Method of forming a distal anastomosis with an autovenous cuff

Shalashov A.G.

Vascular Surgery Department, Regional Clinical Hospital, Samara, Russia

Presented herein is a brief review of the world literature dedicated to methods of formation of composite arterial anastomoses in the femoropopliteal-tibial region The most justified is considered the use of a composite shunt formed proximally from a synthetic vascular graft made of polytetrafluoroethylene and distally with an extension from a portion of the suitable for reconstruction autovein (the so-called autovenous cuff of patch). The use of an autovenous cuff is more physiological since it provides closer correspondence of the diameters of the distal anastomosis being applied between the artery and autovenous extension, as well as contributes to creation of more adequate haemodynamic conditions in the shunt. Also analysed is the technique of performing the previously suggested anastomoses, demonstrating their main disadvantages.

This is followed by describing a new original method of formation of a distal anastomosis using an autovenous insert, showing its advantages, with the main amongst them being the presence of only two vascular sutures and a decrease in the possibility of the onset and development of turbulence in the zone of the anastomosis. A conclusion is drawn that the suggested method contributes to decreasing the duration of the main stage of the operation, decreases the probability of technical defects and reduces the risk for the development of postoperative complications associated with impairments of the processes of haemodynamics in the zone of the anastomosis formed.

KEY WORDS: revascularization of lower limbs, shunt, autovenous insert, autovenous cuff, distal anastomosis.

P. 163

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