Angiographic, ultrasonographic, and macroscopic assessment of aortic growth after VCS clips, interrupted polypropylene, or running polyglycolic acid anastomosis

Heterotopic renal transplantation in piglets using vascular closure stapler metallic clips or conventional suturing techniques: comparison of vessel growth and macroscopical study

“…3. As in prior studies, no injury [8,13], irregularities, or abnormal surface changes [20][21][22] or thrombus or fibrin depositions [23][24][25] were seen in the arterial intima of clip-operated arteries. The only lesion observed was a pseudoaneurysm.…”

“…The artery or vein was then rotated 180°to allow us to complete the anastomosis by applying the VCS clips to the posterior aspect of the vessel. All surgical procedures were performed by the same surgeon, who has extensive experience in vascular microsurgery and vascular suturing and has previously published several works in this field [7][8][9][10][11][12][13][14][15].…”

“…These studies provide experimental confirmation that vascular closure stapler (VCS) clips avoid injury to the intima of the vessels and the appearance of hyperplasia, while enhancing vascular compliance and growth [7][8][9][10][11][12][13][14], probably because they do not penetrate into the vascular wall. Moreover, when compared with conventional suturing techniques, VCS clips are easier to use and decrease surgical time [7,9,12,15].…”

Pediatric Vascular Injury

“…However, a running-type anastomosis using permanent suture tended to inhibit vessel growth. 19 Anastomosis methods have not been directly compared in pediatric patients, and long-term follow-up is poor. It is therefore not possible to know with certainty the advantages and limitations of the various methods.…”

“…Thus, an interrupted suture technique using nondissolvable polypropylene suture should protect against narrowing and will be less thrombogenic. 3,19 When performing arterial anastomoses in growing vessels, one additional technique to protect against narrowing is to create a spatulation. This bevel-shaped connection between the vein graft and the native artery creates a functionally enlarged communication that allows for some vessel growth without stricturing.…”