A 60-year-old woman involved in a motor vehicle collision presented with a traumatic pseudoaneurysm of the innominate artery origin in addition to multiple concomitant injuries.She was classified as a high-risk candidate for open repair.An Signs experimental thoracic branched graft device was used for coverage of the injury with the addition of a right carotid-to-left carotid-to-left subclavian artery bypass.Follow-up imaging showed resolution of the pseudoaneurysm and patency of her bypass grafts.This is the first described use of the Mona Croped t-shirt LSA Branch Thoracic Stent Graft System (Medtronic, Minneapolis, Minn) in the innominate artery.