Thoracoabdominal aortic aneurysms

A thoracoabdominal aortic aneurysm (TAAA) involves the aorta at the diaphragmatic crura and variably extends proximally and/or distally from this point.1 Conventional treatment of TAAA consists of gra replacement with reattachment of the main aortic branches. To improve mortality and morbidity rates, a multimodal approach has gradually evolved to maximize organ protection. Prognosis following surgical repair varies according to the extent and type of aneurysm undergoing repair, with extent I and II aneurysms carrying a higher post-operative complication rate, particularly regarding spinal cord (SC) ischaemia and renal failure.2 Surgical indication must, therefore, take into account these severe and life-threatening complications, which must be balanced against the risk of aneurysm rupture. Careful pre-operative assessment of coexistent comorbidities, standardized surgical techniques and specic guidelines for post-operative management of these patients can have a favourable impact on the morbidity and mortality associated with this procedure, usually allowing for safe and eective repair.