Geometrical analysis of the BeFlared bridging stent-graft in fenestrated endovascular aneurysm repair

TL;DR

This study evaluates the BeFlared stent-graft in complex aortic aneurysm repairs, showing high technical success and favorable early outcomes.

Contribution

The study introduces a geometrical analysis of the BeFlared stent-graft in fenestrated endovascular aneurysm repair.

Findings

100% technical success rate with no endoleaks or reinterventions at 30-day follow-up.

Geometric parameters like protrusion length and flare ratio were within optimal ranges for both renal and visceral stent-grafts.

Abstract

To evaluate the geometrical configuration of the BeFlared bridging stent-graft and the early clinical outcomes in fenestrated endovascular aneurysm repair (FEVAR) for complex abdominal and thoracoabdominal aortic aneurysms.

This retrospective single-center study included 23 consecutive patients who underwent FEVAR using at least one BeFlared stent-graft between December 2024 and June 2025. Technical and clinical data were collected prospectively. Geometrical analysis of the stent-graft configuration was performed using postoperative computed tomography angiography (CTA) at 1 month.

A total of 70 target vessels (TVs) were treated with BeFlared stent-grafts, achieving a 100% technical success rate. No TV-related endoleaks, instability, or reinterventions were observed at 30-day follow-up. Geometric analysis demonstrated a mean protrusion length of 5.27 ± 0.87 mm and a flare ratio of 0.96 ± .03. The mean protrusion length was 5.4 ± .12 mm for renal stent-grafts and 5.1 ± .18 mm for visceral stent-grafts (p = .155). The mean flare ratio was higher in renal stent-grafts (0.97 ± .03) compared to visceral stent-grafts (0.95 ± .03), (p = .045), though both were within optimal ranges. The mean opening flaring angle was 42.3° ± 19.1 for renal stent-grafts and 41.2° ± 19.4 for visceral stent-grafts (p = .809).

Early clinical and technical outcomes of the BeFlared stent-graft in FEVAR are promising, with satisfactory procedural performance and favorable geometric configuration. Larger, multicenter studies with longer follow-up are essential to confirm long-term durability and clinical benefit.

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