Bench testing of bridging stent-grafts in fenestrated and branched endovascular aortic repair: a scoping review

BACKGROUND: To assess and summarize the available bench and experimental evidence regarding the mechanical performance of bridging stent-grafts (BSGs) used in fenestrated/branched endovascular aortic repair (F/BEVAR). METHODS: A PRISMA-ScR-guided scoping review was performed using PubMed to identify bench and experimental studies evaluating the mechanical performance of bridging stent-grafts (BSGs) used in F/BEVAR. Eligible studies assessed mechanical characteristics including pull-out resistance, shear resistance, fatigue behavior, geometric deformation, or performance in simulated anatomical models. Extracted data were synthesized descriptively. RESULTS: Seven experimental studies met the inclusion criteria, including in-vitro mechanical evaluations, comparative bench investigations, fatigue testing, and pre-clinical assessment in perfused 3D printed aneurysm models. Findings highlighted device-specific differences in pull-out force, shear stress force, geometric deformation, and fatigue behavior, as well as the influence of implantation configuration on mechanical performance. CONCLUSIONS: Bridging stent-grafts demonstrate distinct mechanical characteristics in bench and pre-clinical testing. However, the current evidence remains limited and insufficient to establish device superiority. Standardized testing protocols and further comparative studies are needed.