A 69-year-old woman had an innominate artery aneurysm that was adjacent to the right common carotid artery and the right subclavian artery. The patient had a dominant right vertebral artery and an underdeveloped circle of Willis. At surgery, the proximal site of the innominate artery, the right common carotid artery and the right subclavian artery were clamped with the temporary bypass between the ascending aorta and the distal site of the right brachial artery for maintaining the blood flow to the brain. The innominate artery aneurysm was resected, and a woven Dacron Y-shaped graft, 14×7 mm in diameter, was used for reconstructing the innominate artery, the right subclavian artery and the right common carotid artery. The postoperative course was uneventful and there was no postoperative neurological deficit. Temporary bypass for maintaining cerebral perfusion was useful in preventing cerebral ischemia.
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