Respiratory infection due to COVID-19 has been associated with thrombotic events such as deep vein thrombosis, pulmonary embolism, and, to a lesser extent, arterial thrombosis. Cases of acute aortic occlusion in COVID-19 patients have been previously described in the literature. Acute aortic occlusion has been associated with a 30-day mortality rate of 20%, an overall mortality rate of 60%, morbidity ranging from 30% to 74%, and a 30% risk of limb loss. Historically, surgical treatment has included aorto- bifemoral bypass, extra-anatomic bypass (axillo-bifemoral), bilateral inguinal thrombectomy, pharmacomechanical thrombectomy, and thrombolysis. Endovascular techniques provide new tools and therapeutic options, particularly for patients at high surgical risk. In selected cases, these may represent the only therapeutic option. However, optimal surgical management has not been standardized. We report a 64- year-old patient with bilateral acute ischemia caused by aortic occlusion in the context of COVID-19 pneumonia, new-onset atrial fibrillation, and a history of vocal cord cancer. The patient underwent a hybrid procedure under local anesthesia: femoral embolectomy, aortic endograft placement, and femorofemoral bypass due to chronic left external iliac occlusion. This approach is safe, effective and applicable to patients at high surgical risk and/or those contraindicated or unable to undergo intubation.