Abstract:Aortic pathologies involving the visceral segment are characterized by complex anatomy and a high risk of perioperative complications. Although open surgical repair remains a definitive treatment, its invasiveness and associated morbidity limit its application, particularly in elderly and high-risk patients. Advances in endovascular techniques, including fenestrated, branched, and parallel stent-graft technologies, have significantly expanded the therapeutic options for complex aortic lesions involving visceral arteries. Current evidence suggests that endovascular repair offers favorable short-term outcomes, reduced perioperative morbidity, and faster recovery compared with conventional open surgery. Nevertheless, challenges remain regarding patient selection, stent-graft design and materials, imaging-guided precision, procedural standardization, and long-term durability. This review summarizes recent progress in endovascular management of aortic diseases involving the visceral segment, focusing on indications, technological innovations, imaging applications, and clinical outcomes. Future directions, including individualized treatment strategies, multidisciplinary collaboration, and long-term outcome assessment, are also discussed to inform clinical practice and future research.