title: Technical challenges encountered during deployment of the ovation abdominal aortic stent-graft system.
abstract: OBJECTIVE
  To describe technical challenges encountered using the Ovation endograft for abdominal aortic aneurysms and suggest tips and maneuvers for successful management.
  
  
  METHODS
  Deployment of the Ovation's unsupported main body is often associated with the anteroposterior arrangement of the limb gates instead of the usual side-by-side configuration, rendering contralateral catheterization challenging. Successful catheterization of the contralateral limb can be confirmed by lateral deviation of the ipsilateral stiff guidewire caused by balloon inflation within the contralateral limb. Moreover, failure to cannulate the contralateral limb gate due to persistent impingement of the guidewire or compromise of the inflated rings can be overcome using the transbrachial antegrade approach.
  
  
  CONCLUSIONS
  Awareness of certain aspects associated with the use of the Ovation device and adoption of the adjunctive techniques herein described helps the interventionist avoid unexpected challenges or manage technical difficulties to maximize the device's safety and effectiveness.
authors.affiliation: 1 Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Greece.
authors.forename: Efstratios
authors.initials: E
authors.lastname: Georgakarakos
authors.forename: George
authors.initials: G
authors.lastname: Trellopoulos
authors.forename: Chris V
authors.initials: CV
authors.lastname: Ioannou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsetis
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome