Introducer for an iliac side branch device

Abstract

An introduction arrangement for a fenestrated or branched stent graft ( 13 ) intended for deployment into the lumen of a vessel having a blind vessel extending from it. The introducer ( 1 ) has a distal end intended to remain outside a patient in use and a proximal end with a nose cone dilator ( 11 ) and an arrangement to retain the branched stent graft distally of the nose cone dilator. A sheath ( 15 ) on the introducer extends over the branched stent graft to the nose cone dilator. An indwelling catheter ( 22 ) extends from the distal end of the introducer and enters the fenestration or side arm and through to the nose cone dilator, the indwelling catheter has a guide wire ( 29 ) extending through it. The guide wire can be extended beyond the nose cone dilator in use before the sheath is withdrawn from the branched stent graft so that it can be snared from the contra-lateral artery.

1 - 15 . (canceled) 
     
     
         16 . An introducer device and a stent graft retained thereon, the stent graft comprising a tubular body and a fenestration in the tubular body, an indwelling catheter having a guide wire extending therethrough and associated with the introducer device, the indwelling catheter extending through the stent graft and the fenestration and to the proximal end of the introducer device whereby the guide wire can be advanced beyond the proximal end of the introducer device so that it can be snared and a deployment device for a side arm can be deployed over the guide wire, once snared, to enter the fenestration. 
     
     
         17 . The introducer device and the stent graft of  claim 16 , where the stent graft has a proximal end and a distal end and the indwelling catheter extends outside of the stent graft distally of the fenestration and through the fenestration into the stent graft and towards the proximal end. 
     
     
         18 . The introducer device and the stent graft of  claim 16 , where the fenestration includes a side arm extending therefrom. 
     
     
         19 . The introducer device and the stent graft of  claim 18  where the side arm extending from the fenestration extends inside the stent graft towards either the proximal or distal ends thereof. 
     
     
         20 . The introducer device and the stent graft of  claim 18 , where the side arm extending from the fenestration extends outside the stent graft towards either the proximal or distal ends thereof. 
     
     
         21 . The introducer device and the stent graft of  claim 16 , where the stent graft has a proximal end and a distal end and the indwelling catheter extends inside of the stent graft distally of the fenestration and through the fenestration out of the stent graft and towards the proximal end thereof. 
     
     
         22 . The introducer device and the stent graft of  claim 16 , where a nose cone dilator has a longitudinal groove on an outside surface thereof and the indwelling catheter is received into the longitudinal groove. 
     
     
         23 . An introduction arrangement for a stent graft intended for deployment into the lumen of a vessel having a blind vessel extending therefrom, the introduction arrangement comprising an introducer device in combination with the stent graft,
 the stent graft comprising a main tubular body comprising a stent graft distal end and a stent graft proximal end and a main lumen therethrough,   the introducer device comprising an introducer distal end intended to remain outside a patient in use and an introducer proximal end to be introduced into a patient in use, the introducer device comprising a guide wire catheter, the guide wire catheter extending from the introducer distal end to the introducer proximal end, an introduction catheter over the guide wire catheter and extending from the introducer distal end towards the introducer proximal end, the introduction catheter comprising an introducer lumen and the guide wire catheter extending through the introducer lumen, a nose cone dilator on the guide wire catheter at the introducer proximal end and an arrangement to retain the stent graft on the introducer device distally of the nose cone dilator, the guide wire catheter extending through the main lumen of the main tubular body;   a retractable sheath on the introducer device extending over the introduction catheter and the stent graft to the nose cone dilator;   an indwelling catheter and an indwelling guide wire within the indwelling catheter and extending therethrough,   the indwelling catheter extending from the introducer distal end through the introducer lumen in the introduction catheter to the branched stent graft, the indwelling catheter exiting from the introducer lumen at a distal end of the stent graft, the indwelling catheter then entering into the main lumen and then extending out of the proximal stent graft end to the nose cone dilator, the indwelling catheter and indwelling guide wire extending beyond the retractable sheath,   whereby the indwelling guide wire can be extended beyond the nose cone dilator in use before the sheath is withdrawn from the branched stent graft.   
     
