Use of triangulation method in end-to-side arterial microvascular anastomosis

In this article, we present the use of triangulation for end-to-side microvascular arterial anastomosis. The classic end-to-side anastomosis starts by putting 2 sutures 180 degrees apart to the lateral arteriotomy aperture that is parallel to the longitudinal axis. We are performing triangulation in end-to-side microvascular artery anastomoses by putting 3 stay sutures, securing 2 of them to visualize vascular lumen and reduce the risk of passing suture from the back wall. We have been using this method for the last 5 years and found that triangulation seems to be a safer technique to teach and practice end-to-side microvascular anastomosis.