Aneurysms of the innominate and subclavian arteries are uncommon but associ
ated with high mortality rates. We report herein the case of a 45-year-old
man who presented with facial anhidrosis that developed several years after
blunt thoracic trauma, in whom an aneurysm involving the innominate and su
bclavian arteries was revealed by preoperative examinations. Resection of t
he aneurysm and reconstruction from the ascending aorta to both the subclav
ian and common carotid arteries using a bifurcated graft was successfully p
erformed without brain perfusion. Although the left posterior cerebral arte
ry, which was not manipulated during surgery, became occluded, it was recan
alized by thrombolysis. The patient was discharged in good health and has r
emained well since.