Stent graft apparatus and method

A method for repair of an aneurysm in a patient in which first and second iliac arteries branch off of an aorta which includes the aneurysm, the method comprising:

• obtaining a first catheter delivery system provided with a first stent graft having an upper tubular body, a lower bifurcation, and a flexible guidewire, the upper tubular body defining an inlet, the lower bifurcation including a first tubular leg defining a first outlet and a second tubular leg defining a second outlet, the flexible guidewire having an attachment end detachably attached to the upper tubular body and the flexible guidewire extending through the second tubular leg of the lower bifurcation;
• advancing said first catheter delivery system with said attachment end of said flexible guidewire attached to the upper tubular body through the first iliac artery of the patient to a location upstream of the aneurysm in the aorta, such that the attachment end of the flexible guidewire moves together the upper tubular body;
• deploying the first stent graft with the inlet positioned in the aorta upstream of the aneurysm, the first outlet of the first tubular leg positioned in the first iliac artery downstream of the aneurysm, and the second outlet of the second tubular leg positioned at or adjacent the aneurysm;
• advancing a guidewire engagement device distally through the second iliac artery to the flexible guidewire and while the attachment end of the flexible guidewire is attached to the first stent graft, pulling the flexible guidewire out of the first iliac artery and into the second iliac artery;
• advancing a guide catheter over the flexible guidewire to the second tubular leg of the first stent graft while the attachment end of the flexible guidewire is attached to the first stent graft;
• detaching the attachment end of the flexible guidewire from the first stent graft and removing the flexible guidewire from the first stent graft and the second iliac artery;
• introducing a stiffer guide wire through the guide catheter to the second tubular leg of the first stent graft;
• removing the guide catheter from the patient;
• advancing a second catheter delivery system provided with a second stent graft over the stiffer guide wire, the second stent graft defining an inlet and an outlet;
• deploying the second stent graft with the inlet of the second stent graft inside of the second tubular leg of the first stent graft and the outlet of the second stent graft positioned within the second iliac artery downstream of the aneurysm.