Use of diverging buddy wires to aid in precise endovascular stent placement at an arterial branch point

Endovascular stent placement at or near arterial branch points requires precision to avoid complications, including stent jumping or mal-deployment, with potential jailing of adjacent branch ostia. Here we describe the novel use of diverging buddy wires to ensure precise endovascular stent deployment in the innominate artery in a bovine arch initially managed by surgical primary repair. The use of divergent buddy wires provided stability in the complex anatomy, facilitating precise deployment at the arterial branch point with embolic protection in the carotid artery.