Expanded polytetrafluoroethylene versus polyethylene terephthalate bridging stents for brachiocephalic trunk incorporation during arch branched endovascular repair: A comparative analysis and clinical implications.

Abstract

To compare postdeployment geometry, early clinical outcomes, and late durability of expanded polytetrafluoroethylene (ePTFE) vs polyethylene terephthalate (PET) bridging stents (BSs) used for brachiocephalic trunk (BCT) incorporation during arch branched endovascular aortic repair (A-BEVAR). A retrospective single-center analysis was conducted of patients undergoing A-BEVAR with a triple branch and antegrade BCT incorporation between 2018 and 2025. Patients were stratified according to BCT BS material (ePTFE vs PET). Postoperative computed tomography imaging was used to assess stent length behavior, diameter mismatch, angulation, and tortuosity. Early outcomes included technical success and 30-day complications. Late outcomes included BCT-related reinterventions and all-cause mortality. Seventy-nine patients were included (36 ePTFE, 43 PET). PET BSs demonstrated significantly greater foreshortening and changes in angulation compared with ePTFE devices (all P < .05). Technical success exceeded 94% and early clinical outcomes, including stroke, reintervention, and 30-day mortality, were comparable between groups. During follow-up, all-cause mortality did not differ between graft types (log-rank P = .639). Freedom from BCT-related reintervention was significantly higher in the ePTFE group (log-rank P = .039). Although early outcomes were similar, ePTFE BSs demonstrated more favorable postdeployment geometry and improved freedom from late BCT-related reintervention compared with PET stents. These findings suggest that graft material may influence long-term durability after A-BEVAR.