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Hybrid bypass exclusion of isolated common iliac artery mycotic aneurysm

Vanessa Irvine1, Kalpana Vijaykumar2, Edward Choke Tieng Chek3

  • 1Department of Vascular Surgery, Liverpool Hospital, Sydney, New South Wales, Australia.

Journal of Vascular Surgery Cases and Innovative Techniques
|June 12, 2025
PubMed

Insights

This study introduces a new hybrid surgical technique for treating mycotic aneurysms in the common iliac artery. This innovative approach successfully excludes aneurysms while minimizing risks associated with traditional open surgery and endovascular methods.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Medical Devices

Background:

  • Mycotic aneurysms require complex management, often involving high-risk open surgery.
  • Current endovascular aneurysm repair (EVAR) risks persistent infection due to prosthetic placement on infected tissue.

Purpose of the Study:

  • To present a novel hybrid surgical technique for common iliac artery mycotic aneurysms.
  • To offer a less invasive alternative with reduced risk of persistent infection.

Main Methods:

  • A hybrid approach combining aortouni-iliac EVAR, contralateral distal embolization, and crossover femoral bypass.
  • Performed in two patients with common iliac artery mycotic aneurysms.

Main Results:

  • Successful exclusion of mycotic aneurysms in both patients.
  • Avoided direct endoprosthesis placement onto infected aortic segments.

Conclusions:

  • The novel hybrid approach is a viable and effective treatment for common iliac artery mycotic aneurysms.
  • This technique offers a promising alternative to traditional open surgery and standard EVAR.
Keywords:
AneurysmEndovascularIliacMycoticVascular

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