Preloaded contralateral gate techniques during endovascular aortic repair for aneurysms and occlusive disease

We present two preloaded techniques to facilitate gate cannulation during endovascular aortic repair. In the first case, we relined the aorta using a Gore iliac branch endoprosthesis (WL Gore and Associates, Flagstaff, Ariz) for acute occlusion. This allowed for preloading the contralateral gate, which was compressed when deployed, and subsequently dilated open over the preloaded wire to allow for cannulation. The second patient had had an infrarenal aneurysm. A Gore Excluder was partially deployed extracorporeally to preload the gate from the ipsilateral side. The "snare ride" technique was used to rapidly cannulate the gate. Preloaded wire techniques during endovascular aortic repair can facilitate rapid gate cannulation, especially in patients with challenging anatomy.