Short Term Outcomes of a Dedicated Balloon Expandable Bridging Stent in Branched Endovascular Aortic Aneurysm Repair.

Abstract

This study aimed to report the short term outcomes of the BeGraft Peripheral Plus (BGP+) bridging stent graft following branched endovascular aortic repair (BEVAR) of thoraco-abdominal and complex abdominal aortic aneurysms. All consecutive patients treated in six high-volume centers with BEVAR incorporating at least one branch for the renovisceral arteries (outer branches) and who received at least one BGP+ as a bridging stent graft were included and data retrospectively analyzed. A total of 2 418 target visceral vessels in 729 patients undergoing BEVAR were bridged with a BGP+. Technical success was achieved in 99.3% of branches. The median follow up was 17 months (interquartile range 10, 35 months). The estimated 1 and 2 year branch primary patency was 98.3% (standard error [SE] 0.3) and 95.8% (SE 0.7), respectively, with a total of 56 occlusions. The estimated 1 and 2 year branch secondary patency was 99.2% (SE 0.2) and 98.4% (SE 0.3), respectively. The target vessel instability rate was 2.9%, with seven type Ic endoleaks (T1cELs), one type 3b EL, and two type 3c ELs. The overall 30 day mortality rate was 6.0%. Additional unplanned stents were deployed in 268 of 2 418 target visceral vessels owing to vessel dissection (n = 4), need for extended seal (n = 185), vessel angulation (n = 73), vessel perforation (n = 5), or T1cEL (n = 1). The estimated 1 and 2 year freedom from branch related re-intervention was 99.3% (SE 0.2) and 98.4% (SE 0.3), respectively. BEVAR performed with BGP+ bridging stents is associated with very satisfactory short term outcomes. Longer follow up is required to confirm these promising results.