title: Primary Open Stenting to Simplify Distal Anastomosis on Heavily Calcified Artery: The POSE Technique.
abstract: Despite improvements in surgical techniques, performing distal anastomosis on a heavily calcified artery (HCA) remains technically challenging. Clamping lesions and arterial wall trauma while suturing can lead to immediate or delayed arterial dissection and thrombosis. These issues are generally overcome by performing an extensive search for supple arterial zones, using sutureless techniques with covered stent-grafts and/or stenting the anastomosis under fluoroscopic guidance after unclamping. We describe a technique intended to simplify open surgical procedures on HCA. It consists of primary open stenting followed by localized endarterectomy (namely, the primary open stenting followed by localized endarterectomy [POSE] technique) to secure a distal anastomosis on an HCA. So far, we have successfully used the POSE technique in 24 patients but the durability of the technique remains to be determined.
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France; Université Paris-Saclay, Université Versailles Saint-Quentin en Yvelines, CESP, INSERM-U1018, Equipe 5, Villejuif, France. Electronic address: rcoscas@gmail.com.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Coscas
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France; Université Paris-Saclay, Université Versailles Saint-Quentin en Yvelines, CESP, INSERM-U1018, Equipe 5, Villejuif, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Maitrias
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France; Université Paris-Saclay, Université Versailles Saint-Quentin en Yvelines, CESP, INSERM-U1018, Equipe 5, Villejuif, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Javerliat
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France; Université Paris-Saclay, Université Versailles Saint-Quentin en Yvelines, CESP, INSERM-U1018, Equipe 5, Villejuif, France.
authors.forename: Oleg
authors.initials: O
authors.lastname: Rouditch-Pergola
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France; Université Paris-Saclay, Université Versailles Saint-Quentin en Yvelines, CESP, INSERM-U1018, Equipe 5, Villejuif, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Goeau-Brissonniere
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France; Université Paris-Saclay, Université Versailles Saint-Quentin en Yvelines, CESP, INSERM-U1018, Equipe 5, Villejuif, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Coggia
mesh_terms: D000714:Anastomosis, Surgical; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D004691:Endarterectomy; D006801:Humans; D015607:Stents