Purpose Branched endovascular aortic repair with inner branch technology offers a less invasive intervention compared to open surgery for complex aortic repair, particularly in high risk and urgent cases. While high-volume centres have published promising outcomes with such devices (1–3), data from regional institutions is limited. This study reports early outcomes from a regional centre using EnSide and custom JOTEC devices. Methodology A retrospective review was undertaken in a regional tertiary centre for patients who had an inner-branched endovascular repair between 2021-25. Data included demographics, technical outcomes, and complications. Endpoints were technical success and early clinical outcomes. Results Seven patients (6 males, median age 77) underwent the procedure, with one emergency case. Indications included thoracoabdominal aortic aneurysm (43%) and type I/II endoleaks post endovascular aneurysm repair (57%). All procedures involved the coeliac, superior mesenteric and renal arteries. Technical success, defined as successful deployment of the graft with stenting of intended vessels, was achieved in 6 of 7 cases (86%). A total of 25 out of 28 planned target vessels (89%) were successfully stented, with 100% patency of bridged branches on imaging. One patient sustained a postoperative cerebellar infarction, and another developed an axillary artery pseudoaneurysm. Two mortalities occurred: one due to hepatic ischemia following urgent repair, and one from unrelated cardiac complications. Conclusion Inner-branch aortic stent grafts offer a promising approach for managing complex aortic pathology. Long-term surveillance is essential to assess graft durability and clinical outcomes. 1/ Squizzato F, et al. Off-the-shelf inner branch endograft for juxta/pararenal aneurysms. Eur J Vasc Endovasc Surg. 2025 2/ Yazar O, et al. Mid-term E-Liac branched device. Ann Vasc Surg. 2025 3/ Piazza M, et al. Off-the-shelf inner branch device, urgent repair. J Vasc Surg. 2024