UNSOLVED PROBLEMS OF VASCULAR ANASTOMOSES
The actual issue in vascular surgery in current days is the formation of thrombosis inside the shunts after reconstructive surgery. According to some reports, only slightly more than 50% of the performed revascularization interventions remain functionally significant after five years. In other cases, the reocurences of preceding symptoms are perceived. In order to study the mechanisms that unadvantageous impact the long-term outcome after surgical operations, exceptional attention should be given to such pathological processes in the sector of vascular anastomosis, as the formation of neointima, leading to a narrowing of the lumen, the formation of turbulent blood currents and oscillatory movements of the walls of the shunt. The most described are neointimal cell proliferation and turbulent blood flow in the distal anastomosis region, although until now no solutions to these processes have been down to the ground found. Oscillatory movement at the wall of the shunt, called flutter, is now at the forefront in assessing risks in the postoperative period and require special attention not only biophysically, but also from the clinical point of view.