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Proximal suture line support in open abdominal aortic aneurysm repair: a comparative study
J Pillai1, R Britz, M D V Cluver
1Johannesburg Hospital Vascular Unit, Department of Surgery, University of the Witwatersrand, Helderkruin, Johannesburg 1733, South Africa. jayanpillai@telkomsa.net
Objectives:
The aim of this study was to determine whether the collar graft (standard dacron graft with a customized flexible collar attached to the proximal rim) decreased anastomotic bleeding and the overall clamp time.
Design:
Prospective randomised single center study.
Methods:
Between November 2003 and January 2006, 21 patients were treated with a collar graft and 19 with a standard dacron graft. Routine endoaneurysmorraphy was used. Only infra-renal aneurysms between 5.5cm and 6.5cm were included. Aneurysms were diagnosed by CT scans. The total number of bleeding points, the total clamp time, and the number of teflon felt pledgets, was determined.
Results:
The total number of bleeding points; the number of aortic re-clamps and total clamp time (minutes) per patient were all significantly lower in the collar graft group (1.2 versus 2, p<0.04; 0.5 versus 2.0, p<0.001; 13.6 versus 20.1, p<0.003 respectively). The number of teflon felt pledgets and new sutures used was significantly lower in the collar graft group (p<0.001 and p<0.003 respectively).
Conclusion:
The collar graft resulted in fewer anastomotic bleeding points and a shorter clamp time.
