Acute traumatic aortic rupture represents a potentially life-threatening situation. Because of the extremely high early mortality, emergency surgical repair used to be the preferred method of treatment. This group of patients usually is seen with a wide variety of injuries and comorbid conditions, all of which have a major impact on surgical outcome. We present an alternative hybrid approach that combines on-site placement of pumpless extracorporeal lung assist, subsequent patient transfer, and endovascular stent-graft implantation. This procedure may be a potentially useful strategy to reduce the comorbidity and the mortality of both lesions.