Proximal Stent Deployment without Contrast during Endovascular Aneurysm Repair: An Improved Technique

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Abstract
Purpose: To describe a technique to enhance stent visibility on the fluoroscopic monitor during aortic endograft deployment. Technique: To assist in accurate positioning and deployment of the proximal stent in a Parodi-type aortic endograft, the stent is affixed to the balloon so that the radiopaque marker sits at the stent's distal end. When the device is in position and the sheath is retracted, the stent and the radiopaque balloon markers are clearly seen on the fluoroscopic image. Using normal saline only to inflate the balloon allows the stent to remain visible throughout deployment. Conclusions: The use of saline rather than contrast medium for balloon inflation provides continuous visualization of the stent during expansion, thus facilitating accurate deployment and early recognition of balloon migration within the stent.