A Salvage Hybrid Reconstruction Using Covered Stents for Internal Iliac Artery Preservation during Endovascular Aneurysm Repair in a Patient with an Extremely Short Common Iliac Artery: A Case Report

The anatomy of the short common iliac artery (CIA) limits distal sealing during endovascular aneurysm repair (EVAR) and often necessitates internal iliac artery (IIA) embolization. We report the case of a 73-year-old man with an infrarenal abdominal aortic aneurysm and an extremely short right CIA that precluded open repair and application of iliac branch devices. As a salvage approach, EVAR was combined with the placement of a covered stent from the right external iliac artery to the IIA and a femorofemoral bypass. Follow-up imaging at 21 months demonstrated preserved pelvic circulation, absence of aneurysm sac enlargement, and sustained graft patency without limb ischemia.