Late complications after endovascular thoracoabdominal aneurysm repair

Thoracoabdominal aortic aneurysm repair has evolved substantially during the past several decades since its first description over 50 years ago. Despite technological improvements, however, patients continue to face significant risks of perioperative mortality, spinal cord ischemia, and worsening renal function. Endovascular repair of thoracoabdominal aortic aneurysms is still in its infancy, but there now exists a growing body of experience with fenestrated and branched endografts. Long-term follow-up is scant, but endovascular repair does appear to provide some protection against development of spinal cord ischemia. In addition, the less invasive techniques may provide safer alternatives to conventional surgery in treating these high-risk patients. Outcomes will certainly continue to improve with our growing experience and with the refinement of this technology.