The G-branch off-the-shelf mixed branch endograft for thoracoabdominal aortic aneurysm: 1-year results from a prospective multicenter study

Background: The use of off-the-shelf multi-branched endografts for thoracoabdominal aortic aneurysm (TAAA) is increasing; however, these commercially available devices have limited anatomical feasibility for treating TAAA. This study aimed to assess the safety and efficacy of a novel G-branch off-the-shelf endograft for TAAA. Materials and Methods: A total of 73 patients with TAAA were treated using the G-branch endograft at 14 sites across China. The primary endpoints were the 30-day technical success and major adverse events rates. The secondary endpoints were all-cause mortality, secondary intervention, endoleaks, target vessel patency, and freedom from renal function deterioration during a 1-year follow-up. Results: The technical success rate was 95.9% (70/73). Renovisceral artery reconstruction was successful in 99.7% (291/292) of patients. Within 30 days, six patients (8.2%) experienced major adverse events, namely paraplegia (n = 2), acute kidney injury (n = 2), acute myocardial infarction (n = 1), and cerebral infarction (n = 1). During the 1-year follow-up, one patient died from aortic dissection, giving an overall survival rate of 98.6%. Four patients (5.5%) underwent secondary interventions, giving a freedom from secondary intervention rate of 92.8%. Endoleaks occurred in 12 patients (10 type II, 2 type III). The primary patency rate of the target vessels was 95.7%, and three bridged stent grafts were successfully recanalized, resulting in a secondary patency rate of 96.7%. Renal function deterioration occurred in six patients (8.2%), giving a freedom from renal function deterioration rate of 94.6%. Conclusions: The off-the-shelf G-Branch endograft appears safe, with favorable 30-day and 1-year mortality and morbidity rates for both elective and urgent TAAA treatment.