Self-Expandable versus Balloon-Expandable Bridging Stents in Off-the-Shelf Inner Branch Repair: Midterm Results from the INBREED Registry.
To compare the outcomes of self-expandable (S-EXP) and balloon-expandable (B-EXP) bridging stents used with the E-nside off-the-shelf inner-branch endograft for thoracoabdominal and complex abdominal aortic aneurysm repair within the ItaliaN Branched Registry of E-nside EnDograft (INBREED) registry.
All patients enrolled in the INBREED registry between January 2021 and December 2024 were analyzed. Clinical, anatomical, and procedural data were collected for all target vessels (TVs). The most frequently used self-expandable (S-EXP) and balloon-expandable (B-EXP) bridging stents were identified and compared. The primary endpoint was target vessel instability (TVI), defined as a composite of occlusion, significant stenosis, type Ic/IIIb/IIIc endoleak, kinking, disconnection, rupture, or target vessel-related mortality. Secondary endpoints included technical success and reintervention rates.
A total of 581 target vessels (TVs) from 148 patients were analyzed: 423 (72.8%) were bridged with B-EXP and 158 (27.2%) with S-EXP stents. Overall technical success was 99.5%. During a mean follow-up of 22.1 ± 12.3 months, TVI occurred in 40/581 vessels (6.9%), with a lower incidence in the S-EXP group (3.2%) compared to the B-EXP group (8.3%; p = .03). However, this association did not remain statistically significant at multivariable analysis, which identified only renal target vessels (OR 1.87; 95% CI, 1.05-3.82; p = .045) and pre-existing target vessel stenosis (OR 1.93; 95% CI, 1.13-4.11; p = .047) as independent predictors of TVI.
Inner-branch endovascular repair with the E-nside endograft achieved high technical success and favorable mid-term outcomes. A lower crude rate of target vessel instability was observed with self-expandable stents; however, this association did not remain significant after multivariable adjustment. Renal target vessels and pre-existing stenosis were identified as the main predictors of instability.
All patients enrolled in the INBREED registry between January 2021 and December 2024 were analyzed. Clinical, anatomical, and procedural data were collected for all target vessels (TVs). The most frequently used self-expandable (S-EXP) and balloon-expandable (B-EXP) bridging stents were identified and compared. The primary endpoint was target vessel instability (TVI), defined as a composite of occlusion, significant stenosis, type Ic/IIIb/IIIc endoleak, kinking, disconnection, rupture, or target vessel-related mortality. Secondary endpoints included technical success and reintervention rates.
A total of 581 target vessels (TVs) from 148 patients were analyzed: 423 (72.8%) were bridged with B-EXP and 158 (27.2%) with S-EXP stents. Overall technical success was 99.5%. During a mean follow-up of 22.1 ± 12.3 months, TVI occurred in 40/581 vessels (6.9%), with a lower incidence in the S-EXP group (3.2%) compared to the B-EXP group (8.3%; p = .03). However, this association did not remain statistically significant at multivariable analysis, which identified only renal target vessels (OR 1.87; 95% CI, 1.05-3.82; p = .045) and pre-existing target vessel stenosis (OR 1.93; 95% CI, 1.13-4.11; p = .047) as independent predictors of TVI.
Inner-branch endovascular repair with the E-nside endograft achieved high technical success and favorable mid-term outcomes. A lower crude rate of target vessel instability was observed with self-expandable stents; however, this association did not remain significant after multivariable adjustment. Renal target vessels and pre-existing stenosis were identified as the main predictors of instability.
Authors
Mezzetto Mezzetto, Squizzato Squizzato, Simonte Simonte, Piazza Piazza, Pratesi Pratesi, Tshomba Tshomba, Gatta Gatta, Giudice Giudice, Veraldi Veraldi, Antonello Antonello,
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