Abstract
Brachiocephalic arterial trunk aneurysms, comprising 3% of supraaortic aneurysms, often manifest with local compression, thrombosis, or embolization. Surgical exclusion is preferred because of the risks of embolism and aneurysm rupture. We describe the case of a 51-year-old man with a pulsatile neck mass, a 48-mm brachiocephalic trunk aneurysm, and a porcelain aorta. Surgical steps included cannulation, aortic replacement, aortic root treatment, and coronary artery bypass. The patient recovered well postoperatively, and he was discharged on day 5 with no complications. Aortic arch aneurysms, primarily atherosclerotic aneurysms, pose challenges, especially in patients with a porcelain aorta, thus necessitating meticulous surgical planning for optimal outcomes and risk mitigation.