Most abdominal aortic aneurysms (AAA) and thoracoabdominal aortic aneu
rysms (TAAA) are asymptomatic and are found on physical exam or incide
ntally during radiological studies for other indications. These aneury
sms are repaired primarily because their risk of rupture increases geo
metrically as the size exceeds 5 cm. The potential morbidity of intrao
perative visceral and spinal ischemia involved with TAAA repair may be
reduced with various adjunctive maneuvers.