Update on covered endovascular reconstruction of the aortic bifurcation

Vascular. 2020 Jun;28(3):225-232. doi: 10.1177/1708538119896197. Epub 2020 Jan 2.

Abstract

Objective: The covered endovascular reconstruction of the aortic bifurcation (CERAB) technique was introduced in 2009 in order to provide an anatomically and physiologically optimal endovascular reconstruction of the aortic bifurcation.

Method: In the current review, all available evidence on this technique was summarized.

Results: In vitro studies have shown a more favorable geometry of CERAB compared to kissing stents, leading to better local flow conditions. The results of CERAB are at least as good as those achieved with kissing stents in a more complex group of treated patients. The mid-term patency rates approach those of surgical reconstruction. Initial data show that the technique can also be used in combination with chimney grafts in order to preserve side branches.

Conclusion: CERAB has proven to be the most optimal endovascular treatment option for aorto-iliac occlusive disease with regard to geometry and flow and is related to promising clinical outcomes. Prospective and comparative trials are necessary to elucidate the most optimal treatment algorithm for patients with aorto-iliac occlusive disease.

Keywords: Aortoiliac; Leriche syndrome; aortic bifurcation, CERAB; covered balloon-expandable stent; covered endovascular reconstruction of the aortic bifurcation; endovascular; iliac artery; occlusive disease.

Publication types

  • Systematic Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aorta / diagnostic imaging
  • Aorta / physiopathology
  • Aorta / surgery*
  • Aortic Diseases / diagnostic imaging
  • Aortic Diseases / physiopathology
  • Aortic Diseases / surgery*
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / physiopathology
  • Arterial Occlusive Diseases / surgery*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Humans
  • Iliac Artery / diagnostic imaging
  • Iliac Artery / physiopathology
  • Iliac Artery / surgery*
  • Male
  • Middle Aged
  • Prosthesis Design
  • Risk Factors
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency