Coil-Covering Caliber-Conforming Stent Grafting: The 4CSG Technique

Stable coil placement is an imperative when treating arterial pathology at branch points. Coil kick and escape threaten distal organs, particularly as the pack tightens. Before the development of the VBX balloon-expandable stent graft (W.L. Gore, Flagstaff, AZ), vessel caliber change often precluded straightforward stent graft coverage with a single device to secure coils in place. We describe 3 cases using this unique feature of the Gore VBX device to accommodate challenging anatomy. All 3 patients recovered well.