Transluminally placed endovascular graft (TPEG) replacement has been applied to treat various aortic diseases. At the moment of deployment, TPEG receives a pressure pulse force to shove it distally, which possibly results in misplacement. Moreover, deploying the TPEG in the aorta increases cardiac afterload, which may damage myocardial function. To avoid these risks, we developed a new technique to control blood pressure by almost complete venous return occlusion. Two occlusion balloon catheters are inserted into the superior and inferior vena cava via the femoral vein. TPEG is deployed at the proper position during inflation of the vena cava balloon to maintain a blood pressure as low as 60 mm Hg by cardiac preload blockage. We, thus far, have not experienced even a trivial sequela with this technique.
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