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Aortic wall needle extraction: Difference between forceps and needle holder use.

Masato Furui1, Ryo Ozuru2, Mikiko Aoki3

  • 1Department of Cardiovascular Surgery, Fukuoka University Hospital, Fukuoka, Japan.

Asian Cardiovascular & Thoracic Annals
|February 27, 2026
PubMed
Summary
This summary is machine-generated.

Needle holders create smaller defects than forceps during aortic surgery, particularly in acute aortic dissection. This technique may reduce bleeding and prevent tears in fragile aortic walls.

Keywords:
Aortic aneurysmaortic dissectionaortic operationforcepssurgical instruments

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Area of Science:

  • Cardiovascular Surgery
  • Surgical Techniques
  • Aortic Diseases

Background:

  • Investigating differences in extracted surfaces between forceps and needle holder use for needle extraction.
  • Focusing on needle extraction manipulation for smaller needle-hole defects in aortic surgery.

Purpose of the Study:

  • To compare the size of needle-hole defects created by forceps versus needle holders.
  • To evaluate the efficacy of needle holders in minimizing tissue damage during aortic procedures.

Main Methods:

  • Prospective observational study of patients undergoing aortic surgery (December 2023 - January 2025).
  • Aortic wall samples collected from patients with acute type A aortic dissection (n=20) and thoracic aortic aneurysm (n=20).
  • Creation and measurement of 200 needle holes (100 forceps, 100 needle holder) to compare defect dimensions (long axis, short axis, area).

Main Results:

  • Needle holder group showed a significantly shorter long axis (0.48 ± 0.12 mm) compared to the forceps group (0.52 ± 0.18 mm; P=0.036).
  • The defect area was significantly smaller in the needle holder group (0.09 ± 0.03 mm²) versus the forceps group (0.11 ± 0.06 mm²; P=0.022).
  • A trend towards smaller defects with needle holders was observed in acute aortic dissection, but not in thoracic aortic aneurysms.

Conclusions:

  • Needle holders tend to create smaller defect areas than forceps, especially in acute aortic dissection.
  • Utilizing needle holders during anastomotic pullouts in fragile aortic walls may minimize bleeding and prevent distal anastomotic new entry tears.