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  • We propose this technique (Figures 112-3 and 112-4) for cases where vessels have kinks/twists that compromise flow and do not resolve with other approaches such as placing a buttressing fat pad and/or repositioning the transplanted organ.

  • Our approach (developed by Michael B Silva Jr, MD) entails opening in a longitudinal fashion a ringed PTFE graft (or other type of graft that will retain its shape) and using it as an external stenting support placed around the kinked/twisted vessel.

  • Although in the diagrams we illustrate an external stenting of the iliac artery and of the transplant renal artery, this technique can be applied to any vessel individually.

  • When the stent encompasses the transplant renal artery anastomosis or a branching vessel, an opening in the PTFE graft should be made to account for such branching.

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