A double-barrel stent-graft for endovascular repair of the aortic arch.

PURPOSE: To extend the role of endovascular aneurysm repair in the presence of angulation and dilatation of the distal arch that compromise the proximal implantation site. CASE REPORT: A 70-year-old man with an asymptomatic 7-cm thoracic aortic aneurysm was treated with a TAG stent-graft. However, attempts to gain secure hemostatic implantation of the endograft resulted in inadvertent coverage of the subclavian and left carotid arteries. Flow to the left carotid artery was re-established by transcarotid insertion of a self-expanding covered stent alongside the primary stent-graft. CONCLUSION: This technique may have a role as an intended part of endovascular repair when there is no suitable implantation site in the descending thoracic aorta.