"Flaring the gap": short-term results and outcomes of using BeFlared, a pre-flared covered bridging stent in fenestrated endovascular aortic repair. The Danish experience

BACKGROUND: Dedicated bridging stents for fenestrated and branched endovascular aortic repair (F/BEVAR) have recently become available. The BeFlared stent (Bentley InnoMed, Germany) is a balloon-expandable covered stent mounted on a dual-diameter balloon designed to allow simultaneous deployment and flaring. This study reports short-term outcomes of the BeFlared stent used as a bridging stent during complex endovascular aortic repair. METHODS: A retrospective analysis of a prospectively maintained database was performed in two tertiary aortic centers in Denmark. All consecutive patients treated with at least one BeFlared stent during fenestrated or branched endovascular repair between November 2024 and October 2025 were included. Primary outcomes included technical success, target vessel patency, freedom from reintervention, freedom from target vessel endoleak, and freedom from target vessel instability (TVI). Kaplan-Meier analyses were performed for patency and reintervention outcomes. RESULTS: Sixty-seven patients underwent complex endovascular repair incorporating 205 BeFlared bridging stents in 203 target vessels. 189 stents (92.2%) were used in conventional fenestrations, seven (3.4%) were used in semi-branch repair, three (1.4%) for in-situ laser fenestrations, and six (2.9%) for relining of previous bridging stents. Technical success was achieved in 198/205 BeFlared stent implantations (96.6%). During a median follow-up of 93.0 (78.0-113.0) days, the overall primary patency was 99.0%, assisted primary patency 99.5%, and secondary patency 99.5%. Freedom from reintervention was 98.5%, freedom from target vessel endoleak 97.1%, and freedom from TVI 98.0%. CONCLUSIONS: Use of the BeFlared bridging stent during complex fenestrated endovascular repair demonstrated excellent technical success and short-term durability with high target vessel patency and low reintervention rates. Early experience suggests that the BeFlared bridging stent provides a reliable and efficient bridging solution in complex aortic repair.