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Don't be too quick to reach for graft material in surgical treatment of traumatic aneurysms of the aorta.
That is the conservative message of a team of New York surgeons who reported to the Society of Thoracic Surgeons four consecutive cases of treatment by excision of the aneurysm and reconstruction of the aorta by direct anastomosis, "eliminating the need for interposition of a graft in the usual case."
The report was presented by Ralph D. Alley, MD, associate professor, Subdepartment of Thoracic Surgery, Albany Medical College.
The rationale for the approach is based on "the fact that typically the patient is a young adult, free of diffuse vascular disease, and the aneurysm arises from a linear transverse disruption of the intima and media, with no significant loss of adjacent normal vessel.
"Clearly, where feasible, arterial reconstruction by direct suture is preferable to restoration of continuity by graft," Dr. Alley said.
Direct Anastomosis Suggested For Traumatic Aneurysm of Aorta. JAMA. 1966;195(7):35. doi:10.1001/jama.1966.03100070019006
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