Our purpose was to examine the use of fully supported open stent grafting (OSG) with a Matsui-Kitamura (MK) stent for treatment of distal arch aneurysm (DAA). Surgery was performed using a newly developed device in seven DAA patients (six men and one woman) from 58 to 86 years of age (mean, 73 years old) from August 2005 to June 2007. The aorta was transected at the arch between bracheocephalic artery and left subclavian artery under circulatory arrest with total cardiopulmonary bypass and selective cerebral perfusion; then the stent grafting (SG) system was inserted and positioned with a 14 Fr. pusher. The SG and a transected edge were then sutured and anastomosed with the arch graft. The surgery was completed by constructing three cerebral branches. The mean SG diameter and length were 34.6 mm (range, 32-38 mm) and 150 mm (120-200 mm), respectively. The mean time of circulatory arrest time and surgery were 41 min (35-55 min) and 358 min (269-450 min), respectively. Simultaneous mitral valve replacement was performed in one patient. All surgeries were completed successfully, and complete thrombosis of the aneurysm was obtained. Paraparesis and respiratory failure occurred in one patient each, and one patient died of brainstem infarction 1 month after surgery. These initial results suggest that the OSG method is a useful surgical procedure for the treatment of DAA.