Introdution: Aneurismal disease involving the thoracoabdominal segment adds significant complexity to endovascular aortic repair. Objective: Evaluate institutional experience of a tertiary center in fenestrated and branched aneurysm repair for throracoabdominal or juxtarenal aortic aneurysms Methods: Retrospective analysis of a consecutive series of patients treated by endovascular repair using fenestrated or branched stent grafts between October 2010 and May 2016. Results: Twenty-six patients

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... nderwent endovascular repair with fenestrated and/or branched stent grafts (mean age 68±7years; 1 female). Eleven patients had history of previous aortic intervention. Seventeen throracobdominal aneuryms had the following anatomic distribution: Type I: n=1; Type III: n=5; Type IV: n=6 and Type 5: n=5. Additionally nine pararenal aneuryms were treated. Mean maximum aneurym diameter was 72±25mm. There were 3 types of stent graft configuration based on aortic anatomy and aneurysm morphology: 21 custom-made (14 fenestrated and 7 fenestrated/branched) and 5 off-the-shelf multibranched (T-branch). The median number of fenestrations/branches per stent graft was 4(2-4). The total target visceral vessels involved was 88. In 88% another planned endovascular procedure was performed: EVAR n=15; TEVAR n=4 and EVAR+TEVAR n=4. The technical sucess rate was 96% (25/26) (1 case of ostial stenosis of the celiac trunk with unssucessfull catetherization). The 30 day mortality rate was 7,7% (2/26). Spinal cord ischemia occurred in 12% (N=3; acute onset N=1; delayed N=2) There was no difference between the pre- and post-operative (p=0,777). The mean follow-up time was 10±15 months. There were 2 endoleaks, and no late re-interventions nor late aneurismatic ruptures during the follow-up time. Conclusion: Fenestrated/branched devices development allowed the treatment of complex high risk aneurismatic disease in a less invasive manner. These procedures are technically demanding, but safe and effective in prevention of aneurysm rupture in our experi [...]