ArticleFrontiers in cardiovascular medicine2026
Medium-term clinical and imaging outcomes of SilverFlow covered bridging stent implantation using
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Evidence regarding the medium-term performance of SilverFlow covered bridging stents for in-situ fenestrated aortic arch repair remains limited. This study evaluated the clinical and imaging outcomes of SilverFlow covered bridging-stent implantation for the treatment of aortic arch lesions. Methods: This single-centre, single-arm retrospective cohort study included consecutive adult patients who underwent in-situ fenestrated aortic arch repair with SilverFlow covered bridging stents between January 2023 and April 2025. The primary outcome was technical success. Secondary outcomes included 30-day major adverse events, mortality, target-vessel patency, aortic remodelling, and reintervention rates. Results: Eighty-one patients received 140 SilverFlow covered bridging stents. Technical success was achieved in 70 patients (86.4%). Successful stent deployment, completion of planned fenestrations, and immediate target-vessel patency were each achieved in 98.8% of cases. No intraoperative, in-hospital, or 30-day deaths occurred. The 30-day major adverse-event rate was 25.9%. At 12 months, all 107 assessed branch vessels remained patent. At the latest imaging follow-up, per-vessel and patient-level patency rates were 98.5% and 97.5%, respectively. Significant reductions were observed in maximum aortic diameter (-4.0 mm, P = 0.020), false-lumen diameter (-6.8 mm, P < 0.001), and aneurysm-sac diameter (-8.5 mm, P = 0.010). Complete false-lumen thrombosis increased from 32.5% to 55.0% (P = 0.020). During a median follow-up of 19.0 months, four patients died and seven required aortic- or branch-related reintervention. Freedom from reintervention was 92.4% at 12 months and 90.8% at 24 months. Discussion: In this single-centre cohort, in-situ fenestrated aortic arch repair using SilverFlow covered bridging stents demonstrated high immediate reconstruction success, durable target-vessel patency among assessed vessels, and favourable imaging indicators of aortic remodelling during medium-term follow-up. These findings support the feasibility of this technique; however, comparative studies are required to determine its relative effectiveness. Continued imaging surveillance remains essential because reinterventions and device- or aorta-related abnormalities occurred during follow-up.
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