Neurological complications after descending and thoracoabdominal aortic aneurysm (TAAA) correction procedures remain a serious challenge. Their prevention implies proactive approach to manageable risk factors: diagnosis and preoperative correction of latent renal failure [odds ratio (OR)=4.72; p=0.08] and minimization the cross-clamp time (OR=7.0; p=0.03). Extended TAAAs, especially type 1 and 2, (OR=8.5; p=0.03) must be operated only in facilities with sufficient experience in such reconstructions. Prognostic model was suggested to calculate precisely the risk of paraparesis. TAAA correction <<without perfusion>> is accompanied by 1.45-fold higher risk of neurological complications then after procedures that are accomplished under protection.