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this video demonstrates an end to side anastomosis using castro viejo needle drivers and a 6-0 proline suture first we want to prepare our grafts for our to side anastomosis in this case weve cut our graft at an angle and now the graftotomy on the other piece at a roughly similar length initially well start most in decide nastimo sees with stay sutures on the piece of the vessel where the grafts going to be sewn down onto this is done with a small simple suture on each side and using mosquitoes or hemostats to hold that suture apart so it can hold the blood vessel open well start at the heel of the donor vessel and go one suture off of the heel trying to keep the needle tip outside of the blood vessel so its easier to grasp were careful to avoid locking our suture docHubing around the suture line so that we dont get ourselves tangled and again trying to keep our needle tip outside of the blood vessel so its easier to grasp after placing the first three sutures to get us around th