser graft is longer than the other leg and wherein the difference in length between the legs of the trouser graft corresponds to the height of the at least one self-expanding wireform connected to the graft body in each of the two legs.

An intraluminal prosthesis comprising:

• a trouser graft having a trunk and two legs diverging in a downstream direction from the trunk at a septum region which is locatable upstream from an aortic bifurcation, the trouser graft being formed of a graft body having an external surface and an internal surface and comprising one or more expandable wireforms at its upstream end attachable to an aorta;
• at least one self-expanding wireform connected primarily to the external surface of the graft body at the septum region;
• at least one self-expanding wireform connected to the graft body in each of the two legs;
• and
• a lateral reinforcement wire coupled to at least one of the two legs between the self-expanding wireform in the one leg and the self-expanding wireform at the septum region;
• wherein the self-expanding wireforms in the legs and at the septum region each have alternating peaks and valleys around their respective circumferences, and wherein the lateral reinforcement wire extends between a valley on the self-expanding wireform at the septum region and a peak on the self-expanding wireform in the one leg.

An intraluminal prosthesis comprising:

• a trouser graft having a trunk and two legs diverging in a downstream direction from the trunk at a septum region which is locatable upstream from an aortic bifurcation, the trouser graft being formed of a graft body having an external surface and an internal surface and comprising one or more expandable wireforms at its upstream end attachable to an aorta;
• and
• at least one self-expanding wireform connected primarily to the external surface of the graft body at the septum region;
• wherein the initial expanded diameter of one or more of the self-expanding wireforms is slightly larger than the diameter of the portion of the graft body to which it is attached.

A method of deploying a bifurcated intraluminal prosthesis to a site of implantation defined by a main vessel branching into two smaller vessels, comprising:

• endoluminally delivering a bifurcated graft comprising a trunk and two legs within an introducer sheath to a site of implantation;
• positioning the trunk within the main vessel;
• permitting the two legs to expand while preventing the trunk from expanding;
• insuring that the trunk is positioned properly;
• expanding the trunk into contact with the main vessel;
• delivering a first tubular extension into position with by placing one end of the tubular extension within one of the two trunk legs and placing the other end of the tubular extension within one of the two smaller vessels;
• and
• expanding the first tubular extension into contact with one of the two trunk legs and into contact with the one of the two smaller vessels.

A method of deploying a bifurcated intraluminal prosthesis to a site of implantation defined by a main vessel branching into two smaller vessels, comprising:

• providing a bifurcated graft comprising a trunk having one or more balloon-expandable wireforms, and two legs having one or more self-expanding wireforms;
• collapsing the trunk onto a balloon catheter;
• endoluminally delivering a bifurcated graft within an introducer sheath to a site of implantation;
• positioning the trunk within the main vessel;
• removing the graft from the introducer sheath and permitting the self-expanding wireforms to expand the graft legs while preventing the trunk from expanding by refraining from expanding the trunk with the balloon catheter;
• adjusting the position of the graft within the main vessel;
• expanding the trunk with the balloon catheter into contact with the main vessel;
• delivering a first tubular extension into position with one end within one of the two legs and with the other end within one of the two smaller vessels;
• and
• expanding the first tubular extension into contact with one of the two legs and into contact with the one of the two smaller vessels.