Over-the-balloon placement of the Gore Hybrid Vascular Graft in challenging clinical conditions.

This report describes a useful technique for deployment of the Gore Hybrid Vascular Graft (W. L. Gore and Associates, Flagstaff, Ariz) in difficult clinical situations that create challenges in obtaining vascular control before introducing the nitinol-reinforced section of the graft. In both arterial and venous applications, introducing the Gore Hybrid Vascular Graft over a balloon allows concurrent vascular control by inflation of the balloon and easier introduction of the device into the recipient vessel by creating a smoother transition between the leading edge of the graft and the guidewire. Examples of both arterial and venous applications of this novel technique are presented.