端側吻合における二つのパラシュート運針法

Two Methods of End-to-side Parachute Anastomosis

心臓血管外科では中小血管の端側吻合を行うことが多く，通常，連続吻合が選択される．運針法は外科医によって異なるが，ヒール側から開始してトー側を回るのが原則である．

There are two methods of end-to-side parachute anastomosis. For a quick end-to-side anastomosis, the graft and artery are placed in parallel proximity and 5 parachute stitches are performed. There are type A that moves the needle inside to outside the artery and type B that moves inside to outside the graft. Each has its advantages. In type A, complications such as dissection do not occur because the needle is always moved from the inside of the artery. Type B is faster because the first few parachute stitches are done by forehand. However, if arteriosclerosis is severe, there is a risk of dissection. Therefore, it is important to use both types appropriately.