Endovascular Surgery or Both: A Case Report of Hybrid Procedure in a Patient with Abdominal Aortic Aneurysm and Tasc D Aortoiliac Occlusive Disease

Hybrid procedure, a combination of endovascular and open surgical approach, has emerged as the first-line treatment for patients with severe aortoiliac diseases because of its effectiveness. We report a hybrid procedure in a 72 year old man with an Abdominal Aortic Aneurysm (AAA) and Trans-Atlantic Inter-Society Consensus (TASC) D aortoiliac occlusive disease. After two failed attempts using the intraluminal technique (retrograde and antegrade), we successfully performed an endovascular approach with subintimal and Subintimal Arterial Flossing Antegrade-retrograde Intervention (SAFARI) technique with the help of roadmap technology. The vascular surgeon completed the procedure by creating femorofemoral bypass using a Great Saphenous Vein (GSV) graft. The graft was patent and there were no complications at 1 week, 1 month and 6 months follow-up.