Midterm results of iCover stent grafts as bridging stent in fenestrated endovascular aortic repair

Objective: Complex endovascular repair with fenestrated stent grafts is a well-established approach for the treatment of complex aortic aneurysms. Bridging stent grafts (BSGs) are essential to connect the aortic endoprosthesis to the target vessels. This single-center study aimed to evaluate the midterm outcomes of iCover stent grafts implanted as a bridging stent during fenestrated endovascular aortic repair. Methods: Data from all patients treated with at least one iCover stent in a fenestration were prospectively collected between December 2022 and June 2024 and retrospectively analyzed. The database included patient demographics, BSG diameter and length, technical success rates, reinterventions, occlusions, and postoperative events. A computed tomography angiography was performed either before discharge or within 1 month postoperatively. All patients underwent follow-up at 1 year with computed tomography angiography or duplex ultrasound examination and abdominal radiography in cases of renal insufficiency (estimated glomerular filtration rate of <30 mL/min). Results: A total of 41 patients (83% male) were included with 141 fenestrations treated using an iCover as BSG. The technical success rate was 97.6% with one failure owing to a type IC endoleak. Thirty-day mortality was 2.4% with one in-hospital death in a patient treated for a ruptured aneurysm. Primary patency during the study was 100%. During a median follow-up of 21 months (interquartile range, 18-24 months), freedom from target vessel instability was 98.5%. No aneurysm-related mortality was observed. Conclusions: Early and midterm outcomes of the iCover stent used as a BSG in fenestrated endovascular aneurysm repair demonstrate favorable patency rates and freedom from target vessel instability.