Geometrical Analysis of the BeFlared Bridging Stent-Graft in Fenestrated Endovascular Aneurysm Repair

Objective 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. Methods 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. Results 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). Conclusion 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.