MODERN surgery has made some of its greatest strides recently through more intelligent understanding of body metabolism and in techniques of anesthesiology. In vascular surgery, however, meticulous surgical technique remains by far the single most important factor favoring a successful outcome. A slight mechanical defect in surgical technique can nullify the end result in a well conceived surgical plan, despite perfect understanding and management of body metabolism, and a perfectly administered anesthetic.
The modern techniques of vascular surgery, the utilization of autografts, as well as the development of suitable plastic large vessel prostheses, have been well demonstrated by such vascular surgical pioneers as Carrel,1 DeBakey and associates,2 Linton,3 Edwards,4 Cannon,6 Julian,5 Szilagyi,4 and many others. The patch technique of widening an arteriotomy incision is well known and familiar to all vascular surgeons.
In the insertion of an aortoiliac plastic prosthesis the anastomosis of