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The parachute technique is a useful technique for arterial reconstruction, and can be applied to quite small vessels. Here we present a Hepatic Artery reconstruction seen in a living donor liver transplant case, where the technique is used to bring the posterior walls of the donor and recipient hepatic arteries together.
- A gentle degree of tension should be applied to both arterial ends - this prevents kinking of the anastomosis after occluding clamps are removed.
- Heparinized saline should be used to wet the sutures before 'parachuting' to reduce friction.
- Gentle lateral tension should applied in a direction perpendicular to the axis of the vessels; note that the amount of tension should be equal on both ends.
- Intermittent counter-tension should be applied in the direction of the axis of the vessels; this helps distribute tension evenly along the suture.
- The anterior wall would then be completed with the continuation of the running suture.