Endovascular therapy has been advanced in recent years. Thoracic endovascular aneurysm repair (TEVAR) has become the standard treatment for descending aortic aneurysm. For endovascular treatment, there are many pitfalls not found in conventional surgery. From now on, it is necessary not only to master open surgery, but also to master endovascular technique for those who aim at getting qualified as specialist in vascular surgery.