A new way to avoid excessive damage to blood vessels from haemostatic clips

Abstract

Objective: Haemostatic clips are helpful for the successful completion of vascular anastomosis in microsurgery but may cause damage to blood vessels, which remains a concern of scholars. Design: In the first phase, a total of 96 SD rats were randomly allocated into two groups: one treated with disposable haemostatic clips and another treated with metal haemostatic clips. Each group was further divided into four subgroups based on clamping force (30 g, 60 g, 90 g, and 120 g). Injury to the vascular intima was observed using scanning electron microscopy (SEM). The second phase involved measuring the minimum clamping force in the human body to validate the accuracy of the calculation formula. Results: Under SEM, at a clamping force of 30 g, only a portion of the fold was flattened, and minimal damage to the intimal surface of the blood vessel was observed. However, at a clamping force of 90 g and 120 g, the damage inflicted by the two haemostatic clips became more severe, resulting in extensive exfoliation or even complete disappearance of the vascular intima. The measurement results for the minimum clamping force in human subjects indicated no significant difference between the theoretical and actual values (P > 0.05), suggesting a certain reliability of the formula. Conclusions: The degree of injury caused during haemostasis is directly proportional to the clamping force applied by haemostatic clips used in clinical practice. Additionally, the material and surface characteristics of the clip can also impact vascular injury. Disposable haemostatic clips have an advantage over metal clips in terms of reducing vascular injury. The theoretical minimum clamping force calculation formula can be used as a reliable reference for selecting appropriate haemostatic clips.