title: A double-barrel stent-graft for endovascular repair of the aortic arch.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Vascular Surgery, University of California San Francisco, California 94143-0222, USA. hiramotoj@surgery.ucsf.edu
authors.forename: Jade S
authors.initials: JS
authors.lastname: Hiramoto
authors.forename: Darren B
authors.initials: DB
authors.lastname: Schneider
authors.forename: Linda M
authors.initials: LM
authors.lastname: Reilly
authors.forename: Timothy A M
authors.initials: TA
authors.lastname: Chuter
mesh_terms: D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D015607:Stents; D014057:Tomography, X-Ray Computed