ABSTRACT
T he vision of vascular surgery became clearer in 1902, when Alexis Carrel described his triangulation technique for suturing blood vessels together.1 He experimented with vessels o f many sizes and thickness. Suturing was able to accommodate these discrep ancies, and the technique allowed for patent, reproducible anastomoses. Originally, sutures were thick and braided. Relatively inert, monofilament, fine suture was developed. This effec tively eliminated intravascular thrombus formation. Anastomoses of very small vessels with high patency rates became possible. Further advancements have been made with the develop ment of surgical loupes and operative microscopes for magnification, topical hemostatic agents, including glues and fibrin products, artificial conduits and repair patches, endovascular stents for intra-luminal approaches to revascularization, and the ability to provide surgical control of the results, using doppler ultrasound, thermal and contrast angiography. Surgeons now per form a wide variety of advanced surgical procedures, such as experimental and clinical trans plantation of organs, digit and extremity re-attachments, free flap composite tissue reconstruc tion, and direct coronary artery revascularization. In the last one hundred years, surgical subspecialties have evolved different techniques for creating vascular anastomoses. However, the common thread to all of these procedures remains a “thread”.
