Acute intraoperative arterial elongation: an experimental study.

OBJECTIVES: small arterial defects resulting from either trauma or resection of an aneurysm often present difficult problems to the vascular surgeon. DESIGN: to demonstrate that certain arterial gaps as a result of traumatic injury or aneurysm resection could be closed with acute intraoperative arterial elongation. Materials: fifteen mongrel dogs underwent acute intraoperative arterial elongation of the right superficial femoral artery, with the left side used for a control vessel. METHODS: arterial defects created surgically (median 50 (range 25 to 60 mm) mm). Appropriate length of artery was then undermined. A Foley catheter was placed proximally and distally directly beneath this undermined portion of vessel. The vessel is lengthened following 3 expansion/relaxation cycle of Foley catheter. Arterial gaps were closed by end to end anastomosis. Arterial pressure study was performed in all vessels. RESULTS: acutely, arterial pressure differences proximal and distal to the anastomosis were seen only when arterial gaps were exceeded 55 mm. There was no occlusion either acutely or after 4 weeks follow-up period. Light microscopic examination of arterial specimens revealed partial disruption of internal elastic lamina. At the end of the follow-up period, formation of neointima with regeneration of the internal elastic lamina was demonstrated. Scanning electron microscopy revealed minimal endothelial denudation. CONCLUSIONS: we believe that, acute intraoperative elongation can be used as an alternative technique to vein grafting for the repair of small traumatic arterial defects in selected cases.