Appropriate endovascular treatment for aortic bifurcation lesions remains unclear. Incomplete apposition and radial mismatch have not been resolved to date. We treated two cases of aortic bifurcation lesions including common
iliac aneurysms with balloon-expandable covered
stents with "Double-D molding technique (DDMT)." This is the method. First, standard kissing
stent technique with two balloon-expandable covered
stents for aortic bifurcation lesions is performed. Second, either covered
stent post-dilated with a larger size percutaneous transluminal angioplasty (PTA) balloon before the other covered
stent also post-dilated with the same larger size PTA balloon. Kissing balloon technique was performed with the two previous size PTA balloons. Good double-D shape configuration is observed. This DDMT could improve the radial mismatch of the kissing covered
stents to distal aortic wall. 〈Learning objective: The treatment of aortoiliaic bifurcation disease including
iliac aneurysms with balloon expandable covered
stents using "double D-shape molding technique" is safe and effective.〉.