| Summary: | Steno-obstructive lesion of the iliac axes and coexisting abdominal aortic aneurysm (AAA) are classified as TASC D aorto-iliac lesions. Although open surgical repair remains the gold standard, updates on stent-grafts labeling and technical improvements have resulted in a gradual replacement of open surgical bypass with endovascular treatments, especially in high-risk patients. We report a case of an infrarenal AAA with hostile proximal aortic neck associated with a chronic total occlusion of the left external iliac artery (EIA). Ovation Alto stent-graft implantation (Endologix, Santa Rosa, CA, USA) was performed through the iliac endoconduit, after EIA's retrograde subintimal recanalization with the re-entry IVUS-guided catheter.
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