     
         24 . The introduction arrangement for a stent graft as in  claim 23 , where the nose cone dilator has a longitudinal groove on an outside surface thereof and the indwelling catheter and indwelling guide wire are received into the longitudinal groove. 
     
     
         25 . The introduction arrangement for a stent graft as in  claim 23 , where the stent graft includes a side branch extending therefrom and the indwelling catheter extends through the side branch whereby a deployment device for deploying a side arm into the side branch can be deployed over the guide wire, once snared, to enter the side branch. 
     
     
         26 . The introduction arrangement for a stent graft as in  claim 25 , where the stent graft has a proximal end and a distal end and the indwelling catheter extends outside of the stent graft distally of the side branch and through the side branch into the stent graft and within the stent graft to the proximal end of the stent graft. 
     
     
         27 . The introduction arrangement for a stent graft as in  claim 26 , where the side branch extends inside the stent graft towards either the proximal or distal ends of the stent graft. 
     
     
         28 . The introduction arrangement for a stent graft as in  claim 26 , where the side branch extends outside the stent graft towards either the proximal or distal ends of the stent graft. 
     
     
         29 . The introduction arrangement for a stent graft as in  claim 23 , where the stent graft includes a fenestration therein and the indwelling catheter extends through the fenestration whereby a deployment device for deploying a side arm into the fenestration can be deployed over the guide wire, once snared, to enter the fenestration. 
     
     
         30 . The introduction arrangement for a stent graft as in  claim 29 , where the indwelling catheter extends outside of the stent graft distally of the fenestration and through the fenestration into the stent graft and within the stent graft to the proximal end of the stent graft. 
     
     
         31 . The introduction arrangement for a stent graft as in  claim 23 , where the arrangement to retain the stent graft on the introducer device includes trigger wires extending to the introducer distal end and release arrangements for separate release of the proximal and distal ends of the stent graft from the introducer device. 
     
     
         32 . The introduction arrangement for a stent graft as in  claim 31 , where the arrangement to retain the proximal stent graft end of the stent graft on the introducer device comprises a pair of loops of suture material each of which is engaged with a trigger wire and the loops being placed onto the stent graft so that there is formed a smaller and larger fold of the stent graft at its proximal end and the indwelling catheter passing through the region defined by the larger fold. 
     
     
         33 . An introduction arrangement for a fenestrated graft intended for deployment into the lumen of a vessel having a blind vessel extending therefrom,
 the fenestrated stent graft having a main tubular body having a distal end and a proximal end with a main lumen therethrough, a fenestration in the main body,   the introduction arrangement including an introducer, the introducer having a distal end intended to remain outside a patient in use and a proximal end, the proximal end having a nose cone dilator and an arrangement to retain the fenestrated stent graft distally of the nose cone dilator, the fenestrated stent graft being retained on the introducer and a sheath on the introducer extending over the fenestrated stent graft to the nose cone dilator, an indwelling catheter extending from the distal end of the introducer through an introducer lumen in the introducer to the fenestrated stent graft, exiting from the introducer lumen at a distal end of the fenestrated stent graft and entering the fenestration into the main lumen and extending out of the proximal end of the fenestrated stent graft to the nose cone dilator, the indwelling catheter having a guide wire extending therethrough,   whereby the guide wire can be extended beyond the nose cone dilator in use before the sheath is withdrawn from the fenestrated stent graft.   
     
     
         34 . The introduction arrangement for a fenestrated stent graft as in  claim 33 , where the nose cone dilator has a longitudinal groove thereon to receive the indwelling catheter. 
     
     
         35 . The introduction arrangement for a fenestrated stent graft as in  claim 33 , where the means to retain the fenestrated stent graft on the introducer includes trigger wires extending to the distal end of the introducer and release arrangements for separate release of the proximal and distal ends of the stent graft from the introducer.