Anastomosis of Vessels less than 2 mm with the Vascular Clip System Clip Applier.
10.3346/jkms.2001.16.3.303
- Author:
Jae Won LEE
1
;
Suk Jung CHOO
;
Jung Hun OH
;
In Chul LEE
;
Young Mee KWON
;
Yong Jik LEE
;
Sang Kwon LEE
;
Hyun SONG
;
Meong Gun SONG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, Seoul, Korea. sjchoo@www.amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Sutures;
Carotid Arteries;
VCS Clip Applier;
Anastomosis, Surgical;
Vascular Staples
- MeSH:
Angiography;
Animal;
Arteriovenous Shunt, Surgical/*instrumentation/methods;
Carotid Arteries/pathology/*surgery/ultrastructure;
Microscopy, Electron, Scanning;
Rabbits;
Surgical Stapling/*instrumentation/methods
- From:Journal of Korean Medical Science
2001;16(3):303-308
- CountryRepublic of Korea
- Language:English
-
Abstract:
Sutures may cause endothelial trauma and occlusion. The vascular clip system (VCS) clip applier may minimize endothelial injury. Fourteen carotid arteries of nine adult rabbits were transected and re-anastomosed with either #7-0 polypropylene (Group I, n=8) or VCS clips (Group II, n=6). The animals were sacrificed at 1, 3, 8, 14, and 30 days postoperatively. The operation time and bleeding amount were checked for each anastomosis. Carotid angiograms, photography, H&E staining and scanning electron microscopy (SEM) were performed. Fibrin and thrombus, inflammatory cell infiltration, endothelial disruption, luminal distortion, fibrosis, and wall thickening were compared. The luminal diameter was greater in group II. There were minimal differences in thrombosis, wall thickening and fibrosis between the two groups. However, fibrin, inflammatory cell infiltration, multinucleated giant cell formation, endothelial disruption, and luminal distortion were greater in group I. On SEM, group I showed trans-mural penetration. In contrast, group II showed suture margin eversion and no transmural penetration. Stenosis was greater in group I than in group II on carotid angiogram. The operation time was shorter in group II than in group I, i.e. 5+/-1.4 min vs. 11+/-3.8 min, respectively. The current data showed similar or superior results with VCS clips in comparison to conventional suturing with polypropylene.
