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Aortic arch is the most common location for developing aortic aneurysm. The location of this aneurysm is close to brachiocephalic vessels and atheromatous plaque and thrombus are often present not only in the aneurysm but nearby aorta and its branches. The open repalcement with brachicephalic vessel reconstruction with prosthetic graft is still the gold standard procedure for this pathology. Our procedure for this aneurysm is simple and standardized. Systemic cooling until 25 to 28 degree at tympanic membr
