Endovascular repair of a proximal aortic arch aneurysm: a novel approach of supra-aortic debranching with antegrade endograft deployment via an anterior thoracotomy approach.

Although open surgical repair continues to be the standard therapy for thoracic aortic aneurysms, endovascular intervention has evolved into an acceptable strategy for patients who have prohibitive risks for conventional surgical treatments. Aortic arch aneurysm, in particular, is associated with substantial surgery-related morbidities, yet is typically not suitable for endovascular intervention. We describe a combined technique of supra-aortic trunk debranching through an anterior thoracotomy followed by endovascular repair of a large proximal arch aneurysm in an 82 year-old man 8 years after an ascending aortic aneurysm repair.