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Arterial repair with synthetic patch by using titanium clips
E Pikoulis1, P Rhee, T Nishibe
1Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA. pikoulis@hellasnet.gr
Background:
Vascular closure staple (VCS) clips made of titanium were originally developed for microvascular anastomoses. There is limited experience with their applicability to vascular reconstruction in larger vessels. This study compares VCS clips to standard sutures in arterial repair using a synthetic patch.
Methods:
In an experimental study with pigs, two sequential 10-mm abdominal aortotomies were allocated randomly to synthetic patch (polytetrafluoroethylene) repair with VCS clips or continuous 6-0 polypropylene sutures. Angiographic, macroscopic, and microscopic results were assessed after 2 months.
Results:
There were no significant differences in the patency rate, vessel diameter at the repair site, or healing indices. The mean (SD) clamp time was 8.7 (3.0) minutes for clip repair and 14.3 (7.4) minutes for suture repair (p = 0.04), and the times required for the vessel reconstruction were 5.3 (1.3) and 9.3 (3.0) minutes, respectively (p = 0.009).
Conclusion:
Patched arterial repair with VCS clips is faster than sutured reconstruction with comparable results after 2 months of follow up.