ABSTRACT
For the sake of completeness, I included this illustration of a saphenous vein patch graft. I no longer use this technique, and have converted entirely to the Hemashield graft material.
The technique is simple whether the case is shunted or unshunted. An ellipticshaped patch graft is fashioned from high saphenous vein and oriented so that there will be no valves to impede the column of flow. An anchor bite is then placed in the ICA, and a long suture line is run along the medial aspect of the repair. The lateral aspect of the repair is closed with a two-armed suture line, just as in a primary carotid repair, facilitating evacuation of the intraluminal contents prior to final closure and likewise facilitating removal of the shunt if a shunt has been called for by monitoring parameters.
