Late Suture Failure in the Pathogenesis of Anastomotic False Aneurysms

The important role of graft organization at the vascular prosthetic anastomosis.

“…Causative factors of anastomotic aneurysms other than infection have been postulated (Gaylis et al 1959;Moore and Hall 1970;Szilagyi et al 1975;Knox 1976;Sasaki 1977). Knox (1976) emphasized that suture material, end-to-side anastomo sis, proximity of the anastomosis to a joint and intimectomy of the recipient artery should be taken into consideration.…”

“…Knox (1976) emphasized that suture material, end-to-side anastomo sis, proximity of the anastomosis to a joint and intimectomy of the recipient artery should be taken into consideration. Moore and Hall (1970) showed that anastomotic aneurysms in 25 cases were due to prosthetic graft. Silk suture had been used in almost all of these cases, and when anastomotic aneurysms occurred, silk sutures were found either broken or dissolved.…”

“…graft organization; strength of vascular anastomosis; absorbable suture; anastomotic aneurysm Even after the healing process of the anastomosis has been completed aneurysm may occur at the anastomotic site of vascular prosthesis. There are many factors which may be involved in the pathogenesis of anastomotic aneurysm and their roles are controversial (Gaylis et al 1959;Moore and Hall 1970;Szilagyi et al 1975;Knox 1976;Sasaki 1977). These include the weakness of suture material, the integrity of the wall of recipient vessel, the way of the anastomosis, infection of the anastomosis, etc.…”

False Aneurysms

“…Claytor and associates, in 1956, reported the first case of anastomotic aneurysm in a patient after prosthetic aortic graft placement [45]. Although silk was used as a suture material for anastomosis (prior to 1967), the most frequent cause of FAA was breaking of the suture material [47][48][49][50][51][52][53][54]. Introduction of synthetic polyfilament suture materials has significantly decreased this cause.…”

Nahtaneurysmen als Sp�tkomplikation gef��rekonstruktiver Eingriffe an der unteren Extremit�t

“…Ftir die Pseudoaneurysmaentstehung werden eine Reihe Faktoren diskutiert: Es sind dies, abgesehen von der nicht mehr gebr~iuchlichen Seide als Nahtmaterial [5,10], Nahtbruch yon Polypropylenefaden [2,5], Durchschneiden der Naht in der Gef'aBwand, wechselnde Spannung bei Bewegung im Gelenksbereich [5], Endarteriektomie der AnschlugsteUen [9], Turbulenzen und Auftreten von Scherkr~if-ten bei End-Seit-Anastomosen [5,9,11], Ausfransen der (gewebten) Prothese, Degeneration der Empfangerarterie [1], Anastomose unter zu starker Spannung, Hypertonie [9,11], frfihzeitige Anticoagulation, Wundheilungsst6rung [11] und Infektion [5]. Andere Autoren machen hauptsachlich eine Ursache ftir die Entwicklung von Nahtaneurysmen verantwortlich:…”