Is open repair still an option for treating of thoracoabdominal aneurysms in endovascular era?

Besides new advanced thoracic stent graft and devices, as well as an improvement of surgical skill, open repair of thoracoabdominal aortic aneurysms is still very important. The main indications for it include patients with unfavorable aneurysm anatomy, patients with connective tissue disorders, good-risk patients with life expectancy of at the least 10 years regardless of anatomic suitability and genetic, then patients with mycotic thoracoabdominal aortic aneurysms and finally patients with same long-term complications after previous TEVAR. Open repair of thoracoabdominal aortic aneurysms can be only performed in high volume centers, while younger generation of vascular surgeons should be educated in both endovascular and open aortic surgery.