Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) Using Double D Technique for Leriche Syndrome: A Case Report

Abstract

Several studies of the covered endovascular reconstruction of the aortic bifurcation (CERAB) technique for aortoiliac occlusive disease have recently been reported. We treated a patient with Leriche syndrome who presented with 20-m severe intermittent claudication. Computed tomography showed that the left renal artery was located 20 mm caudal to the right renal artery. Eighty percent stenosis of the aorta at the right renal artery and aortic occlusion at the left renal artery were also depicted. The aortoiliac occlusion extended to both distal external iliac arteries. It was assumed that a height mismatch between the right and left stents into the juxta-renal abdominal aorta would occur if treated using the kissing stent technique. In this case, the CERAB technique was successfully implemented. We performed CERAB using the double D technique with only stent grafts and bare metal stents for peripheral artery use. The patient did not exhibit any symptoms for 1.5 years after undergoing the procedure, and the stent grafts and bare metal stents were patent without any reintervention.