Carotid-subclavian bypass or transposition extends the proximal landing zone for GORE thoracic branch endoprosthesis deployment

Managing proximal aortic arch pathology remains complex. The thoracic branch endoprosthesis (TBE) offers a promising endovascular option. This retrospective case series evaluates TBE deployment after carotid-subclavian bypass and transposition in anatomically challenging patients. Ten patients underwent thoracic endovascular aortic repair with TBE between 2022 and 2025. Technical success was 100%, with no 30-day mortality, stroke, myocardial infarction, or respiratory complications. One patient required reintervention for a type III endoleak. The median patient age was 59 years, and the median hospital stay was 11.5 days. These findings support the safety and feasibility of TBE use with debranching in complex aortic arch repairs.