title: The utility of the VCS clip for creation of vascular access for hemodialysis: long-term results and intraoperative benefits.
abstract: The purpose of this study was to compare the effectiveness of the VCS vascular clip approximating system for the creation of hemodialysis access fistulas. 173 new vascular accesses were created, 92 prosthetic grafts and 81 autologous fistulas over a 40-month period. 50 sutured and 42 clipped fistulas comprised the prosthetic graft series, and 33 sutured and 48 clipped cases the autologous series. Risk factors associated with access patency were correlated and the primary patencies compared in the suture versus clipped group. A significant improvement in primary patency was noted for the clipped prosthetic group at all time points studied, with a positive trend also noted for clipped autologous fistulae.
  
  
  CONCLUSIONS
  The vascular clipping system (the VCS system) provides both long-term and immediate advantages for vascular access construction. Clips have been used successfully to treat seven consecutive patients with upper extremity arterial steal syndrome without the technical difficulties associated with traditional methods of repair.
authors.affiliation: Department of Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL 33136, USA.
authors.forename: A F
authors.initials: AF
authors.lastname: Schild
authors.forename: C S
authors.initials: CS
authors.lastname: Pruett
authors.forename: M I
authors.initials: MI
authors.lastname: Newman
authors.forename: J
authors.initials: J
authors.lastname: Raines
authors.forename: F
authors.initials: F
authors.lastname: Petersen
authors.forename: T
authors.initials: T
authors.lastname: Konkin
authors.forename: P
authors.initials: P
authors.lastname: Kim
authors.forename: C
authors.initials: C
authors.lastname: Dickson
authors.forename: W M
authors.initials: WM
authors.lastname: Kirsch
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000295:instrumentation*; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*; D014656:Vascular Surgical Procedures / Q000295:instrumentation