Arterial and venous repair with vascular clips: Comparison with suture closure

Leppäniemi, Ari; Wherry, David C.; Pikoulis, Emmanouil; Hufnagel, Howard; Waasdorp, C.; Fishback, N.; Rich, Norman M.

doi:10.1016/s0741-5214(97)70142-3

Cited by 66 publications

(40 citation statements)

References 5 publications

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“…The speed with which the VCS clips can be applied is their main advantage over sutures. This advantage also has been pointed out in several vascular reconstruction procedures including arterial and venous anastomoses [2][3][4]. Use can be made of VCS clips in all vascular operations wherein time is of critical importance for a favorable outcome, as with organ transplantation [3] and management of multiple vascular injuries in trauma patients [6].…”

Section: Discussionmentioning

confidence: 99%

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Study comparing sutures and nonpenetrating titanium clips for arteriotomy closure after embolectomy

et al. 2001

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Section: Discussionmentioning

confidence: 99%

“…The use of VCS clips in microvascular anastomoses has been well described previously [1]. Recently published experimental studies [2,4] suggest their applicability also in larger vessels. The purpose of this study was to evaluate the use of VCS clips for arteriotomy closure after embolectomy.…”

mentioning

confidence: 99%

Study comparing sutures and nonpenetrating titanium clips for arteriotomy closure after embolectomy

et al. 2001

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“…However, reported benefits may offset the greater cost of these clips. In experimental studies, some authors have noted differences between nonpenetrating titanium clips and conventional sutures as regards the time taken to suture vascular walls, 1,2,7,12,19 and the mean vascular suturing time was significantly shorter when nonpenetrating titanium clips were applied, as compared with the time required to apply sutures. One study reported that nonpenetrating titanium clips saved up to 88% of the vascular suturing time compared with conventional sutures.…”

Section: Fig 8 Leakage Patterns Without Coverings Of Fibrin Glue Anmentioning

confidence: 99%

Utility of nonpenetrating titanium clips for dural closure during spinal surgery to prevent postoperative cerebrospinal fluid leakage

Itō¹,

Aoyama²,

Horiuchi³

et al. 2015

SPI

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OBJECT The nonpenetrating titanium clip has been successfully used in peripheral arterial bypass surgery. The purpose of this study was to evaluate the leakage pressures and patterns of nonpenetrating titanium clips using a simple model that mimicked spinal surgery. In addition, the authors describe their surgical experience with these clips and the follow-up results in 31 consecutive patients. METHODS The authors compared nonpenetrating titanium clips and expanded polytetrafluoroethylene (ePTFE) sutures in relation to the water pressure that could be tolerated by sutured ePTFE sheets, and the leakage pressure patterns were determined. The changes in leakage pressures at 5 minutes, 30 minutes, and 12 hours were examined when the clips and sutures were used in combination with the mesh-and-glue technique in an in vitro study. Thirty-one patients underwent spinal intradural procedures using nonpenetrating titanium clips to suture the dura maters using the meshand-glue technique, involving fibrin glue and polyglycolic acid-fibrin sheets. RESULTS A significant difference was apparent between the ePTFE suture group and the nonpenetrating titanium clip group, with the latter showing a leakage pressure that could be sustained and was 1508% higher than that of the former (p = 0.001). In relation to leakage patterns, the nonpenetrating titanium clips did not make any suture holes in the ePTFE sheet and fluid leakage occurred between the clips, whereas fluid leakage was associated with the pressure elevation that occurred at the suture holes made by the ePTFE sutures. Of the 31 patients who underwent spinal intradural procedures using nonpenetrating titanium clips, 1 (3.2%) experienced cerebrospinal fluid (CSF) leakage postoperatively. No other complications—for example, allergic reactions, adhesions, or infections—were encountered. CONCLUSIONS The interrupted placement of nonpenetrating titanium clips enables dural closure without creating any holes. These clips facilitate improvements in the initial leakage pressure and reduce postoperative CSF leakage following spinal surgery. The authors conclude that it is very beneficial to suture the spinal dura mater using nonpenetrating titanium clips given the anatomical characteristics of the spinal dura mater and the fact that the clips do not create suture holes.

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“…8 Clinical use of the VCS clip applier system  during the creation of an arteriovenous Brescia-Cimino fistula. Inlay shows four different sizes of the clip applier, everting forceps and a clip remover clips compared with sutures are a reduced anastomotic time 42,43 and a higher patency rate, probably related to an improved anastomotic healing pattern 5,6,43 -45 .…”

Section: Staples and Clipsmentioning

confidence: 99%

Non-suture methods of vascular anastomosis

Zeebregts¹,

Dungen³

et al. 2003

British Journal of Surgery

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The non-suture techniques can be categorized into five groups based on the materials used: rings, clips, adhesives, stents and laser welding. With all these techniques a faster and less traumatic anastomosis can be made compared with sutures. However, each device is associated with technique-related complications. As a consequence, suturing continues to be the standard approach. The disadvantages of the non-suture techniques include: rigidity and a non-compliant anastomosis with rings; toxicity, leakage and aneurysm formation with adhesives; early occlusion with stents; cost, reduced strength in larger-sized vessels and demand for surgical skills with laser welding. Further refinement is needed before widespread adoption of these techniques can occur. Clips, however, may be particularly promising but long-term evaluation is required.

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Arterial and venous repair with vascular clips: Comparison with suture closure

Cited by 66 publications

References 5 publications

Study comparing sutures and nonpenetrating titanium clips for arteriotomy closure after embolectomy

Study comparing sutures and nonpenetrating titanium clips for arteriotomy closure after embolectomy

Utility of nonpenetrating titanium clips for dural closure during spinal surgery to prevent postoperative cerebrospinal fluid leakage

Non-suture methods of vascular anastomosis

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