The aim of this study was to report the technique for endovascular treatment using aortic extension cuff in a patient with two large ascending aorta pseudoaneurysms A 76-year-old woman, nine months after an aortic and mitral valve replacement, developed a swelling at the upper third of the sternum A computed tomography (CT) scan demonstrated two pseudoaneurysms originating from the ascending aorta Because of the patient's poor physical condition, open repair was considered to be an extremely high-risk option Patient's anatomy was considered to be suitable for endovascular repair We selected an aortic extension cuff of the abdominal device (Endurant Medtronic, Minneapolis, MN, USA) delivered via a left axillary artery Final angiography, as well as a 30-day CT scan, confirmed total exclusion of pseudoaneurysms This case report confirms that endovascular techniques represent a successful approach …