Evaluation and Management of Peripheral
Vascular Injury
Part 2

Annotation for Point O

Narrowing of either anastomosis on the completion arteriogram mandates reheparinization as indicated, reapplication of proximal and distal vascular clamps or vessel loops, and cutting out the polypropylene sutures. Frayed tissue at the end of the vessel is then debrided, especially the adventitia. Should the end(s) of the artery appear to be in spasm, a Garrett coronary artery dilator or Bakes biliary dilator is used to gently dilate the end of the vessel.36 If a continuous suture technique was used on the first anastomosis, an interrupted suture technique is used on the redo.