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Introduction The ‘Mega J’ technique represents an innovative adjunctive maneuver designed to promote braided-stent expansion and improve vessel wall apposition with a macrowire in lieu of balloon angioplasty. The Colossus wire (0.035’) is introduced through an intermediate catheter with its distal tip shaped like a ‘J’ and carefully advanced into the stent construct. Using the wire, distal and proximal segments of the braided-stent are gently manipulated to facilitate expansion and optimize vessel wall apposition. Follow-up angiography demonstrated patency of the Surpass Elite device with satisfactory proximal and distal apposition and no evidence of in-stent thrombosis.Methods An IRB-approved, prospectively maintained database of the senior authors’ cases was retrospectively reviewed to identify patients who underwent flow-diversion (FD) and utilized the MEGA J technique. Patient demographics, aneurysm characteristics, and procedural outcomes were recorded.Results From October 2025 to March 2026, 15 patients were identified who underwent a FD procedure utilizing the Mega J technique. The average age of these patients was 61 ± 3.9 years with 73% of them being female (11 patients).From the cohort, the average aneurysm size was 8 ± 1.3 mm with the majority of aneurysms located along the internal carotid artery (13 cases, 87%), one in the external carotid artery (1 case, 7%), and one in vertebral artery (1 case, 11%). The profile of aneurysm types included saccular (12 cases, 80%) and ruptured (3 cases, 20%). Out of the 15 patients, three received previous treatment for their aneurysms including clip (1 case), coiling (2 cases), and flow diversion (1 case). No complications were noted amongst this cohort, no iatrogenic vessel dissection occurred. No cases required balloon angioplasty. No cases required adjunctive stenting for apposition.Conclusion The use of this novel macrowire manipulation strategy demonstrates promise as a safe and effective adjunctive maneuver for optimizing stent vessel wall apposition during flow diversion procedures, while minimizing risk of perforation and wire disruption of the braid. These early results suggest that the ‘Mega J’ technique may serve as a valuable tool for neurointerventionalist’s, particularly in complex aneurysm cases requiring precise stent deployment.Disclosures K. Van Orden: None. J. Collard de Beaufort: None. J. Campos: 2; C; Rapid Medical. M. Arthur: None. B. Polis: None. J. Hamilton: None. F. Laghari: None. N. Beaty: 6; C; proctor for Medtronic Neurovascular, Stryker Neurovascular, and CMO of NeuroMedica. G. Colby: 2; C; Medtronic Neurovascular, MicroVention-Terumo, Rapid Medical, Cerenovus, and Stryker Neurovascular. A.L. Coon: 2; C; Medtronic Neurovascular, MicroVention-Terumo, Stryker Neurovascular, Cerenovus, Rapid Medical, Avail MedSystems, Imperative Care, Deinde, InNeuroCo, Q’apel. 6; C; proctor for MicroVention-Termo, Stryker Neurovascular, and Medtronic Neurovascular.Abstract E-024 Figure 1Illustration of the ‘Mega J’ technique, used to enhance vessel wall apposition during flow diversion with a Surpass Evolve stent in a previously coiled right posterior communicating artery aneurysm