360 Driving Technology for Endovascular Aortic Arch Repair: An International Analysis of Relay Branched Outcomes

Abstract

Abstract Aim The introduction of endovascular aortic arch repair (EAR) represents a paradigm shift in the management of complex arch pathologies. In this multicentre study, a comparative analysis of international outcomes data on the single-, double- and triple-branch RELAY™ endografts is presented. Method Multicentre data was collected prospectively (2019-2022) and stored in an international registry. This was later retrieved and analysed retrospectively. All patients were followed-up for 24 months. Outcomes measured included target vessel patency (TVP), reintervention, stroke, and mortality. Results Of the total 148 patients, 17 (11.5%) received the single-branch RELAY™, 108 (73%) double-branch, and 23 (15.5%) triple-branch. The group characteristics were similar at baseline. Target vessel cannulation and technical success were achieved in 99.3% of patients. TVP at 30 days post-EAR was 100% in all groups, however, this became 93.8%, 74.0% and 100% at 24 months in the single-, double- and triple-branch endograft groups, respectively. As for reinterventions, these were only required with the double-branch RELAY™ (n=50, 34%). Similarly, disabling strokes were only observed in the double-branch group (n=35, 32.4%), and the overall study incidence was 23.8%. Non-disabling strokes had an overall incidence of 12.8% (n=19). The overall mortality rate was 2.7%, with all 4 deaths recorded occurring in the double-branch group. Logistic regression analysis showed a significant association between urgency (acute) and reintervention. Conclusions Our results clearly demonstrate that EAR using RELAY™ Branched is a highly efficacious strategy. Nevertheless, it seems that clinical outcomes with the single- and triple-branch RELAY™ are more favourable than with the double-branch configuration.