Minimally invasive surgery for thoracoabdominal aortic aneurysms

Open surgical repair of thoracoabdominal aortic aneurysms (TAAA) remains a highly morbid procedure. In recent years, several minimally invasive techniques have been introduced to treat TAAA. These include hybrid procedures and purely endovascular approaches using modified aortic endografts. Although still investigational, this burgeoning technology has the potential to improve outcomes in TAAA repair, as well as to circumvent the morbidity and mortality associated with the traditional surgical approach to TAAA. While the reported experience is limited to several institutional case series, results are encouraging, and suggest that fenestrated and branched endografts are likely to figure prominently in the management of TAAA in the future. An overview of these minimally invasive techniques, as well as the role of computer-assisted imaging analysis, is provided.