The use of an extra-corporeal graft to maintain cerebral perfusion during thoracic endovascular aneurysm repair.

Endovascular access for aneurysm repair can be challenging in patients with iliofemoral occlusive disease. The carotid artery is an alternative access site, but may increase the risk of cerebral hypoperfusion during stent delivery. We describe a novel approach, where temporary extra-corporeal bypass was used to maintain cerebral perfusion during endovascular thoracic aneurysm repair via the carotid artery, in a patient with significant aorto-iliac and arch vessel disease.