PMC9233568_01
Computed tomography angiography reconstruction showed a giant aneurysm of the descending aorta with obvious calcification at the aneurysm wall.
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Computed tomography angiography (CTA) of the aorta revealed a fusiform dilatation at the descending part of the aortic arch, with a maximum diameter of 71 mm, which was consistent with an aortic aneurysm ( Fig. 1 ). 
Good blood flow was found in the artificial blood vessel after surgical supra-aortic bypass.
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 Then, the angiography showed that the left common carotid artery and axillary artery were supplied with blood from the brachiocephalic trunk through the artificial blood vessel, with good blood flow ( Fig. 2 ).
During Castor stent implantation, the stent branch was introduced into the brachiocephalic artery.
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A 34-mm-28-mm-200-mm Castor single-branched stent-graft (Castor, Shanghai Microport Endovascular MedTech, Shanghai, China) was introduced along the guide wire, and the stent branch (diameter 12 mm) was introduced into the brachiocephalic trunk ( Fig. 3 ).
Postoperative angiography showed that the aneurysm cavity had disappeared. There was no obvious endoleak, and the supra-arterial blood flow was smooth.
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The patient underwent angiography again, which showed that the thoracic aorta stent-graft was attached tightly, the blood flow in the supra-arch vessel was good, and a small amount of contrast agent regurgitation was detected in the left vertebral artery ( Fig. 4 ).