RS16 - Early Real-World Experience with Thoracoabdominal Branch Endoprosthesis from a Physician-Initiated Multicenter Post-Market Registry

Friday, June 12, 2026

8:53 AM - 9:00 AM ET

Location: Hynes CC, Third Level, Ballroom B

Presenting Author only(s)

Carrie Tackett, DO

California

Senior Author Discussant(s)

Sukgu M. Han, MD, MS (he/him/his)

Professor of Surgery and Chief, Division of Vascular Surgery and Endovascular Therapy
Keck Medical Center of Univerisity of Southern California
Los Angeles, California

Co-Author(s)

PP

Pouria Parsa
Jonathan Bath, MD

Vascular Surgeon
University of Missouri Health Care
Columbia, Missouri
Jason T. Lee, MD

Professor and Chief of Vascular Surgery
Stanford Health Care
Stanford, California
Carlos H. Timaran, MD, MS

Professor of Surgery
University of Texas Southwestern Medical Center Dallas
Dallas, Texas
Mark A. Farber, MD

Professor
University of North Carolina
Chapel Hill, North Carolina
Bernardo C. Mendes, MD

Professor of Surgery
University of California, Los Angeles (UCLA)
Los Angeles, California
WY

William J. Yoon

Director of Complex Aortic Center
Medstar Washington Hospital Center/Georgetown University Hospital
Washington, District of Columbia
Mitri K. Khoury, MD

Associate Professor of Surgery
Arizona State University
Phoenix, Arizona
ND

Nathan Droz
AR

Ali Rana

Chair of Vascular Surgery
UNM
Albuquerque, New Mexico

Objectives: Recent commercial approval of the Thoracoabdominal Multibranch Endoprosthesis (TAMBE) has enabled wide dissemination of four-vessel multibranched endovascular aortic repairs in the US. However, real-world performance benchmark remains incompletely characterized. This study evaluated 30-day clinical outcomes of patients receiving TAMBE across diverse practice settings.

Methods: We performed a retrospective study of commercial TAMBE implants across multiple U.S. centers between May 2024 and November 2025. The primary outcomes were 30-day mortality and technical success. Secondary outcomes included overall adverse events (AE), and major adverse events (MAE). Intraoperative metrics and clinical outcomes were compared between centers with prior investigational access to TAMBE (PRE) and those adopting the device after commercial approval (POST).

Results: Total of 182 patients from 11 centers were included. The mean age was 73.8 ± 9.01 years. Most patients were ASA class III (51.6%) or IV (36.3%), with a high prevalence of prior aortic repairs (20.1% open; 40.5% endovascular repair). Aneurysm extent included complex abdominal aneurysms (68%) and thoracoabdominal aneurysms (32%). (Table I). Technical success was achieved in 95% of cases. Thirty-day mortality was 3.3%, and 20% of patients experienced AE, among which MAE occurred in 13.7%.

Technical success, 30-day mortality, and MAE did not differ between the PRE and POST centers. POST centers had longer operative, fluoroscopy times, and higher 30-day AE (33.3% vs 11.8%, p < 0.001). TAAA were more frequently repaired in the PRE centers, whereas pararenal aneurysms were more commonly treated at the POST centers. The overall incidence of spinal cord ischemia (SCI) did not differ significantly between PRE and POST centers (9.1% vs 5.6%, p = 0.43). At PRE centers, most SCI events resolved with minimal residual deficit (60%), whereas at POST centers, majority of SCI cases resulted in permanent, severe deficits (75%). (Table II)

Conclusions: Early commercial experience demonstrates that TAMBE can be safely adopted in broader clinical practice, with high technical success and low 30-day mortality across participating centers. Although POST centers demonstrated higher overall 30-day AE rates and longer procedural times, MAE was similar across center types. These findings underscore the importance of comprehensive training, standardized perioperative protocols, and continued monitoring of neurologic outcomes as TAMBE implementation expands.