ABSTRACT
Thoracoabdominal aortic aneurysms (TAAA) occupy an inaccessible location high in the
retroperitoneum, and they have branches to organs, such as the liver, kidneys and small
intestine, with little tolerance for ischemia. Consequently, traditional surgical repair of these
aneurysms has produced high rates of mortality and morbidity (1). Endovascular techniques
employ a transarterial route of access to the aneurysm and do not interrupt flow for more than a
few seconds, and therefore have the potential to greatly reduce mortality, morbidity, hospital
stay, pain, and debility. Given these advantages, endovascular repair would have replaced
surgical repair a long time ago were it not for one challenge; how to exclude the aneurysm from
the circulation without also excluding flow to its branches.
