Microarterial anastomosis with a distal tapering technique

In microsurgical arterial anastomoses, there are some occasions in which the diameter of the distal artery is much larger than that of the proximal one. A fish-mouth incision technique is useful when there is considerable size discrepancy. However, this method cannot be used when the distal artery is much larger than the proximal artery because turbulent flow and thrombus formation occur, due to the sudden increase of luminal diameter. The distal tapering technique is recommended to prevent turbulent flow. A wedge resection is performed in the distal surplus vessel wall, and there is no sudden change in luminal diameter. Two clinical cases are presented in which this technique was used effectively.