Salvage of endoluminal exclusion of an anastomotic arch aneurysm with a "kissing" carotid stent

Traditional open repair of thoracic aortic aneurysms remains a high-risk surgical procedure. Thoracic aneurysm stent-graft repair is evolving but has promise as a minimally invasive treatment option. Herein a case is presented of an anastomotic arch aneurysm treated with a custom-made thoracic stent-graft after a left subclavian artery-to-carotid artery transposition. Proximal extension for a type I endoleak necessitated a bailout procedure with a "kissing" left common carotid artery bare stent.