Can The Arterial Clamping Method Be Used Safely Where The Tourniquet Cannot Be Used?

Abstract

Background: Vascular clamp application is widely used in visceral organ surgery to ensure bleeding control. This raises the question: why not use clamping in tumor resection or revision surgery where not suitable for tourniquet. This experimental animal study aimed to compare the arterial clamp and tourniquet applications regarding their histologic effect and also inflammatory response at molecular level, on the artery, vein, nerve and muscle tissues.Methods: Twenty-one rabbits were divided into three groups (group I: proximal femoral artery clamp; group II: proximal thigh tourniquet, and group III: control group). In the clamp group, the common femoral artery was clamped with a microvascular clamp for 2 hours. In the tourniquet group, a 12-inch cuff was applied to the proximal thigh for 2 hours with 200 mmHg. The common femoral artery and vein, femoral nerve, rectus femoris, and tibialis anterior muscles were excised and analysed in all groups. Results: Artery and vein total injury scores were higher in the clamp and tourniquet groups relative to the control group (p≤0.001 and p=0.007, respectively). No statistical difference was found between the clamp and tourniquet groups in terms of arterial, vein, muscle and nerve injury.Conclusions: This experimental study can give an idea that arterial clamp application can be performed with the help of a vascular surgeon in hemorrhagic limb surgeries where not suitable for tourniquet application, resulting in close to tourniquet vessel injury rates but without tourniquet related complications.