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Standard open repair of true or false aneurysms of the aortic arch usually require cardiopulmonary bypass, hypothermia and circulatory arrest, associated with increased mortality and morbidity rates. Thus, an alternative strategy that avoids cardiopulmonary bypass (CPB) and hypothermic circulatory arrest would benefit the patient. Endovascular stent-grafting has developed as a safe and effective treatment for descending aortic pathologies.5,6 We share our experience with the endovascular approach to pseudoaneurysm of the aortic arch in a patient with high risk for aortic arch replacement under extracorporal circulation.