Driving Technology for Thoracic Endovascular Aortic Repair: An International Analysis of Single-versus Double-Branch RELAY Outcomes

Abstract

The introduction of endovascular aortic arch repair (EAR) represents a paradigm shift in the management of complex arch pathologies usually treated with open surgical repair (OSR). This shift in treatment of aortic arch disease has also been accompanied with a rise in commercial interest in EAR resulting in the development of several endografts. However, the RELAY™ Branched by Terumo Aortic can be considered the prime endograft choice. In this international original study, a retrospective comparative analysis of international prospective outcomes data on the single- and double-branch RELAY™ stent-grafts is provided. International data on EAR procedures carried out from January 2019 to January 2022 using the single- and double-branch RELAY™ endograft configurations were collected prospectively. Follow-up data was collected at 30 days, 6 months, 12 months, and 24 months postoperatively. Retrospective descriptive analysis, logistic regression, and Kaplan-Meier analysis were performed. A total of 125 patients were included, out of which 17 (13.6%) received the single-branch RELAY™ and 108 the double-branch device. In the single-branch group, no mortalities, strokes or reinterventions were recoded over 24 months of follow-up. The rates of these outcomes were higher in the other group, however, the differences did not reach significance. Target vessel patency was maintained at 100% throughout the study period with the single-branched RELAY™. Overall, our Kaplan-Meier analyses proved that both configurations of RELAY™ Branched yield excellent short- and mid-term survival and freedom from reintervention. Our series has clearly demonstrated that EAR using RELAY™ Branched is a highly efficacious strategy that yields very favourable results which can be considered superior to other EAR devices as well as OSR. Nevertheless, it seems that clinical outcomes with the single-branch RELAY™ are more optimal than with the double-branch device.