A combination double-barreled and debranching stent graft and methods for its use, where the stent graft comprises, a main body stent graft defining a single lumen and having distal and proximal ends, a first bifurcation defining first and second lumens, the main body stent graft defines a tubular wall that is contiguous with the first and second lumens such that any fluid entering the main body stent graft must exit by entering one of the first or second lumens, a second bifurcation within the second lumen defining first and second legs, and a third bifurcation within the second leg defining third and fourth legs.
