A
stent graft for placement in the thoracic arch of a patient has a tubular body defining a main lumen therethrough, a plurality of zig zag stents along the tubular body, each of the stents comprising a plurality of struts and bends, the bends being between adjacent struts. At least a first
stent and an adjacent second
stent having at least a pair of adjacent bends on the first stent aligned with an adjacent pair of bends on the second stent, whereby a first pair of adjacent struts of the first stent and a second pair of adjacent struts of the second adjacent stent together define
a diamond shape region. A recess is within the
diamond shaped region with the recess extending into the lumen of the tubular body. A fenestration extending into the tubular body within the recess in the
diamond shaped region and a graft tube leading from the fenestration into the main lumen. There can be one, two or three
diamond shaped regions, recesses, fenestrations and graft tubes Proximally of the or each diamond shaped region the tubular body has a first
diameter, distally of the diamond shaped region the tubular body has a second
diameter and in the region of the tubular body around the diamond shaped region the tubular body has a third
diameter, the first diameter being greater than the second diameter and both the first and second diameter being greater than the third diameter whereby a
central region is defined which will allow circumferential
blood flow during an operation out of the graft tube into the recess and then into the
central region.