Hybrid bypass exclusion of isolated common iliac artery mycotic aneurysm

The management of mycotic aneurysms traditionally involves open surgical resection, extensive debridement, and in-situ revascularization, which carry substantial perioperative morbidity and mortality. Endovascular aneurysm repair offers a less invasive alternative, but risks persistent infection owing to direct prosthetic implantation onto infected aortic segments. We present a novel hybrid approach for common iliac artery mycotic aneurysms that avoids direct endoprosthesis placement onto infected aortic tissue. Performed in two patients, it combines aortouni-iliac endovascular aneurysm repair, contralateral distal embolization, and a crossover femoral bypass. Surveillance confirmed successful aneurysm exclusion.