This article is part of the operation script for grafting an abdominal aortic aneurysm. The article can be used on its own, or to go to the next part of the operation, click on NEXT PART OF THE OPERATION at the bottom of this page.
AORTIC ANEURYSM 250 SECTION 13.00 - CHOOSING A STRAIGHT OR Y GRAFT
STEP 13.01 INTRODUCTION
- A straight graft involves only 2 anastomoses, upper and lower, compared with the 3 anastomoses of a Y graft.
- However the 2 femoral anastomoses are quicker and easier to perform.
- After including the time to explore the groins and to make the vascular tunnels, inserting a Y graft usually takes longer than a straight graft.
- A straight graft can be anastomosed to the bifurcation of the aorta in about 70% of cases, using an inlay technique.
- See SECTION 16.00 CHOOSIING A TRANSECTION OR INLAY TECHNIQUE FOR ANASTOMOSIS
- Where the anastomosis is to be made using a transection technique, the proportion of suitable cases for a straight graft falls to about 50%.
- Where there is aneurysmal or occlusive disease of the iliac arteries, a Y graft is mandatory.
- If there is such disease:
- Some surgeons still prefer a Y graft, even if there is only minor dilatation of the iliac arteries.
STEP 13.02 CHOOSE A GRAFT
- For a straight graft:
- Match the diameter of the graft to the aorta.
- Usually a 16mm. diameter graft is adequate.
- Go to SECTION 16.00 CHOOSING A TRANSECTION OR INLAY TECHNIQUE FOR ANASTOMOSIS
- For a trouser graft:
- Usually a 16mm. diameter aortic section graft with 8mm. diameter iliac limbs is adequate (90 %).
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