A technique for adequate coverage of the proximal suture line during abdominal aortic aneurysm repair

Position of proximal anastomosis after abdominal aneurysm repair with aortobifemoral graft.

Mobile flap has been created in aneurysm sac on right side with electocautery. This is then rotated cephalad to cover proximal anastomosis (inset ). The apex of the aneurysm sac on left side is then approximated to the corner created on right side, after mobilizing the flap superiorly (solid arrow ).

Flap is closed over proximal repair, and aneurysm sac is closed over graft. This illustration shows final appearance of such closure over graft.