[Open stent-grafting for the distal arch aneurysm using a new delivery sheath]

Surgical graft replacement of the distal aortic arch aneurysm has been known to have rather poor outcome. Open stent-grafting has been employed in many institutions, but several complications have been reported. Especially, embolism of the distal artery by debris of aneurysmal wall is a serious complication. Therefore we have developed and applied a new delivery sheath. The sheath is constructed with a ready-made delivery sheath and a part of a ready-made tracheostomy tube. That is called "balloon sheath". Five patients underwent distal arch stent-grafting using the device, all of whom had excellent result. The merits of the sheath are smooth delivery of stent-graft and less invasiveness for aortic wall. The new device is considered to be able to prevent aortic wall injury and peripheral embolic complication during insertion of stent-graft.