Mid-Term Outcomes of 'Covered Endovascular Reconstruction of Iliac Bifurcation: The 'CERIB' Technique
Miltiadis Matsagkas1, Petroula Nana1, Athanasios Chaidoulis1
1Vascular Surgery Department, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
Background:
The aim of this study is to present the 30-day and mid-term outcomes of the off-the-shelf covered endovascular reconstruction of iliac bifurcation (CERIB) technique in patients managed with endovascular repair for aortoiliac aneurysms.
Methods:
A single-center retrospective analysis was conducted including patients with aorto-iliac aneurysms that received the CERIB technique from December 2022 to December 2025. Proximal repair of the aorta was performed either with standard endovascular aneurysm repair (EVAR) or complex EVAR. Mortality, patency, presence of endoleak (EL), and reinterventions were analyzed at 30 days and during mid-term period.
Results:
Fifty-nine patients (mean age: 71.6 ± 6, 100% males) were included, receiving 78 CERIB procedures (19 bilaterally). Nineteen patients had previous endovascular aortic aneurysm repair and half of them (49%; 29/59) received primarily EVAR. The technical success was 100%. Two deaths (3,3%) were recorded in 2 fenestrated/branched endovascular aortic aneurysm repair (F/BEVAR) patients during 30-day postop period. The mean follow up was 12 ± 7 months, with one cancer-related death (1.7%; 1/57). Patency rate was estimated at 98% [standard error; (SE) 2%] at 12 months and remained the same with no further event during follow up. The freedom from gutter EL Ib rate was 96.8% (SE 2.2%) at 6 months and remained the same with no further event. The freedom from reintervention rate was 93.8% (SE 3%) at 6 months and remained the same with no further event.
Conclusion:
The CERIB technique represents an endovascular procedure for managing complex aorto-iliac pathology, with excellent technical success, favorable patency rates, low early complication and reintervention rates, and durable mid-term outcomes.
