J.Jpn. Surg. Soc.. 79(9): 1139-1143, 1978

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Report on the annual meeting

TREATMENT OF THE AORTIC ANEURYSM WITH INTRALUMINAL ANASTOMOSIS OF THE PROSTHETIC GRAFT

In order to minimize the anastomotic complication of the surgical treatment of the aortic aneurysm intraluminal anastomosis with polypropylene monofilament suture (Prolene) was developed. This technic is only possible with this suture material which is so slippery and slide readily that approximation of the graft and the aorta is easily made even after completion of the circumferencial suture.
After occluding clamps are applied to the aorta above and below the aneurysm, a longitudinal incision is made in the anterior surface of the aneurysm. A prosthetic graft is then anastomosed to the aorta proximal to the aneurysmal sac with a running over- and -over suture from within the aortic lumen. The suture is started on the posterior wall of the aorta, and carrying bilaterally to the anterior portion of the anastomosis. The two ends of the suture are then pulled taut, which brings the graft and the inner surface of the aorta in close approximation, and anchored by ligating them together. The distal anastomoses are performed with standard methods, and the graft is covered with the aneurysmal wall.
Seven cases of the abdominal and one case of the thoracic aortic aneurysm were operated with this technic without operative death or anastomotic complication.

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