Endovascular Management of Complex Aortoiliac Occusive Disease with a Bifurcated Endograft: A Case Report and Literature Review

Severe aortoiliac occlusive disease (AIOD), particularly TransAtlantic Inter-Society Consensus (TASC) II C/D lesions, presents a therapeutic challenge and has traditionally been managed with aortobifemoral bypass, which offers durable patency but carries substantial perioperative morbidity and mortality. Endovascular approaches, including bifurcated endografts, have emerged as less invasive alternatives, demonstrating favorable patency outcomes, technical advantages, and reduced hospital stays. We present the case of a 49-year-old male with complex TASC II D lesions who was successfully treated with a bifurcated endograft. The procedure achieved complete revascularization without perioperative complications, and one-year follow-up confirmed durable patency. This case highlights the feasibility of bifurcated endografts in selected high-risk patients with advanced AIOD. Although encouraging, their application in non-aneurysmal disease remains off-label, underscoring the need for long-term and comparative studies to validate outcomes and guide patient selection.