The disclosure is directed to a pre-loaded stent graft delivery device. The pre-loaded stent graft delivery device includes a guide wire catheter having a guide wire lumen therethrough; and a handle assembly disposed at a distal end of the guide wire catheter. The handle assembly includes a proximal handle, a rotational handle, a slot, and a sheath follower. The proximal handle, including a manifold including at least one side port, is disposed at a proximal end of the handle assembly. The slot is disposed inside the rotational handle, and is fixed and remains stationary relative to the proximal handle. The sheath follower is disposed slidably in the slot and fixed to a distal portion of a sheath. The rotational handle includes an internal thread mechanically coupled with the sheath follower, so that, when the rotational handle rotates toward a first rotational direction, the sheath is pulled to move distally.