Figure 2.

illustrates the construction of a complex wide-neck bifurcation aneurysm. The purpose of this figure is to display schematically how we perform the aneurysm reconstruction represented in Figure 3. For the preparation of this complex model, we require the use of two arterial grafts and one venous graft (image 2a). The first arterial graft is used as a recipient of the second arterial graft and part of the venous graft. For its subsequent implementation, two oblique cuts are made at each end, as well as two lateral slits (fish mouth). In this same artery two lateral slits are made for the suturing of the second arterial graft. In the second arterial graft, two oblique cuts and two lateral slits are made to facilitate anastomosis to the first graft. However, at the proximal end of this second graft additional slits are made, the length of which determines the neck of the aneurysm and the location of the base on one or both branches. In other words, the shorter the upper groove in relation to the lower one, the lower the aneurysm will be in relation to this vessel. To carry out the anastomosis, the usual technique is followed, in which anchorage is made at the margins and a continuous suture is put under tension once all points have been correctly passed (images 2b and 2c).