Hybrid and endovascular therapy for extensive thoracoabdominal aortic disease

The past 4 decades have witnessed tremendous strides in the evolution of endovascular technology with increased operator experience, greater availability of more sophisticated and versatile endovascular devices, and advances in imaging modalities. In an attempt to limit the physiologic derangements associated with aortic crossclamping and extensive tissue dissection during traditional open surgical repair of extensive thoracoabdominal aortic aneurysms, less invasive strategies have been explored using endovascular technology: hybrid approaches and solely endovascular techniques. This article describes these techniques and their advantages, their current role in thoracoabdominal aortic aneurysm repair and potential future developments in this field.