[Distal Stent Graft-induced New Entry on the Lesser Curvature of Distal Aortic Arch:Report of a Case].

A 62-year-old male was admitted for cerebral hemorrhage, enhanced computed tomography (CT) revealed a dissecting thoracic aortic aneurysm in the distal arch. Following cerebral hemorrhage treatment, the patient was referred to our department and underwent a total arch replacement using the frozen elephant trunk (FET) technique. The patient was followed up regularly post operatively at our hospital. Enhanced CT at 31 months post surgery revealed a distal stent graft-induced new entry (dSINE) on the lesser curvature of the distal arch. Additional thoracic endovascular aortic repair (TEVAR) was performed. Although dSINE can be caused by various factors, it is usually seen on the greater curvature of the aorta and is relatively rare on the lesser curvature, as in this case in Japan. We will discuss the mechanisms underlying the development of dSINE on the lesser curvature with reference to the literature.