Covered endovascular reconstruction of the aortic bifurcation (cerab) for chronic aortoiliac occlusion: a two-caseseries at Dong Nai General Hospital

Abstract

Background:Complex aortoiliac occlusive disease is a major cause of chronic limb ischemia, impairing quality of life and increasing amputation risk. Aortobifemoral bypass surgery provides durable results but with high morbidity. Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) offers a less invasive and hemodynamically favorable alternative.

Objectives: To initially evaluate the safety, feasibility, and efficacy of CERAB in treating complex aortoiliac occlusive disease

Methods: We report two male patients (58 and 70 years) with multiple cardiovascular risk factors, diagnosed with terminal aortic and bilateral common iliac occlusion. Both underwent CERAB at Dong Nai General Hospital, with post-procedural clinical, ABI, and imaging follow-up.

Results:
Technical success was achieved in both cases with restored flow and ABI improvement from ~0.4 to > 0.9. No peri-procedural complications were observed. At 3-month follow-up, imaging confirmed stent patency; one residual iliac stenosis was successfully treated with adjunctive stenting.

Conclusion:
CERAB is a safe, feasible, and effective technique for complex aortoiliac disease. Its implementation at provincial hospitals provides significant patient benefits, reduces overall costs, and underscores the strategic importance of advancing endovascular interventions in local healthcare systems.