Study comparing sutures and nonpenetrating titanium clips for arteriotomy closure after embolectomy

Pikoulis, Emmanouil; Koronarchis, D.; Filis, K.; Leppäniemi, Ari; Papas, S.; Xiromeritis, N.; Papalambros, Efstathios; Bastounis, Elias

doi:10.1007/s00464-001-0003-9

Cited by 9 publications

(5 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A clinical series examining vascular access in hemodialysis revealed that the application of VCS clips is an easy to manipulate, safe, and time‐saving method compared with hand‐sutured anastomosis . Similar results have been reported for arteriotomy closure after embolectomy, peripheral arterial bypass procedures and graft replacements . Theoretically, the vascular intima is intact, and hyperplasia is absent after achieving anastomosis with non‐penetrating clips, as demonstrated in animal experiments .…”

Section: Introductionsupporting

confidence: 53%

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

Wang

Zhao

Pan

et al. 2017

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

Section: Introductionsupporting

confidence: 53%

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

Wang

Zhao

Pan

et al. 2017

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…Pikoulis, et al, 9 published a comparative study of vascular closure staple clips and interrupted nylon sutures in surgery of upper-or lower-extremity embolisms. 9 In their study, the time required for arteriotomy closure with these clips was considerably shorter than the time required for suturing, resulting also in shorter clamp times (closure with clip compared with suture: 11.2 Ϯ 2.7 seconds compared with 241.2 Ϯ 48.7 seconds; clamp times: 380.8 Ϯ 127.3 seconds compared with 612.7 Ϯ 112.6 seconds).…”

Section: Discussionmentioning

confidence: 99%

Direct repair of a blisterlike aneurysm on the internal carotid artery with vascular closure staple clips

Yanagisawa

Mizoi²,

Sugawara³

et al. 2004

Journal of Neurosurgery

View full text Add to dashboard Cite

Vascular closure staple clips made of titanium were originally developed for microvascular anastomosis. Clinical applications for these clips include arteriotomy closure for carotid endarterectomy, extracranial-intracranial bypass, and dural closure. This is the first report in which vascular closure staple clips have been used successfully for direct repair of a tear on the internal carotid artery (ICA). This report involves a 65-year-old man who presented with sudden onset of headache. Admission computerized tomography scans demonstrated a diffuse and thick subarachnoid hemorrhage in the basal cisterns. Cerebral angiograms demonstrated a broad-based, small bulge on the superomedial wall of the left ICA. Intraoperatively, an extremely thin-walled aneurysm was seen on the segment of the ICA at the C-2 vertebral level. The aneurysm ruptured abruptly, although no surgical manipulation was being performed on the aneurysm itself. After temporary clips were applied on the vessel, a large tear of the ICA was repaired with vascular closure staple clips. Reconstruction with the vascular closure staple clips required only a short period of temporary occlusion of the ICA. Postoperative angiograms revealed reduction of the aneurysm bulge and good patency of the ICA. The postoperative course was uneventful, and the patient has been free of symptoms. The vascular closure staple clipping procedure is useful for urgent repair of an aneurysm tear. This method is a new treatment option for these fragile aneurysms in cases in which other options, such as encircling clips or bypass procedures, may have drawbacks or be impossible.

show abstract

“…30 The nonpenetrating titanium clip system permits reapproximation of vascular edges without penetrating the vessel wall. [31][32][33][34] It has demonstrated efficacy for use in major vascular injuries in skull base surgery and has recently been approved for dural reconstruction for its potential in preventing postoperative CSF leaks. 6,35 Thus far, there is evidence that the clips can be used to repair leaks in the spinal dura, [36][37][38][39] as well as one case report that demonstrated the use of titanium clips in repairing a CSF leak at the skull base.…”

Section: Discussionmentioning

confidence: 99%

Failure Pressures of Dural Repairs in a Porcine Ex Vivo Model: Novel Use of Titanium Clips Versus Tissue Glue

Chorath

Krysinski

Bunegin

et al. 2019

Allergy�Rhinol (Providence)

View full text Add to dashboard Cite

ObjectiveEndoscopic skull base surgery is advancing, and it is important to have reliable methods to repair the resulting defect. The objective of this study was to determine the failure pressures of 2 commonly used methods to repair large dural defects: collagen matrix underlay with fibrin glue and collagen matrix underlay with polyethylene glue, as well as a novel repair method: fascia lata with nonpenetrating titanium vascular clips.MethodsThe failure pressure of the 3 dural repairs was determined in a closed testing apparatus. Defects in porcine dura were created and collagen matrix grafts were used as an underlay followed by either fibrin glue (FG/CMG) or polyethylene glycol glue (PEG/CMG). A third condition using a segment of fascia lata was positioned flush with the edges of the dural defect and secured with titanium clips (TC/FL). Saline was infused to simulate increasing intracranial pressure (ICP) applied to the undersurface of the grafts until the repairs failed.ResultsThe mean failure pressure of the PEG/CMG repair was 34.506 ± 14.822 cm H2O, FG/CMG was 12.413 ± 5.114 cm H2O, and TC/FL was 8.330 ± 3.483 cm H2O. There were statistically significant differences in mean failure pressures among the 3 repair methods.ConclusionIn this ex vivo model comparing skull base repairs’ ability to withstand cerebrospinal fluid leak, the repairs that utilized PEG/CMG tolerated the greatest amount of pressure and was the only repair that exceeded normal physiologic ICP’s. Repair methods utilizing glues generally tolerated higher pressures compared to the novel repair using clips alone.

show abstract

Study comparing sutures and nonpenetrating titanium clips for arteriotomy closure after embolectomy

Abstract: The VCS clip applier system, a quick and easy method for closing arteriotomies, is as safe as sutures in terms of narrowing of the artery and formation of pseudoaneurysm.

Cited by 9 publications

References 6 publications

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

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

Direct repair of a blisterlike aneurysm on the internal carotid artery with vascular closure staple clips

Failure Pressures of Dural Repairs in a Porcine Ex Vivo Model: Novel Use of Titanium Clips Versus Tissue Glue

Contact Info

Product

Resources

About