[Can minimal arterial aggressions using non-penetrating mechanical clip suture prevent myo-intimal hyperplasia? Preliminary results].
METHODS
Vascular anastomosis is still associated with a significant rate of early (stenosis, thrombosis) and delayed (intimal hyperplasia) complications. Even though suture closure remains the most widespread standard procedure, many mechanical systems have been developed mostly using non penetrating clips, aiming to make the suture easier, to reduce the operating time and to reduce the scarring process of the arterial wall. We investigated the usefulness of non penetrating titanium Vascular Closure Staple (VCS) developed for peripheral blood vessels anastomosis, in a study on 20 rabbits with the small VCS system.


METHODS
On 20 rabbits, 9 of the aortic sutures were done with VCS clips and 11 were done by standard closure.


RESULTS
We found a significant improvement in the operating time of the closure (9 +/- 2 minutes versus 14 +/- 4 minutes), early and delayed (10 weeks) patency and the respect of the aorta diameter (0.248 +/- 0.01 centimetres versus 0.246 +/- 0.039 centimetres) and loss of surface (40.3 +/- 5.59% versus 45.6 +/- 6.34%). The main improvement is the reduced intimal hyperplasia (0.128 +/- 0.05 millimetres versus 0.198 +/- 0.032 millimetres. P=0.012).


CONCLUSIONS
Arterial closure can be performed more rapidly with VCS clips than with suture closure, and with a marked reduced reaction of intimal hyperplasia. With those elements it is necessary to continue the experimental studies and to evaluate the VCS sutures at mean and long term.
Service de Chirurgie Vasculaire, Hôpital Saint-Philibert, Faculté libre de médecine, université catholique de Lille, 115, rue du Grand But, 59462 Lomme, France.
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Ducasse
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Basseau
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Puppinck
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Baquey
D000818:Animals; D001012:Aorta, Abdominal / Q000473:pathology / Q000601:surgery*; D001018:Aortic Diseases / Q000517:prevention & control*; D001157:Arterial Occlusive Diseases / Q000517:prevention & control*; D002921:Cicatrix / Q000517:prevention & control*; D005260:Female; D006965:Hyperplasia; D011183:Postoperative Complications / Q000517:prevention & control*; D011817:Rabbits; D013536:Suture Techniques; D013537:Sutures; D017539:Tunica Intima / Q000473:pathology* / Q000601:surgery; D017540:Tunica Media / Q000473:pathology* / Q000601:surgery