Endovascular therapy of ascending thoracic aorta.

We describe the endovascular treatment given to a patient who, after surgery on the ascending thoracic aorta due to acute type A dissection (Bentall's procedure), developed a pseudoaneurysm 12 cm in diameter of the ascending aorta at the brachiocephalic trunk. Firstly, an extra-anatomical carotid-carotid bypass was performed, which was followed by endovascular treatment, excluding the aortic arch from the origin of both coronary arteries to the origin of the left common carotid artery, occluding the brachiocephalic trunk. For accurate placement of the endoprosthesis, the device was released after cardiac arrest with adenosine.