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 were 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 favorable 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.
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- Mid- and long-term outcomes of thoracic endovascular aortic repair in acute and subacute uncomplicated type B aortic dissection.J Card Surg. 2022; 37: 1328-1339
- Endovascular aortic arch repair: a comparison of outcomes and current trends.Asian Cardiovasc Thorac Ann. 2022; https://doi.org/10.1177/02184923221140756
- The international registry of acute aortic dissection (IRAD): new insights into an old disease.JAMA. 2000; 283: 897-903
- Early-and medium-term results after aortic arch replacement with frozen elephant trunk techniques—a single center study.Ann Cardiothorac Surg. 2013; 2: 606-611
- Progress in endovascular management of type A dissection.Eur J Vasc Endovasc Surg. 2012; 44: 406-410
- RELAYTM branched–international results of vessel patency and reintervention.Front Cardiovasc Med. 2022; 9: 962884
- Final operative and midterm results of the European experience in the RELAY Endovascular Registry for Thoracic Disease (RESTORE) study.J Vasc Surg. 2011; 53: 565-573
- Worldwide results from the RESTORE II on elective endografting of thoracic aneurysms and dissections.J Vasc Surg. 2016; 63: 1466-1475
- Favorable neurological outcomes in thoracic endovascular aortic repair with RELAY™ branched—an international perspectieve.J Card Surg. 2022; 37: 3556-3563
- Long-term clinical outcomes of thoracic endovascular aortic repair for arch aneurysms with the Najuta thoracic stent-graft system.Ann Vasc Dis. 2020; 13: 384-389
- Outcomes for supra-aortic branch vessel stenting in the treatment of thoracic aortic disease.J Vasc Surg. 2014; 60: 914-920
- Predictors of stroke and paraplegia in thoracic aortic endovascular intervention.Eur J Vasc Endovasc Surg. 2010; 41: 303-310
- The Society for Vascular Surgery Practice Guidelines: management of the left subclavian artery with thoracic endovascular aortic repair.J Vasc Surg. 2009; 50: 1155-1158
- Editor’s choice - subsequent results for arch aneurysm repair with inner branched endografts.Eur J Vasc Endovasc Surg. 2016; 51: 380-385
- Clinical outcomes of thoracic endovascular aneurysm repair using commercially available fenestrated stent graft (Najuta endograft).J Vasc Surg. 2015; 62: 1473-1478
- What is the optimal timing for thoracic endovascular aortic repair in uncomplicated type B aortic dissection?.J Card Surg. 2022; 37: 993-1001
- Does endovascular duration impact clinical outcomes in aortic arch repair? The RELAY™ branched international stance.Front Cardiovasc Med. 2022; 9: 969858
- Cost analysis of thoracic endovascular aortic repair in type B aortic dissection: how much does quality cost?.Ann Vasc Surg. 2022;
Published online: February 22, 2023
Accepted: February 10, 2023
Received: January 7, 2023
Publication stageIn Press Journal Pre-Proof
Conflict of interest: None.
Funding sources: None.
Author contributions: Authors MJ, AOS, MT, RC, and LA were involved in the literature search and manuscript writing. MJ and AOS performed the statistical analysis and provided the tables and figures. GP reviewed the manuscript and provided feedback. All authors contributed to the manuscript and approved its final submitted version.
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