Implantation of an endovascular covered stent-graft for distal aortic archaneurysm via midsternotomy under pigtail catheter guidance

We implanted an endovascular covered stent-graft for distal aortic arch ane urysm involving the left subclavian artery in 12 cases. A stent graft was d elivered just below the aneurysm via aortotomy with direct vision using a 1 2 F delivery sheath under guidance of a pigtail catheter placed via the gro in artery. The proximal anastomosis of the stent-graft was performed with i nclusion technique, and the aortotomy was then closed with it. This techniq ue reduces operative damage by eliminating distal anastomosis and should re duce operative mortality and morbidity. (C) 1999 Elsevier Science B.V. All rights reserved.