Technical advantages of a ringed intra-luminal graft in the management of difficult aortic aneurysms

The ringed intra-luminal graft has been designed for aortic repair with non-sutured anastomosis. The graft and technique of insertion are described. It is proposed that this type of prosthesis might have advantages over conventionally sutured grafts for the surgical management of thoraco-abdominal, suprarenal and dissecting aneurysms, and occasionally for infrarenal aneurysms when the neck is ectatic or excessively friable. This proposition is supported by reference to five patients with complex aneurysms which were repaired successfully with non-sutured grafts. The importance of appropriate patient selection and attention to technical detail is stressed.