Inner Branch Endografts in Complex AAA: Case Reports Comparing Off-The-Shelf and Custom-Made Options

Complex aortic aneurysm repair has witnessed remarkable advancements through endovascular solutions. In current practice, many endovascular repairs of the abdominal and thoracic aorta rely on patient-specific endografts designed and manufactured on demand, as their anatomical requirements cannot be met by assembling conventional off-the-shelf components. However, the E-nside system is currently the only commercially available thoracoabdominal endograft that incorporates pre-cannulated inner branches in an off-the-shelf design. The objective of this case series is to describe and compare clinical indications, technical features, and intraoperative outcomes of complex abdominal aortic aneurysm (AAA) treated using the inner branched off-the-shelf E-nside and custom-made E-xtra Design MultiBranch endografts under real-life circumstances. Both endografts were safe for treating complex aortic aneurysms. E-nside was more suitable for emergent cases due to easy availability and quick access. Patients of the custom-made series had lower aortic coverage, but radiation exposure did not differ.