The relay single-branched stent graft for distal aortic arch repair: mid-term single-center results

Endovascular repair of the aortic arch has progressed toward less invasive single-branched designs, aiming to reduce procedural morbidity while preserving effective supra-aortic vessel perfusion. The present study reports single-center outcomes using the Relay^™ single-branched stent graft.

Between February 2021 and September 2023, 11 consecutive patients underwent elective endovascular repair of distal aortic arch pathologies with the Relay^™ single-branched device. The study was designed as a retrospective observational cohort study. Device configuration included single branch alone (N.=5) or single branch combined with proximal scallop or fenestration (N.=6). Technical success, early complications, and mid-term outcomes were assessed.

Technical success was achieved in 10 patients (91%), with no in-hospital mortality. During a median follow-up of 17 months (range, 3-54 months), four non-aortic-related deaths were observed. Late complications occurred in two patients: one case of stent-induced new entry at 13 months, successfully managed with a distal extension, and one case of retrograde type A dissection at 5 months post-endovascular repair, treated with open aortic arch replacement using a frozen elephant trunk. No early neurological events were reported. Both reinterventions were successful, and target vessel patency was preserved in all cases.

The Relay^™ single-branched endograft demonstrated excellent technical success and favorable neurological outcomes in patients with distal arch disease. While the limited sample size restricts inference, these findings support the use of tailored single-branched devices as a safe alternative to more complex branched configurations in anatomically suitable patients.