Covered stent grafts are increasingly used for endovascular control of traumatic and iatrogenic access‑related arterial bleeding, such as those of the common femoral and external iliac arteries [1].

Both self‑expanding and balloon‑expandable covered stent grafts are used. In clinical practice, self‑expanding stent grafts are often preferred in junctional or mobile arterial segments, such as the groin, where there is risk of stent graft collapse.

In hemodynamically unstable patients, vessel diameter might be difficult to assess because of hypotension, vasospasm or ongoing hemorrhage. Balloon‑expandable covered stent grafts provide controlled, stepwise expansion with precise deployment and adaptation to the actual vessel caliber. This facilitates rapid sealing when landing zones are short, close to the inguinal ligament or branch vessels, and even in tapered anatomy at the iliac–femoral transition, and thereby faster bleeding control [2].

Figure 1 demonstrates active arterial extravasation from the right common femoral artery. Vessel diameter was estimated using measurements obtained from prior computed tomography imaging. A BeGraft covered stent graft was then deployed with progressive balloon inflation, enabling sizing adjustments. Successful bleeding control was achieved (Figure 2) and at the one‑month clinical follow‑up, limb perfusion was preserved. This case illustrates a typical EndoVascular Resuscitation and Trauma Management (EVTM) scenario in which device choice is guided by anatomical and procedural considerations rather than a generalized preference for a specific stent type [3].