Acute intraoperative arterial elongation: an experimental study.

Abstract

small arterial defects resulting from either trauma or resection of an aneurysm often present difficult problems to the vascular surgeon. to demonstrate that certain arterial gaps as a result of traumatic injury or aneurysm resection could be closed with acute intraoperative arterial elongation. fifteen mongrel dogs underwent acute intraoperative arterial elongation of the right superficial femoral artery, with the left side used for a control vessel. arterial defects created surgically (median 50 (range 25 to 60 mm) mm). Appropriate length of artery was then undermined. A Foley catheter was placed proximally and distally directly beneath this undermined portion of vessel. The vessel is lengthened following 3 expansion/relaxation cycle of Foley catheter. Arterial gaps were closed by end to end anastomosis. Arterial pressure study was performed in all vessels. acutely, arterial pressure differences proximal and distal to the anastomosis were seen only when arterial gaps were exceeded 55 mm. There was no occlusion either acutely or after 4 weeks follow-up period. Light microscopic examination of arterial specimens revealed partial disruption of internal elastic lamina. At the end of the follow-up period, formation of neointima with regeneration of the internal elastic lamina was demonstrated. Scanning electron microscopy revealed minimal endothelial denudation. we believe that, acute intraoperative elongation can be used as an alternative technique to vein grafting for the repair of small traumatic arterial defects in selected cases.