Khoury MK, Acher C, Wynn MM, et al. - Researchers conducted a retrospective review of a prospectively maintained database at their institution from 1983-2015 including patients who underwent open or endovascular repair for descending thoracic or thoracoabdominal aortic aneurysms (dTAA or TAAA) with the aim to determine variables that were linked with mortality over time in these patients. They identified a total of 946 patients meeting the study criteria; the median age of the cohort was 71 years. Following variables were noted to be linked with mortality over time: age, surgical era, acute pathology, dissection, preoperative creatinine, and Type IV TAAAs. Further, they identified mortality to be linked with experiencing the following complications in the postoperative period: neurological, cardiac, and pulmonary. Over the study period, they noted aortic related mortality of 2.1% (n = 20). Overall findings suggest that with reasonable perioperative mortality rates, TAAAs can be repaired. Aortic-related mortality remains low after undergoing repair of the aneurysm. A dramatic change in the management of patients with dTAAs and TAAAs has occurred following the addition of endovascular options. In addition, endovascular repair was linked with decreased perioperative mortality and significantly improved long-term survival in acute patients. Generally, patients undergoing TAAA repair are considered high-risk and hence, researchers emphasize performing extensive long-term follow-up for management of their comorbidities and complications as these are the main contributors to mortality over time.