Today, with the increasing experience and advances in graft technology, endovascular grafting is applied nearly to all levels of the aorta for the treatment of various aortic pathologies. The major route of the stent graft deployment is from the femoral region through the iliac arteries. Since both aneurysms and arterial occlusive diseases share atherosclerosis as the common ancestor of etiology, some patients may posses both aneurysms and stenosis together. These stenotic changes occurring in the iliac and femoral arteries may complicate the passage of the stent graft system. In this report, we sought to evaluate an alternative novel route of graft system application for endovascular treatment of thoracic aortic aneurysms.