Anatomic Considerations The aortic arch gives off, from right to left, the innominate, the left common carotid, and left subclavian arteries. The innominate artery passes beneath the left innominate vein before it divides into the right subclavian and the right…
Exposure of Major Abdominal Arteries Anatomic Considerations The aorta enters the abdomen through the aortic hiatus in the diaphragm at the level of T12 vertebra. It is surrounded at this level by the right and left crura of the diaphragm…
Introduction Surgical exposure of the aorta involves three main segments: the ascending aorta and aortic arch, the descending thoracic aorta, and the abdominal aorta. Depending on the pathology, either one or several of these segments will need exposure simultaneously. This…
Introduction Due to the close anatomic association between fine lymph vessels, lymph nodes, and corresponding arteries and veins, the possibility of lymphatic complications should always be considered when proceeding with vascular operations. Although the ability of transected or ligated lymphatics…
In vascular surgery, venous complications arise from different mechanisms, ranging from traumatic to iatrogenic injury, both directly and indirectly. Complications may present as bleeding and hematoma immediately after venous injury or as occult thrombosis or fistula detected only after many…
Introduction Endovascular procedures are often the first intervention for peripheral arterial disease and many other vascular surgical conditions. , Although these are thought to be less invasive and “safer,” endovascular interventions can have unique complications that surgeons and other interventionalists…
Introduction Aortoenteric fistula (AEF) is defined as a communication between the aorta and gastrointestinal (GI) tract. AEF is classified as primary or secondary based on the underlying cause leading to the fistula development. Primary AEF is a communication between the…
Introduction In 1956, Birch et al. reported the first case of anastomotic aneurysm in a patient after prosthetic aortic graft placement. Since then, anastomotic aneurysms have been recognized as an infrequent, although important, late complication of prosthetic arterial reconstruction. Although true…
Introduction The incidence of infection involving vascular prostheses is relatively low because of routine antibiotic prophylaxis before surgical procedures, refinements in the sterilization and packaging of devices, and careful adherence to aseptic procedural and surgical technique. When infection does occur,…
Introduction Postoperative graft thrombosis remains a significant clinical challenge in contemporary vascular surgical practice. Whether early or late, graft thrombosis continues to account for significant morbidity, limb loss, and mortality in patients requiring vascular intervention. Historically, at 1 year after…