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Hemodynamic control
Anastomosis
4. Types of anastomoses
Vascuar pathologies
- wall
- lumen
Principles of vascular anastomoses
1. ASEPTIC technique
2. Controlled HEMODYNAMIC conditions
3. Appropriate instruments ATRAUMATIC
4. Restore of intimal continuity EVERTING
5. Maintaining lumen permeability NONSTENOTIC
and NONTHROMBOTIC
6. Maintaining VIABILITY
Double ended
Monofilament
Synthetic
Slowly absorbable
Round bodied needle
The thickness of the thread depends on the
thickness of wall (not the lumen diameter)
SSCR - Basic Surgical Skills, 2nd edition, Bucharest
Prostheses
Synthetic:
Polyester = Dacron
Polytetraflourethylene=
Gore-tex
Biological:
Homonymous vein
(Treated) cadaver artery
or vein
Bovine pericardium
Clamping
Ligation
Dabbing
Transverse - completely stops blood flow and it is done both downstream and
upstream of the incision.
Longitudinal Transverse
Uses:
Portacaval shunt in portal
hypertension
Radiocephalic arteriovenous fistula for
hemodialysis
The needle will pass through the vessel wall on the first
attempt
Improper spacing
Fogarty
embolectomy
catheter
http://www.ecu.edu/cs-dhs/surgery/upload/Skills-lab-Vascular-surgery-
one.pdf
http://www.ecu.edu/cs-dhs/surgery/upload/Skills-lab-Vascular-
surgery-two.pdf