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Combined procedures involving an endovascular stenting technique and transposition of the aortic arch vessels have been proposed for the treatment of aneurysms or chronic dissections involving the descending thoracic aorta and the aortic arch. This novel concept abandons the use of extracorporeal circulation and can be applied without a full-length sternotomy.1 Reductions in surgical trauma and periprocedural morbidity and mortality have therefore been proposed as advantages for this novel technique.2 Here we report on 2 cases of Stanford type A aortic dissection that occurred during supra-aortic debranching and endovascular stenting of the aortic arch and the descending aorta.