Although this is an established procedure, from a technical point of view the precise deployment of a stent at the origin of the common iliac artery is often critical. Two points must be considered: type of stent (selfexpandable or balloon expandable) and approach (ipsilateral or contralateral). Concerning the first point many Authors support the use of balloon expandable stents at the origin of the CIA because deployment is more precise without any problems such as the "jumping effect", sometimes observed with selfexpandable stents. Concerning the approach the ipsilateral approach is the one preferred because easier and more precise. The contralateral approach generally is a second choice and used when the ipsilateral approach fails. Generally it is a good option for EIA lesions which can be crossed better with an antegrade approach rather than in a retrograde fashion, but for lesions involving the origin of the CIA stent deployment can be difficult because the use of a stiff wire and of long introducer sheath tend to modify the anatomy of iliac bifurcation causing an inaccurate deployment. The reported manouvre of retracting the guide wire leaving only the distal floppy part of the wire inside the balloon catheter reduces the modifications of bifurcation anatomy and makes stent deployment more precise. This is a manouvre to use in selected cases from experienced operators.
Further advantages observed in this case are that a second arterial puncture was avoided reducing in this way discomfort for the patient, time procedure and costs (closure device).
Written informed patient consent for publication has been obtained.
 Self-Expanding Versus Balloon-Expandable Stents for Iliac Artery Occlusive Disease: The Randomized ICE Trial Journal: JACC Cardiovasc Interv., 2017, 2017 Aug 28;10(16):1694-1704.. Author: Krankenberg H, Zeller T, Ingwersen M et Al
 Percutaneous stenting in the treatment of iliac steno and obstructive lesions Journal: Radiol, Med., 1993, Sep;86(3):308-20. Author: Rabbia C, Rossato D, Savio D, Margarita G.
 Percutaneous iliac artery stent: angiographic long-term follow-up. Journal: Radiology, 1991, Sep;180(3):771-8. Author: Long AL, Page PE, Raynaud AC, Beyssen BM, Fiessinger JN, Ducimetière P, Relland JY, Gaux JC.