Transverse versus longitudinal arteriotomy: an experimental study in dogs.

An arteriotomy is a commonly used surgical technique. Either a transverse or a longitudinal incision can be made, but no study has been done to determine if one technique results in more stenosis or flow disturbance than the other. Six-millimeter arteriotomies were made on the carotid and femoral arteries of six dogs. Transverse arteriotomies were made on the right, and longitudinal arteriotomies were made on the left. Four weeks later the vessels were reexplored. Duplex scanning was used to assess the amount of turbulence at each arteriotomy. Afterward, latex casts of the arteries were made to determine the percent stenosis caused by each arteriotomy. The mean percent stenosis associated with transverse arteriotomies was 10.5% (+/- 4.4%), versus 22.8% (+/- 9.4%) for the longitudinal arteriotomies, (p = 0.001, matched t test). No difference in the amount of turbulence associated with each technique was demonstrated. A longitudinal arteriotomy results in significantly greater stenosis than does a transverse arteriotomy. Unless there is a specific indication for a longitudinal arteriotomy, a transverse arteriotomy should be used.