Global experience with an inner branched arch endograft

Area of Science:

• Vascular Surgery
• Endovascular Interventions
• Aortic Aneurysm Treatment

Background:

• Branched endografts represent a novel therapeutic approach for aortic arch aneurysms.
• Treatment of aortic arch aneurysms is challenging, particularly in high-risk patient populations.
• This study addresses the need for alternative treatment options beyond conventional open repair.

Purpose of the Study:

• To evaluate the feasibility and safety of a new branched endograft for aortic arch aneurysm repair.
• To assess early and mid-term outcomes, including mortality, technical success, and complications.
• To compare early experience with later outcomes to identify learning curve effects.

Main Methods:

• Retrospective multicenter analysis of 38 patients with aortic arch aneurysms treated with a specific branched endograft.
• The endograft featured two inner branches for supra-aortic trunk perfusion.
• Outcomes were analyzed, including 30-day and follow-up mortality, technical success, secondary procedures, and cerebrovascular complications.

Main Results:

• Technical success was achieved in 84.2% of patients.
• The 30-day mortality rate was 13.2%, with no aneurysm-related deaths during a median 12-month follow-up.
• Early cerebrovascular complications occurred in 15.8% of patients; early experience was associated with higher complication rates.

Conclusions:

• Endovascular repair using this branched endograft is feasible and safe in selected high-risk patients with aortic arch aneurysms.
• The study suggests this approach provides a viable alternative when conventional options are unsuitable.
• Experience gained over time may improve outcomes, reducing intraoperative complications and secondary procedures.