Covered Endovascular Reconstruction of the Aortic Bifurcation as Salvage Endovascular Treatment for Post-Endovascular Aortic Repair Mycotic Pseudoaneurysm

Abstract Post-endovascular aortic repair mycotic pseudoaneurysms are rare, life-threatening complications. We report a 46-year-old man who developed Serratia marcescens bacteremia after infrarenal aortic stenting and presented 1 year later with abdominal pain, fever, weight loss, and vomiting. Computed tomography angiography demonstrated a 37-mm infrarenal mycotic pseudoaneurysm with periaortic inflammation and bilateral iliac stenoses. Endovascular salvage using the covered endovascular reconstruction of the aortic bifurcation (CERAB) successfully excluded the pseudoaneurysm. Follow-up at 1 and 6 months showed patent stents, symptom resolution, and reduced inflammation, supporting CERAB as a feasible salvage option.