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December 1964

Long-Term Comparison Of Vein Patch With Direct SutureTechnique of Anastomosis of Small Arteries

Arch Surg. 1964;89(6):1083-1088. doi:10.1001/archsurg.1964.01320060151027

Introduction  The use of an autogenous vein patch for closure of an arteriotomy in a small artery was suggested in 1959 by Senning10 and Crawford.4 Subsequently, DeLeon and Spencer suggested a technique of using a vein patch when direct end-to-end anastomosis of small arteries was performed.5 The patch graft was used to widen the lumen and prevent annular constriction from a circular suture line. Initial results indicated that higher patency rates might be obtained with the patch graft reconstruction than with conventional end-to-end anastomoses. Long-term data, however, have not been reported. Chatterjee and Warren recently described significant necrosis and fibrosis of venous patch grafts 60 days after insertion and speculated that long-term function was questionable in the presence of such changes.3 Similar histologic findings have been described by Hardy.6 This study was accordingly designed to compare long-term patency rates of small artery anastomoses constructed either