Endovascular repair of a chronic arch dissecting aneurysm with a branched endograft

Acute type A dissection requires emergent surgery that often includes ascending aorta replacement. Regular follow-up with computed tomography (CT) can identify aneurysmal dilatation of the false lumen distal to the open repair. Because redo operations can be high risk, we performed an endovascular repair on a patient deemed unfit for open operation using an aortic arch branched device with 2 internal branches for the innominate trunk and the left common carotid artery. This endovascular approach is a possible alternative to open surgical procedures in selected cases.