Vascular Closure System Type of Nonpenetrating Arcuate-Legged Titanium Clips for Graft-Artery and Graft-Graft Anastomoses: Review of Our Clinical Experience

Abstract

Vascular Closure System clips were useful to coapt a prosthetic graft to an artery unless the arterial wall was thicker than 2 mm or calcified. Thus, VCS clips could be durable enough for graft-artery anastomoses in the iliac or popliteal region.

Venous anastomosis using a non‐penetrating vascular closure system in orthotopic liver transplantation

“…A clinical series examining vascular access in hemodialysis revealed that the application of VCS clips is an easy to manipulate, safe, and time‐saving method compared with hand‐sutured anastomosis . Similar results have been reported for arteriotomy closure after embolectomy, peripheral arterial bypass procedures and graft replacements . Theoretically, the vascular intima is intact, and hyperplasia is absent after achieving anastomosis with non‐penetrating clips, as demonstrated in animal experiments .…”

“…Although positive results were easy to obtain in experimental conditions, the benefit of the VCS was uncertain in patients with atherosclerosis . After performing 100 vascular anastomosis, Yoshinori proposed that if the arterial wall is heavily calcified and thicker than 2 mm, likely due to atherosclerosis, hand sewing with polypropylene should be regarded as the first choice . In our opinion, the complications associated with the VCS were reported in the early phase of its usage and likely occurred at the beginning of the learning curve.…”