Journal of Vascular Surgery Cases and Innovative Techniques (Aug 2025)
Hybrid bypass exclusion of isolated common iliac artery mycotic aneurysm
Abstract
The management of mycotic aneurysms traditionally involves open surgical resection, extensive debridement, and in-situ revascularization, which carry substantial perioperative morbidity and mortality. Endovascular aneurysm repair offers a less invasive alternative, but risks persistent infection owing to direct prosthetic implantation onto infected aortic segments. We present a novel hybrid approach for common iliac artery mycotic aneurysms that avoids direct endoprosthesis placement onto infected aortic tissue. Performed in two patients, it combines aortouni-iliac endovascular aneurysm repair, contralateral distal embolization, and a crossover femoral bypass. Surveillance confirmed successful aneurysm exclusion.
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