Abstract
Thoracoabdominal aortic aneurysms (TAAAs) are complex and if untreated have high mortality
and morbidity rates. Open surgical repair is the historical treatment approach; however,
postoperative complications remain high with spinal cord ischemia notably one of the
more serious and common complications. The avoidance of thoracotomy or laparotomy
with the advent of endovascular aortic repair (EVAR) and thoracic endovascular aortic
repair (TEVAR) have decreased the morbidity and mortality with TAAA repair, especially
in patients with significant comorbidities such as a history of aortic surgery, underlying
cardiac disease, and chronic obstructive pulmonary disease. Endovascular treatment
options have grown to include fenestrated EVAR, multibranched EVAR, and physician-modified
fenestration stent grafts. These techniques have achieved lower mortality rates than
traditional open repair, but complications such as limb ischemia, spinal cord ischemia,
and long-term durability must be considered. This review provides an overview of the
most common endovascular techniques for TAAAs as well as short- and midterm outcomes.
Keywords
thoracoabdominal aortic aneurysms - endovascular repair - fenestrated EVAR - branched
EVAR - physician-modified fenestrated stent graft
