Impact of nonpenetrating clips on intimal hyperplasia of vascular anastomoses.
Non-penetrating, arcuate-legged titanium clips create an interrupted, non-penetrated, yet compliant vascular anastomoses that is associated with significantly reduced anastomotic neointimal hyperplasia. Recent experimental and clinical studies provide evidence that the non-suture alternative changes the biology of vessel-to-vessel and graft-to-vessel connections that reduces the stimulus for hyperplasia at a number of critical points in the response to injury schema. The compliant, "blood-tight" characteristics of clipped vascular reconstructions are associated with no endothelial injury or intraluminal foreign body, minimal platelet aggregation and laminal flow. Clinical applications including vascular access, femoropopliteal bypass, and closure of carotid endarterectomies are remarkable for the absence of restenosis and preserved anastomotic patency.
Berman
S S
SS
Section of Biomedical Engineering, The University Of Arizona, Tucson, AZ, USA.
Kirsch
W M
WM
Zhu
Y H
YH
Anton
L
L
Chai
Y
Y
D000714:Anastomosis, Surgical / Q000295:instrumentation; D006801:Humans; D006965:Hyperplasia; D013537:Sutures; D017539:Tunica Intima / Q000473:pathology* / Q000648:ultrastructure; D014656:Vascular Surgical Procedures / Q000295:instrumentation*