Repair of thoracoabdominal aneurysm and dissection with branched and fenestrated technology

Endovascular repair has transformed the management of complex aortic aneurysms and chronic aortic dissections, providing a minimally invasive alternative to open surgery. The introduction of fenestrated and branched endografts (FBEVAR) has significantly expanded the anatomical eligibility for endovascular repair, allowing for the treatment of thoracoabdominal and complex abdominal aneurysms with improved patient outcomes. This review provides a comprehensive analysis of recent advancements in FBEVAR, focusing on technical success, durability, reintervention rates, and the evolving strategies to mitigate complications such as spinal cord ischemia. While FBEVAR has demonstrated high procedural success and mid-term efficacy, challenges related to long-term durability, bridging stent performance, and spinal cord protection remain critical areas of ongoing research.