Gore Viabahn VBX balloon expandable covered stent might provide an excellent option for branched thoracoabdominal stent graft.

The Gore Viabahn VBX is a balloon-expandable covered stent combining a nitinol-reinforced ePTFE graft with a stainless steel stent platform. Unlike self-expanding stents, the balloon-expandable design allows precise diameter and length control during deployment, making it particularly useful in complex anatomical locations.

The balloon-expandable mechanism provides greater precision in deployment and higher radial force, which is advantageous in calcified arteries and at the aortic bifurcation. Self-expanding stents are better suited to locations requiring flexibility, such as the femoral artery. The VBX is preferred in the iliac arteries and aortic segments where precise placement is critical.

The VBX’s precise deployment characteristics and covered design make it suitable for use as a bridging stent in branched or fenestrated thoracoabdominal stent graft repairs. It can be used to connect the main aortic device to the visceral vessels (coeliac, superior mesenteric, and renal arteries) through fenestrations or branches.

Published clinical data has demonstrated good results with the VBX in aorto-iliac and complex endovascular applications, including CERAB reconstructions and fenestrated EVAR. The device has shown favourable patency rates and low complication rates in experienced hands.

As a balloon-expandable device, the VBX is not suitable for locations that require significant flexibility, such as the femoral or popliteal arteries. It also requires careful sizing and is less forgiving of deployment in tortuous or heavily calcified anatomy. Operator experience is important for optimal results.