Wrapping technique for prevention of anastomotic false aneurysm in synthetic prostheses: clinical and experimental.

ABSTRACT

A clinical review of late anastomotic false aneurysm in 293 prosthetic reconstructions including 694 anastomoses for larger arteries at the Department of Surgery II, Kyushu University, from 1965 to 1979, revealed the incidence of anastomotic false aneurysm to be 3.9% of 204 abdominal aortic anastomoses and 12.9% of 209 common femoral anastomoses, respectively. A major contributing factor to development of the anastomotic false aneurysm was deterioration of the parent artery. In order to prevent this complication, we successfully applied a dacron felt wrapping to 45 abdominal aortic, 44 iliac arterial and 27 common femoral arterial anastomoses and there have been no postoperative complications at 5 years. The reliability of the dacron felt wrapping technique was also evaluated by an experimental study using dogs. Furthermore, we devised a double wall anastomosis technique for application in cases with severely sclerotic abdominal aortic aneurysms. Five patients in whom this technique was used are well after 3 years.