{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:17:12Z","timestamp":1783531032668,"version":"3.55.0"},"reference-count":12,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Post-dissection thoracoabdominal aortic aneurysm (PD-TAAA) is a late sequela of chronic aortic dissection. Complex endovascular aneurysm repair (EVAR), including fenestrated and branched techniques (F\/B-EVAR), enables aneurysm exclusion while preserving visceral perfusion; however, bridging stents are not specifically designed for PD-TAAA and are frequently used off-label. Evidence on bridging stent performance is largely derived from degenerative aneurysm cohorts, and PD-TAAA-specific data remain limited. This study evaluated outcomes of the VBX Stent Graft when used as a bridging stent during F\/B-EVAR for PD-TAAA. This retrospective analysis included patients with PD-TAAA from the EMBRACE registry (ClinicalTrials.gov: NCT05143138), a multicenter, single-arm registry with retrospective and prospective components, with all outcomes core-laboratory-adjudicated. Procedural, early (thirty-day), and midterm outcomes at one and three years were assessed. The primary endpoints were all-cause mortality and freedom from target vessel instability, defined as loss of durable target vessel reconstruction. Twenty-one patients (mean age 61.5 years; range, 28\u201377 years) underwent F\/B-EVAR with at least one VBX Stent Graft. In total, 82 visceral arteries were treated, of which 51 were bridged with a VBX Stent Graft. Technical success was 100%. Two serious adverse events occurred perioperatively, one requiring reintervention, with no thirty-day mortality or major adverse events. Freedom from all-cause mortality was 95.2% at one year and 90.5% at three years, with two deaths during follow-up. Freedom from target vessel instability at the patient level was 85.7% at both one and three years (95% CI, 62.0\u201395.2%). VBX Stent Grafts used as bridging stents during F\/B-EVAR for PD-TAAA demonstrated high technical success, low early morbidity and mortality, and acceptable mid-term survival and target vessel stability, supporting their use in this challenging anatomical setting within the limitations of a small PD-TAAA cohort.<\/jats:p>","DOI":"10.3390\/jcdd13070311","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:56:42Z","timestamp":1783349802000},"page":"311","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Three-Year Outcome of VBX Stent Graft Used as a Bridging Stent in Endovascular Repair of Post-Dissection Thorachoabdominal Aortic Aneurysm"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5779-9106","authenticated-orcid":false,"given":"Frida","family":"Jonsdottir","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6871-2176","authenticated-orcid":false,"given":"Luca","family":"Bertoglio","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences (DSCS), University and ASST Spedali Civil Hospital of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Resch","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1016\/j.jvs.2014.01.042","article-title":"Predictors of aortic growth in uncomplicated type B aortic dissection","volume":"59","author":"Tolenaar","year":"2014","journal-title":"J. Vasc. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.ejvs.2022.06.019","article-title":"Fenestrated and Branched Endografts for Post-Dissection Thoraco-Abdominal Aneurysms: Results of a National Multicentre Study and Literature Review","volume":"64","author":"Gallitto","year":"2022","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"194","DOI":"10.23736\/S0021-9509.25.13383-1","article-title":"Bridging stents in endovascular repair of chronic aortic dissection: A scoping review","volume":"66","author":"Jonsdottir","year":"2025","journal-title":"J. Cardiovasc. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1053\/j.semvascsurg.2022.06.002","article-title":"Fenestrated and branched stent grafts for the treatment of post-dissection thoracoabdominal aortic aneurysms","volume":"35","author":"Ibraheem","year":"2022","journal-title":"Semin. Vasc. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jvs.2024.08.063","article-title":"Midterm outcomes of the Viabahn VBX balloon-expandable covered stent for fenestrations during complex endovascular aortic aneurysm repair","volume":"81","author":"Pavarino","year":"2025","journal-title":"J. Vasc. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.jvs.2019.10.089","article-title":"Outcomes of bridging stent grafts in fenestrated and branched endovascular aortic repair","volume":"72","author":"Torsello","year":"2020","journal-title":"J. Vasc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e78970","DOI":"10.2196\/78970","article-title":"GORE\u00ae VIABAHN\u00ae VBX Balloon-Expandable Endoprostheses as a Bridging Stent with Branched and Fenestrated Endografts in the Endovascular Treatment of Aortic Aneurysms: Protocol for a Retrospective Multi-Center registry (EMBRACE Study)","volume":"15","author":"Dioni","year":"2026","journal-title":"JMIR Res. Protoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"4s","DOI":"10.1016\/j.jvs.2020.06.011","article-title":"Reporting standards for endovascular aortic repair of aneurysms involving the renal-mesenteric arteries","volume":"73","author":"Oderich","year":"2021","journal-title":"J. Vasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1177\/15266028241300005","article-title":"Mid-Term Outcomes of the Viabahn Balloon-Expandable Endoprosthesis as Bridging Stent Graft for Fenestrated and Branched Endovascular Aortic Repair","volume":"33","author":"Kappe","year":"2024","journal-title":"J. Endovasc. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.jvs.2024.10.002","article-title":"A three-year experience with the balloon expandable GORE VIABAHN VBX in the treatment of thoraco-abdominal aortic aneurysms within the EXPAND trial","volume":"81","author":"Usai","year":"2025","journal-title":"J. Vasc. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.ejvs.2024.04.041","article-title":"Post-dissection Thoraco-abdominal Aortic Aneurysm Managed by Fenestrated or Branched Endovascular Aortic Repair","volume":"68","author":"Gorgatti","year":"2024","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"5198","DOI":"10.21037\/qims-21-1240","article-title":"Changes in the renal artery and renal volume and predictors of renal atrophy in patients with complicated type B aortic dissection after thoracic endovascular aortic repair","volume":"12","author":"Yu","year":"2022","journal-title":"Quant. Imaging Med. Surg."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/7\/311\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:38:48Z","timestamp":1783528728000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/7\/311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":12,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcdd13070311"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13070311","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]}}}