Branched Endografts

The introduction of standard endovascular repair of abdominal aortic aneurysm (AAA) was followed by a number of improvements and developments in stent-graft technology that enabled endovascular treatment of more complex pararenal and thoracoabdominal aortic aneurysms (TAAA) by endovascular means. One of the most important developments in stent-graft design was the addition of directional branches as tubular protrusions arising from the main lumen of the endovascular graft, aiming to preserve blood flow to vessels originating from the aneurysm. Directional branches were first applied for the internal iliac artery but gradually were developed further and were also used for the visceral arteries in extensive TAAAs and the supra-aortic branches in aortic arch pathology. The present chapter summarizes the evolution, planning, technical execution, and clinical outcomes of branched endografts in complex aortic endovascular repair.