The Use of the Off-the-Shelf Inner Branch E-nside Endograft for the Treatment of Elective and Emergent Complex Aortic Aneurysms—A Single-Center Experience

Abstract

The aim of this single-center study was to evaluate the early results of the off-the-shelf inner branch E-nside endograft in the treatment of complex aortic aneurysms and thoracoabdominal aortic aneurysms. We performed a retrospective analysis of a prospectively maintained database of all patients treated with the E-nside endograft at our institution during the years 2021-2023. Parameters evaluated were technical success, early major adverse events, target vessel patency, and the presence of endoleaks. In total 16 patients underwent treatment with the E-nside endograft. Six additional patients were evaluated for the device but were excluded due to anatomical considerations. Mean age was 71 (range 59-84) and 14 (88%) were males. Mean aneurysm diameter was 66mm(range 54-85). Aneurysms treated included thoracoabdominal in 9 (56%), juxtarenal aneurysms in 5 (31%), postdissection aneurysm in 1 (6%) and a type 1A endoleak after a failed endovascular aneurysm repair in 1 (6%). Five of the treated aneurysms were symptomatic. A total of 58 side branches were placed into target visceral arteries. Mean operative time was 190min (range 150-360). Technical success was achieved in 15/16 of the patients (94%). At 30days, 1 perioperative mortality and 3 major adverse events occurred, 2 of them branch related. The E-nside endograft is a feasible option for the treatment of a broad spectrumof aortic pathologies. As it is an off-the-shelf device, it can be used selectively inelective and emergent settings with acceptable30-day mortality and morbidity. Further follow-up is required to determine the durability of this treatment option and patency of side branches.