[Management of hemoperitoneum due to rupture of visceral branches of the aorta with a cylinder-type balloon catheter].

We have designed a cylinder-type balloon catheter and devised a new procedure for the management of the aneurysm in a condition difficult for treatment. This balloon catheter consists of a balloon located at the tip of a catheter. The balloon has a central lumen for maintaining the distal aortic bloodflow and can be inflated at various intended sites. The catheter with a deflated balloon was inserted into the abdominal aorta upward through a vascular graft sutured at the side of the aorta. In the case of a ruptured visceral artery, e.g., celiac axis or superior mesenteric artery, controlling of hemorrhage is very difficult because the ruptured lesion is surrounded by an intricate anatomical structure and therefore it is necessary to do the highly invasive procedure of aortic cross-clamping. Therefore we attempted this time to use the device in the management of this disease. In experimental investigation in dogs, this balloon selectively blocked the blood flow to the visceral branches successfully while maintaining the distal aortic flow. With this method, the various hemostatic procedures can be performed satisfactorily without concern for complications, namely renal failure provided that hemorrhage is easy to control in a short time without the aortic clamp. As mentioned above, this instrument will be useful for the management of rupture of the visceral artery and so reduce its mortality rate.