Open Repair of Thoracoabdominal Aortic Aneurysms in the Endovascular Era: When and for Whom

Open surgical repair continues to play an essential role in the contemporary management of thoracoabdominal aortic aneurysms, despite the dramatic advances and growing adoption of endovascular aortic techniques, which include the combination of thoracic endovascular aortic repair and complex endovascular aortic repair with fenestrated and branched endovascular repair. The relative advantages and limitations of open vs. endovascular approaches must be carefully balanced in each patient. However, open repair of thoracoabdominal aortic aneurysms continues to provide unique advantages in selected patients. This manuscript presents a narrative review of the current literature, addressing both open surgical repair and endovascular approaches in repairing thoracoabdominal aortic aneurysms.