1. Complications of Vascular Anastomosis
Badr Aljabri MD, FRCSC
Associate Professor and Consultant Vascular Surgeon, KKUH

2. Anastomotic bleeding Needle hole bleeding.
- more common with PTFE grafts.
- Rx: Local haemostatic agents.
Reverse systemic heparin effect.

3. Anastomotic bleeding Suture line bleeding.
- Rx: Simple or U-shaped suture at the defect.
tying should be with non-Pulsetile flow.

4. Anastomotic Psudoaneurysm
Disruption of the suture line at the anastomosis result in walled off extra- luminal circulation of the blood.

5. Material Factors Technical Factors Native Artery Disease. Infection.
Patient Factors
Native Artery Disease.
Infection.
Smoking
Hypertension.
Healing complications
( Seroma, Hematoma)
Material Factors
Graft Defect
Suture Degradation or breakage.
Prosthetic graft- arterial wall compliance mismatch
Technical Factors
Inadequate suture bites.
Excessive tension.
Joint Motion.
Redo Procedure.
Endarterectomy.

10. Anastomotic stenosis Early : Technical.
1-18 months: Intimal hyperplasia.
> 18 months: Progression of atherosclerosis.

14. Graft thrombosis Early Intermediate Late
Technical (kink, missed valve, AV fistula, intimal flap)
Poor choice of inflow or outflow sites.
Insufficient runoff.
Ongoing or progression of soft tissue infection
Low circulatory volume.
Hypercoagulable state.
Intermediate
Intimal Hyperplasia
(1 month -18 months)
Late
Progression of Atherosclerosis.
Degenerative lesions in the graft

15. Thrombectomy

16. Thank you