Paraplegia Prevention in Aortic Aneurysm Repair by Thoracoabdominal Staging

Inclusion Criteria: * TAAA, Crawford type II or III * planned open or endovascular repair of aneurysm within four months * ≥ 18 years old Exclusion Criteria: * complicated (sub-) acute type B aortic dissection * ruptured and urgent aneurysm (emergencies) * untreated aortic arch aneurysm * bilaterally occluded iliac arteries or chronic total occlusion of left subclavian artery * pre-operative neurological deficits or spinal cord dysfunction * major untreated cardio-pulmonary disease * life-expectancy of less than one year * high risk for segmental artery embolism * severe contrast agent allergy, severe reduction in glomerular filtration rate (CKD stage 4) * expected lack of compliance * pregnant or nursing women * impaired thyroid function, if not under stable treatment * women of child bearing potential without highly effective contraceptive measures * current participation in other interventional clinical trial * patients under legal supervision or guardianship * patients placed in an institution by official or court order