A 68-year-old man developed aneurysmal degeneration Blood Pressure Monitoring of the aortic arch and proximal descending aorta after an open ascending graft for a type A aortic dissection.A three-branched endovascular aortic arch repair was performed with patency of all branches despite some degree of initial misalignment of the branches in relation to the target vessels.At 6 months postoperatively, an asymptomatic partial crushing of the left common carotid bridging grafts was observed on computed tomography angiography.This was treated by reinforcing the Grooming branch with a balloon-expandable endograft.The postoperative course was uneventful but a computed tomography angiography after 1 month showed recurrent asymptomatic compression.
A left carotid-subclavian bypass was eventually performed.We have reported a new failure mode of an inner branch arch repair of residual type A chronic dissection.