Evolution of the covered endovascular reconstruction of the aortic bifurcation technique for complex aorto-iliac occlusive disease

INTRODUCTION: The covered endovascular reconstruction of aortic bifurcation (CERAB) technique was introduced as a more anatomical and physiological configuration of stents to overcome the limits of standard endovascular technique with kissing stenting in terms of patency and reintervention rates in the treatment of complex aorto-iliac occlusive disease in particular when the aortic bifurcation is involved. The purpose of this systematic review is to report the evolution of this technique during recent years. EVIDENCE ACQUISITION: Data were retrieved from retrospective studies and case series excluding letters, editorial, and reviews conducted from 2000 to September 2022. EVIDENCE SYNTHESIS: The literature analysis provided data on the evolution of CERAB technique and the current evidence about clinical results. CONCLUSIONS: Since its introduction in 2009, CERAB technique has grown as a safe and effective endovascular therapeutic option for aorto-iliac occlusive disease. Data from prospective multicenter registries with dedicated stent grafts and comparative trials are needed to validate the technique.