Endovascular Branched Stent Grafts for Aortic Arch Pathologies in Spain (ENDOBARC-S Study): A Prospective Multicentre...

This study aimed to evaluate the outcomes of branch stent grafts for aortic arch pathologies, with proximal landing in zone 0.

This was a multicentre, prospective, clinical follow up, non-sponsored, nationwide study. Consecutive patients with aortic arch pathologies treated with branched stent grafts (Nexus stent graft system, Relay Branch, or Zenith Arch Branch Graft) from January 2022 to November 2025 were identified from a prospective database. The primary endpoint was 30 day mortality.

Fifty one cases were identified from 11 centres. Patient age (mean ± SD) was 74.3 ± 7.8 (59 - 86) years, and 77% were men. Twenty eight patients (55%) had aortic aneurysms, 18 (35%) had chronic aortic dissection, 3 (6%) had penetrating aortic ulcers, and two (4%) had intramural haematoma. Thirty four patients (67%) were managed using the Nexus endograft, 14 (28%) with Relay, and three (6%) with Zenith. A total of 77 branches were included in the study, and 45 patients (88%) underwent supra-aortic vessel revascularisation surgery. Two patients (4%) died intraprocedurally. Technical success was achieved in 96% of cases. Minor strokes were recorded in nine cases (18%); 67% of these occurred after Relay Branch stent graft implantation (p = .027). Full recovery was observed in all cases. The 30 day technical success was 82%, and the total 30 day mortality rate was 18%. After 1 year follow up, the cumulative mortality was 22% and the cumulative reoperation rate was 16%. Despite the limited sample size, no statistically significant differences in mortality were found between endograft types.

Endovascular treatment of aortic arch pathologies with branched endografts offers a minimally invasive treatment option for patients with prohibitive risk for open surgical repair, but it is not exempt from the occurrence of life threatening complications and short term mortality. Nevertheless, the 1 year results remain encouraging.