Hybrid surgical technique for open abdominal aortic aneurysm repair in the setting of severe iliac artery calcification

In the present report, we describe the case of a patient with an infrarenal abdominal aortic aneurysm that had been incidentally noted on an imaging study. Treatment decisions for this case were complicated by the presence of a hostile infrarenal aortic neck and significant bilateral iliac artery circumferential calcification, precluding iliac artery clamping and standard distal anastomotic techniques. We performed a hybrid surgical procedure, deploying bilateral iliac stent grafts into the distal aneurysmal aorta and sewing our aortic graft to the proximal extent of these stents. The findings from the present case add to the previously reported techniques of hybrid surgical management of abdominal aortic aneurysms with iliac disease and expand the technique to a larger application.