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

This study aimed to evaluate the outcomes of branched 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 thirty day death.

Fifty-one cases were identified from 11 centres. The mean patient age was 74.3 ± 7.8 years (range 59 - 86 years), and 76% were men. Twenty-eight patients (55%) had aortic aneurysms, 18 (35%) had chronic aortic dissection, three (6%) had penetrating aortic ulcers, and two (4%) had intramural haematoma. Thirty-four patients (67%) were managed using the Nexus endograft, 14 (27%) 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 during the procedure. 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 thirty day technical success was 82% and the total thirty day mortality rate was 18%. After one year follow up, the cumulative mortality rate was 22% and the cumulative re-operation 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 at prohibitive risk of open surgical repair, but is not exempt from the occurrence of life threatening complications and short term death. Nevertheless, the one year results remain encouraging.