Carotid Arteriotomy Closure Using a Vascular Clip System

Abstract

As a result of this small study, we determined that clip closure of carotid arteriotomies was feasible, but it remains questionable whether the increased speed of a sutureless closure is clinically important for this procedure. Concerns regarding the strength of clip closure of an endarterectomized vessel and the cost of clip closure compared with standard suture techniques suggest that there may be no clinically significant benefits of arterial clip closure over suture closure after carotid endarterectomy, and there is potentially some risk.

Venous anastomosis using a non‐penetrating vascular closure system in orthotopic liver transplantation

“…In a small‐sample pilot study, the speeds of the achievement of anastomosis with VCS clips and sutures were similar, but anastomotic rupture due to clip malfunction and thrombosis occurred in the non‐penetrating titanium clips group . In another clinical experience, two cases of hemostasis problems occurred when carotid arteriotomies were closed using vascular clips . Some surgeons have suggested that whether this technique should be applied depends on the thickness and characteristics of the artery .…”

“…In our experience, because the average age in the VCS group was 51 years, atherosclerosis was common and even serious in most cases. Furthermore, most of the reported hemorrhagic complications associated with VCS clips occurred in cases of arterial anastomosis . Therefore, because we considered it a technical risk, we were prudent to not apply the VCS clips in arterial anastomosis.…”

Comparison of Experimental Microvascular End-to-End Anastomosis via VCS®-Clips versus Conventional Suture Technique in an Animal Model

“…These include a higher rate of vascular stenoses and higher costs. According to Birth et al 9 and Findlay et al, 10 the titanium clips, when applied expertly, seize more tissue than a microsurgical suture. The result is ''piling'', which leads to luminal stenosis, especially with vessels of small diameter.…”

Four-year surveillance study of metal clip anastomoses in peripheral arterial reconstruction

“…Its use in various types of small and large vessels has been studied mainly experimentally in animals [2][3][4][5][6][7]. There are only a few studies in which VCS clips have been used in clinical practice: in creation of arteriovenous fistulae for hemodialysis [8], for coronary anastomosis [9], for carotid arteriotomy closure after endarterectomy [10], and in anastomosis of peripheral arterial reconstructions [11]. Because the reconstruction time with VCS clips is shorter than with sutures, Leppa¨niemi et al [12] have suggested that this device could serve as a viable alternative to standard suture reconstruction techniques in cases such as multiple vascular trauma when it is important to reduce warm ischemic time, and in situations where the crossclamping time should be kept to a minimum.…”