First results of clampless distal anastomosis in peripheral vascular bypass with LeGoo, a thermoreversible polymer

Abstract

LeGoo gel can be used to stop blood flow in small-bore arteries in the lower limbs to allow anastomoses to be performed.

A Novel Reverse Thermosensitive Polymer to Achieve Temporary Atraumatic Vessel Occlusion in Infra-popliteal Bypasses

“…A similar adverse event has been reported previously as part of the learning curve of using this product. 12 Intraluminal flushing of cold saline into the polymer in order to dissolve the plug is of particular importance in calcified vessels, due to the poor thermoconductivity of porcelain arteries. In the rare case when the polymer does not provide adequate haemostasis for suturing, conversion to standard vascular surgical techniques with vessel control using loops or clamps can be easily performed.…”

“…10 The applicability of this technique in peripheral vascular surgery has been shown in initial reports. 11,12 However, the use of this polymer in distal bypasses for limbthreatening ischaemia has not been assessed yet.…”

Effects of induced pressure and clamping force by vascular clamps on the vascular endothelium of rat aorta

“…Surrounding tissues should be sufficiently retracted with sufficient exposure, and bleeding should be minimized. [10,11] The traumatic effects of surgical procedures and devices that provide bloodless intervention have been known for decades. [12] Most vascular injury studies have focused on vascular clamps because of the common use of such devices.…”

“…[11] Despite the advanced techniques, vascular clamps are still the most highly available devices to stop bleeding and provide good operation conditions. [10,11] Manship et al [13] demonstrated vascular endothelial and presumed medial injury in clamped vessels using all types of vascular clamps, and they claimed that vascular loops could protect the vascular endothelium better. Thereafter, Margovsky et al [2] described a measurement of an endothelial injury method by staining an endothelial surface area, and reported that vascular clamps lead to increased endothelial injury.…”

Intraoperative embolization with poloxamer 407 during surgical resection of a carotid body tumor

“…In peripheral vascular surgery, it has achieved a satisfactory bloodless field in 92% of anastomoses 4 and a mean occlusion time of 13.4 minutes. 5 We present this combined open surgical and endovascular technique that used poloxamer 407 as a temporary occlusion device during the surgical resection of a CBT.…”