Thoracoabdominal aortic aneurysm repair: historical review and description of a re-engineered technique

Most complications related to thoracoabdominal aortic reconstruction stem from ischemia-induced injury to the viscera, kidneys, and spinal cord. Pioneers in the treatment of thoracoabdominal aortic aneurysms recognized the danger of producing ischemic damage to these vital organs. In addition to adjunctive methods designed to minimize metabolic demands of the spinal cord during aortic cross-clamping, a variety of extracorporeal techniques have been developed that provide supplemental blood flow to vital end organs during the period of clamp-induced ischemia. This article reviews these extracorporeal methods and provides a historical perspective of thoracoabdominal aortic aneurysm repair. In addition, a reengineered technique for thoracoabdominal aortic aneurysm repair is highlighted.