Infrarenal aortic balloon expandable stent-graft deployment utilizing the sheath control technique in a patient with hemorrhagic shock secondary to an aortoenteric fistula

Abstract: A 40-year-old male patient presented with hemorrhagic shock due to an aorto-duodenal fistula. Angiography demonstrated vasospasm of the right common femoral artery to 2 mm. A balloon expandable stent graft was utilized given the smaller sheath diameter compared to the standard self-expandable aortic stent grafts. Given the undersized delivery balloon for the aorta, a sheath control technique was utilized. The stent-graft was deployed with approximately 1/3rd remaining in the sheath. The 11 mm balloon was then exchanged out for a 16 mm balloon and used to achieve apposition to the aortic wall bridging the patient to definitive surgical repair.