Endovascular treatment of complex aortic aneurysms

Endovascular aortic aneurysm repair has been established as an alternative to open surgical repair. One of the main limitations of endovascular aortic aneurysm repair is the need for a sufficient sealing zone below or above vital aortic branches. During the last 10 years, efforts have been made to overcome these limitations by incorporating fenestrations or branches into customized stent grafts. First, short-necked infrarenal aneurysms were addressed. Later, juxtarenal and suprarenal aneurysms were treated with the same technique. Last, it became possible to treat thoracoabdominal aneuryms by endovascular means. This article reviews the technical and clinical possibilities, as well as the published results of endovascular aortic aneurysm repair with fenestrated and branched stent grafts. The current status and future considerations are discussed.