Hemiaortic arch debranching using native supra-aortic vessels

Endovascular treatment of aortic arch aneurysms with a proximal landing zone in zone I requires carotid-carotid bypass. We report two patients with aortic arch aneurysms in whom we used a new hybrid approach by transposing the left common carotid artery and left subclavian artery to the right common carotid artery. This innovative technique uses a native vessel instead of prosthetic material and a shunt to maintain cerebral perfusion, thereby avoiding bilateral carotid clamping.