Hybrid Treatment of Complex Para-anastomotic Aortic Arch Pseudoaneurysm

The development of pseudoaneurysms increases with time since the original operation, with incidence 0.2 to 25%. The axillofemoral bypass is employed to treat selective aortoiliac obstructions. Rarely, it is used in reverse form and always for treatment of occlusive arterial disease. We report a para-anastomotic aortic arch pseudoaneurysm and add to the literature a successful hybrid treatment, with bilateral femoroaxillary bypasses, thromboexclusion of all supra-aortic trunks, and aortic arch covering with an endograft.