Suture –line deter
Suture –line deterioration .
It is well be established that suture-line failure , leading to aneurysm and ultimate graft failure ,is due to stress occuring at the suture line .The hemotoma confined ,to some extent , by the surrounding tissue , will then seal the arterial leak and a cap-shaped depression will form because of the swirling action of the blood. Endothelialization of the inner surface of the sack from the hast artery will occure,this type of aneurysm commonly known as a false aneurysm or pseudoaneurysm is thus composed of an organized clot, surrounding fibrosis and an inner endothelial lining .(111) The probability of graft failure increases with time not only because of increased compliance mismatch but also possibly because of the weakening in both the suture material and the graft, as a result of reaction with body fluids aneurysm . The prosthetic –arterial anastomosis which generally indicates suture –line deterioration may result from may result from the fracture of the suture material . This was particularly happens in the early years of vascular surgery .(101) Another cause of an astomatic aneurysm may be graft failure close to the suture -line brought about by either yarn slippage or yarn breakage , to overcome this problem it has been suggested that suture should be placed well away from the edges of the prostheses .
A final cause of suture –line failure is the tearing of suture out of the host arterial wall ,this may be due to the progression of the disease or aseptic necrosis of the suture line resulting from devascularization of the host artery at the time of surgical dissection (111) It could be due to the exceptional rigidity and strength of the graft , the probability of failure would be markedly reduced if the suture were to be placed further from the edge of the graft clearly. (101)