Arterial reconstruction

Types of arterial procedures

 * suture (simple, with venous or artificial patch – plastic)
 * endarterectomy (opened, semi-closed)
 * direct compensation – aneuryzma (bulge)
 * shortenning – folding of long blood-vessels (kinking karotidy)
 * implantation
 * embolectomy, trombectomy – Fogart's catheter
 * bypass (bypass)

Types of vascular replacements

 * 1) Biological (artery or vein) – autologous, alogenous, xenogenous (bovine);
 * 2) * a. thoracica interna –artery fo elastic type, which is resistant to Atherosclerosis;
 * 3) artificial – knitted (polyester);
 * 4) * porous wall ( must be precoagulated);
 * 5) * well accomplished, however is often infected (Staphylococcus epidermidis);
 * 6) tissues
 * 7) ferociously (PTFE) – microporous wall
 * 8) combined

Principles of surgery

 * We prepare and suture the blood vessels subadventically and during the procedure we use fine atraumatic non-absorbable fibers (např. Prolene&reg;). Before reconstruction we administer heparin (1–2 mg/kg) and before resuming of the blood flow we neutralised it with protamine (1,5 mg protamine / 1 mg heparin). The flow then resumes slowly from the periphery, we control the restoration of the flow and stop any bleeding.

Postoperative comlications

 * early – bleeding, seal, infection], [[thrombosis, postoperative peripheral embolisation, postperfusion syndrome (leaching of metabolites from previously ischemized tissues), compartment syndrom (a sudden increase in the tissue pressure in the compartment)
 * late – seal (lock), pseudoaneurysm, right aneurysm

There are three basic surgical methods used for the reconstruction of the passage – desobliteration, patch or bypass.

Patch

 * extension of the lumen by sewing a patch from an autologous vein or from an artificial material
 * can be combined with TEA

Related articles

 * Ischemic heart disease
 * Chronic ischemic disease of the lower limbs
 * Occlusion of large veins
 * Acute arterial occlusions