A 73-year-old female was referred to our hospital because of pain in the right upper extremity, left hemiparesis and syncope. Computed tomography (CT) of the head showed no active lesion, but chest CT showed Stanford type A aortic dissection with occlusion of the brachiocephalic artery. Carotid ultrasonography showed occlusion of the right common carotid artery. Emergent graft replacement of the ascending aorta and aortic arch was performed. The right common carotid artery was opened but no thrombus was found. In order to restore and maintain the cerebral circulation, the right carotid artery was cannulated. Postoperative head CT showed a small cerebral infarction of the right parietal lobe. Syncope did not recur and her hemiparesis was treated by rehabilitation. Cannulation of the carotid artery is useful for cases with occlusion of the brachiocephalic artery.
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