Initial Outcomes of Physician-Modified Inner-Branched Endovascular Repair for Distal Aortic Arch Aneurysm

Background/Objectives: Few clinical studies have reported on physician-modified inner-branched endovascular repair (PMiBEVAR) for aortic arch aneurysm. Herein, we evaluate the outcomes of proximal landing zone 2 PMiBEVAR. Methods: This retrospective study analyzed data from six patients who underwent zone 2 PMiBEVAR for aortic arch aneurysms at a single center between October 2021 and June 2024. The outcomes were in-hospital mortality and postoperative complications. Results: The median follow-up period was 12.5 (7.3-25) months. Males constituted four out of six cases and females constituted two out of six cases. The patients had a median age of 78.5 (76.5-79.0) years, and the aneurysm diameter was 56 (50-61) mm. Technical success was achieved in 5/6 (83.3%) cases. The median modification and operative times were 56 (45-60) min and 92 (79-308), respectively. Postoperatively, delayed type Ia endoleak and vascular access-site pseudoaneurysm occurred in one patient each. However, no patients experienced other complications. The median hospital stay was 10 (7-41) days, and no deaths or reinterventions occurred after 30 days. During the post-discharge follow-up, the aneurysm diameter remained "unchanged" in four patients, including the one with delayed type Ia endoleak, while two patients experienced "shrinkage". Conclusions: PMiBEVAR for distal aortic arch aneurysm might be effective in improving postoperative outcomes.