ObjectiveTo analyze the main points and advantages of covered endovascular reconstruction of aortic bifurcation (CERAB) technique in the treatment of complex aortic and iliac artery lesions. MethodThe data of the patient with bilateral common iliac artery stenosis and lower abdominal aortic calcification treated by CERAB technology in the Department of Vascular Surgery of West China Hospital of Sichuan University and the technology in combination with the characteristics of balloon-expandable covered stent were analyzed. ResultsThe lesions were successfully treated by CERAB technique. The stents of bilateral iliac arteries were in perfect shape and good adherence. The radiography of the abdominal aorta and bilateral internal and external iliac arteries were well displayed. ConclusionsFrom analysis results of this case, CERAB technology is effective and feasible in treatment of lesions at the bifurcation of the main aortic and iliac artery. The shape of aortic bifurcation is satisfactorily recovered. The key point for the successful implementation of this technology is balloon-expandable covered stent.
ObjectiveTo evaluate the mid-term clinical outcomes of covered endovascular reconstruction of aortic bifurcation (CERAB) for the treatment of complex aortoiliac occlusive disease and to evaluate the efficacy and safety of this technique. MethodsA total of 12 patients with complex aortoiliac occlusive lesions [Trans-Atlantic Inter-Society Consensus (TASC) Ⅱ C and D] who underwent CERAB reconstruction at West China Hospital of Sichuan University, from December 2020 to December 2024 were prospectively enrolled and analyzed. Baseline and procedural data and follow-up data at 1, 6, 12, and 24 month(s) were collected. Technical success and 30-day complications as well as overall survival were evaluated. Patency and freedom from target lesion revascularization rates were analyzed using Kaplan-Meier curve. ResultsAll patients were male, with an age of (66.1±8.3) years; 10 cases were TASC Ⅱ C and 2 were TASC Ⅱ D. Technical success was achieved in all procedures. There were 2 cases of the procedure-related complications: one patient developed acute ischemia of the left lower limb postoperatively and recovered after emergency thrombectomy and endarterectomy; another patient died of a cerebrovascular event on day 3 after surgery. No bleeding, renal failure, pseudoaneurysm, or dissection occurred. The cumulative overall survival rates at 6, 12, and 24 months after surgery calculated by the Kaplan-Meier method were all 91.7%, with the cumulative primary patency rates being 86.7%, 73.4%, and 73.4% respectively, and the cumulative secondary patency rates being 100%, 100%, and 92.9% respectively. No amputations occurred during follow-up. ConclusionsThe results of this cohort suggest that CERAB induces favorable mid-term efficacy and safety in the treatment of complex aortoiliac occlusive lesions (TASC Ⅱ C and D). However, the further research is required to explore its suitability for the juxtarenal lesions of TASC Ⅱ D.