Abstract: Apparatus and methods for endoluminally advancing a tubular prosthesis and a plurality of fasteners to a site in a lumen in a human body and passing the fasteners from an inner surface of the prosthesis through the prosthesis and a wall of the lumen to secure the prosthesis to the wall. Embodiments include simultaneous deployment of fasteners using a graft alone or in conjunction with a stent graft. Another arrangement includes guide lines to guide the end of the fixation deployment device to a specific location of the wall of the prosthesis.

Abstract: A tubular prosthesis having an opening formed in a side wall thereof is positioned in a first passageway in a human body with the opening facing and providing fluid flow to a first branch passageway that branches from the first passageway. A portion of the prosthesis that is in the vicinity of the juncture between the first passageway a second branch passageway is located and a second opening is formed in the located portion of the prosthesis so that the second opening faces the second branch passageway. In another embodiment, a tubular prosthesis is endovascularly delivered and positioned in a first passageway in a human body in the vicinity of a second passageway that branches from the first passageway. An imaging device, which is positioned in the prosthesis, locates the juncture between the first passageway and the second passageway after which a piercing member is advanced from the imaging device to a portion of the prosthesis adjacent to the juncture to form an opening in that portion of the prosthesis.