Endovascular techniques have proven useful in aortic arch management because they allow less invasive treatment and potentially faster recovery. We present the case of a 66-year-old woman with a 2-month history of precordial pain. Imaging studies revealed a saccular aortic arch aneurysm in the anterior portion of the arch. A Valiant Navion CoveredSeal (Medtronic, Santa Rosa, CA) device was modified with a double fenestration and used to treat it. The symptoms resolved and follow-up imaging showed aneurysm exclusion and patency of the supra-aortic branches. To our knowledge, this the first total endovascular arch repair to have been performed with this device.
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