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Use of a Molding Balloon to Facilitate Introduction of Guiding Catheters in Fenestrated Stent-Graft Procedures

Purpose: To present a technique that addresses the problem of passing guiding catheters through a stent-graft fenestration and into the target orifice over the wire within the visceral vessel when the fenestration is remote from the top cap. Technique: A compliant molding balloon is introduced into the main body of the stent-graft and inflated above the fenestration to fill the redundant space in the proximal stent-graft to prevent upward angulation and subsequent displacement of the wire from the target vessel when a less flexible catheter is passed. Conclusion: This technique is useful in cases with tortuous and complex anatomy and may reduce overall procedure times.