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KMID : 0191120010160030303
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Journal of Korean Medical Science
2001 Volume.16 No. 3 p.303 ~ p.308
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Anastomosis of Vessels less than 2 mm with the Vascular Clip System Clip Applier
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Jae Won Lee
Suk Jung Choo/Jung Hun Oh/Inchul Lee/Young Mee Kwon/Yong Jik Lee/Sang Kwon Lee/Hyun Song/Meong Gun Song
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Abstract
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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.
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KEYWORD
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Sutures, Carotid Arteries, VCS Clip Applier, Anastomosis, Surgical, Vascular Staples
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