Endovascular aortic repair (EVAR) has gained increased popularity for the repair of various acute and chronic bdominal aortic pathologic abnormalities.1-4 Results have been encouraging and several analyses have shown the longterm efficacy of the approach. As a consequence, increasing efforts were put forth on advancing the technology to more proximal thoracic aortic segments with their inherent challenges, especially with regard to the handling of renal and visceral arteries.5,6 Recently, several reports have been published reconfirming feasibility and effectiveness of these approaches. However, it has to be determined whether the initially encouraging results will remain stable over the years.7 The aim of this article is to illustrate currently available technology for EVAR as well as for endovascular handling of the renal and visceral arteries.