An assessment of different types of anastomosis with significant vessel disproportion using thin-walled interposition vein grafts.

The microvascular anastomosis of vessels with a diameter difference in the range of 3:1 can be a difficult surgical exercise, with the risk of bleeding or thrombosis. Five different techniques for dealing with such asymmetries were investigated in a series of autogenous rabbit vein grafts. An assessment was made of patency rates and of factors involved in the performance of the anastomoses. It is concluded that the end-to-end with oblique cut procedure is the most suitable for the clinical situation.