Real world one-year outcomes of the GORE® VIABAHN® balloon-expandable endoprosthesis in FEVAR and BEVAR: insights from the EXPAND and EMBRACE registries.

The aim of this study was to evaluate one-year clinical performance and safety of the GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis (VBX Stent Graft) used as a bridging stent in fenestrated and branched endovascular aortic repair (FEVAR and BEVAR). This narrative review summarizes one-year outcomes from two multicenter European registries, EXPAND and EMBRACE. Outcomes are presented separately for FEVAR and BEVAR cohorts within each study, without statistical pooling or cross-study comparison. Endpoints assessed included target vessel (TV) technical success, primary patency, target-vessel instability (TVI), freedom from reintervention, and survival at one year. EXPAND included 39 FEVAR patients (97 TVs) and 73 BEVAR patients (223 TVs), and EMBRACE included 103 FEVAR patients (208 TVs) and 165 BEVAR patients (454 TVs). Technical success was 100% for both FEVAR cohorts and reached 100% and 99.6% in the EXPAND and EMBRACE BEVAR cohorts, respectively. At one year, TV primary patency in FEVAR was 100% (EXPAND) and 99.4% (EMBRACE), while BEVAR patency was 94.9% (EXPAND) and 98.9% (EMBRACE). Freedom from TVI was 100% and 96.6% in FEVAR and 97% and 94.5% in BEVAR (EXPAND and EMBRACE, respectively). Patient-level freedom from reintervention remained high across FEVAR (100% EXPAND, 94.8% EMBRACE) and BEVAR (92.6% EXPAND, 91.7% EMBRACE). All TV reinterventions were managed endovascularly. One-year survival was higher in FEVAR (94.9% EXPAND, 94.1% EMBRACE) than in BEVAR (86.2% EXPAND, 79.2% EMBRACE). The VBX stent graft is an effective bridging stent, with near-perfect technical success and excellent one-year TV patency in FEVAR and BEVAR. BEVAR showed higher reintervention rates that remained low and manageable with percutaneous secondary procedures.