Mid-term outcomes of 'Covered Endovascular Reconstruction of Iliac Bifurcation: the 'CERIB' technique.

INTRODUCTION: The aim of this study is to present the 30-day and mid-term outcomes of the off the shelf Covered Endovascular Reconstruction of Iliac Bifurcation (CERIB) technique in patients managed with endovascular repair for aortoiliac aneurysms. METHODS: A single-centre retrospective analysis was conducted including patients with aorto-iliac aneurysms that received the CERIB technique from December 2022 to December 2025. Proximal repair of the aorta was performed either with standard EVAR (endovascular aneurysm repair) or complex EVAR. Mortality, patency, presence of endoleak and reinterventions were analysed at 30-days and during mid-term period. RESULTS: Fifty-nine patients (mean age: 71.6±6, 100% males) were included, receiving 78 CERIB procedures (19 bilaterally). Nineteen patients had previous endovascular aortic repair and half of them (49%; 29/59) received primarily EVAR. The technical success was 100%. Two deaths (3,3%) were recorded in two F/BEVAR patients during 30-day post-op period. The mean follow up was 12±7 months with one cancer related death (1,7%; 1/57). Patency rate was estimated at 98% [standard error; (SE) 2%] at 12 months and remained the same with no further event during follow-up. The freedom from gutter endoleak Ib rate was 96.8% (SE 2.2%) at 6 months and remained the same with no further event. The freedom from re-intervention rate was 93.8% (SE 3%) at 6 months and remained the same with no further event. CONCLUSION: The CERIB technique represents an endovascular procedure for managing complex aorto-iliac pathology, with excellent technical success, favourable patency rates, low early complication and reintervention rates, and durable mid-term outcomes.