Classical surgical therapy of dilatation disorders of the aortic arch require extracorporeal circulation, selective brain perfusion and/or deep hypothermia and it is still associated with very high mortality and morbidity. Endovascular therapy has until recently indicated only been in cases when the disease did not affect the area of the origins of the main branches within the aortic arch. We are presenting a case report of a 68 year female patient with a vascular anomaly (arteria lusoria) and 2 pseudoaneurysms of the aortic arch between the origins of arteria carotis communis on the right and arteria carotis communis on the left, respectively between a. carotis communis on the left and arteria subclavia on the left, when we took advantage of a hybrid procedure in the therapy. The patient was treated by creating a new branching of the aortal arch using a prosthesis from the ascendant aorta and subsequently by an introduction of 2 stent-grafts to the aortic arch using femoral arteries.