Single-Disk’s Plug-Based Embolization of Directional Branches During Urgent Complex Endovascular Aortic Aneurysm Repair

Single-disk vascular plugs without DB elongation provide a safe, feasible, time-effective and cost-effective solution for DB closure during B-EVAR, with favorable outcomes and reduced procedural complexity, even in urgent setting. Multicenter studies are needed to validate these findings and establish standardized DB management techniques for challenging anatomical and urgent cases.Clinical ImpactOur study demonstrated the feasibility, safety, and time- and cost-effectiveness of single-disc vascular plug (AVP) embolization for directional branches during urgent or emergent branched endovascular aortic aneurysm repair using off-the-shelf devices, even without elongation using balloon-expandable stent-grafts. This technique simplifies the procedure, reducing complexity and potential complications. It is particularly advantageous in urgent scenarios, where minimizing procedural time is critical to improve patient outcomes and survival. Moreover, it offers significant benefits in resource-limited settings by ensuring efficient use of healthcare resources. Overall, this approach represents a practical, effective solution that can enhance procedural efficiency and broaden clinical applicability.