Endovascular stent-graft repair is a less invasive technique than traditional open aortic reconstruction for strictly selected patients with descending thoracic aortic aneurysms. To prevent distal migration of the device as a result of the propulsive flow during systole, it is helpful to induce temporary asystole for > or = 20 s while the stent-graft is placed in the thoracic aorta.We report here a case study of a patient who was given a bolus dose of 60 mg of adenosine to induce temporary asystole. Placement of the stent-graft was successfully performed during the temporary asystole. After 45 s the patient returned to normal sinus rhythm. He was extubated 4 h after the conclusion of surgery and was discharged after 1 week.Induction of temporary asystole with bolus adenosine to facilitate placement of stent-grafts in the thoracic aorta is a simple, easy and effective method of avoiding distal device migration.