Prevention of Thrombus Formation in Small-Artery Anastomoses

The present vigorous activity in vascular surgery is chiefly focused upon the larger vessels of the body, such as the aorta and iliac and femoral arteries. Remarkable progress has been made, and successful replacements, shuntings, and endarterectomies are commonplace in these larger vessels. Much less attention has been given to the smaller arteries, where the need is perhaps even greater. An exception is the coronary artery, which has received, and is receiving, much study. The problems involved in securing successful anastomoses in large arteries are no doubt similar to those encountered in small-vessel anastomoses, but in the smaller vessels there is a far greater tendency toward occlusion of the anastomotic site by thrombosis. Because of this tendency of small-vessel anastomoses to occlude, the techniques which have been used so successfully in large vessels often fail in small arteries.

Reports have varied considerably in the degree of success achieved when small