A single-center, mid-term study evaluating the efficacy of branched stent grafts in the treatment of aortic arch pathology in non-urgent patients.

INTRODUCTION: Branched thoracic endovascular aortic repair (bTEVAR) is a method enabling the treatment of complex aortic arch pathologies in patients who are not eligible for open surgery. This single-center study evaluated the medium-term results of aortic arch pathology treatment using the bTEVAR method. AIM: To evaluate the technical feasibility, safety and mid-term outcomes of bTEVAR technique for complex aortic arch pathologies in non-urgent patients. MATERIAL AND METHODS: The study included 15 patients treated with double- and triple-branched stent grafts based on specific criteria. Treatment evaluation was performed using computed tomography angiography. Technical success, perioperative complications, and follow-up results were assessed. RESULTS: Technical success was achieved in 12 (80%) patients. Within 30 days after the procedure, 1 (6.7%) death and 2 (13.3%) strokes, 1 of which was non-disabling, were observed. During the follow-up period, which averaged 15.6 months (median: 10 months, range: 0-47 months), endoleaks were observed in 3 patients, 2 of whom required reintervention. Three patients required further treatment due to progression of aortic pathology. No retrograde type A dissection, stent-graft-induced new entry, or stent-graft infection was observed. CONCLUSIONS: The bTEVAR technique using double- and triple-branched stent grafts in the treatment of patients with aortic arch pathology is a relatively effective method that prevents arch degeneration and offers acceptable medium-term results. This method can only be used by experienced vascular units due to the high risk of neurological complications and postoperative mortality.