A 76-year-old man who 2 years before underwent thoracic endovascular aortic repair for aneurysm of the aortic arch was admitted to our department with dysphonia and dysphagia due to an increasing diameter of aneurysm of the aortic arch because of type Ia endoleak. To obtain an adequate proximal neck for conventional thoracic endovascular aortic repair, the double chimney graft technique was chosen using a hypogastric component of the iliac branch Excluder (W. L. Gore & Associates, Flagstaff, Ariz) for the anonymous trunk. At 1-year follow-up, computed tomography scan showed patent?chimney graft and no endoleaks. This is the first report in the literature using a hypogastric branch in the aortic arch.
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