title: Comparison of nonabsorbable polymer ligating and standard titanium clips with and without a vascular cuff.
abstract: OBJECTIVE
  To compare the efficacy of nonabsorbable polymer ligating (NPL) and titanium clips applied with and without a 1-mm vascular cuff at physiologic and supraphysiologic pressures.
  
  
  METHODS
  An in vitro equine-vessel model was created to test clip occlusion strength. Ten-millimeter NPL and standard Ti clips were applied to veins (10 mm) and arteries (10, 6, and 5 mm) with and without a 1-mm cuff and tested until they held a pressure of 300 mm Hg (veins) or 760 mm Hg (arteries) for 2 minutes or leaked.
  
  
  RESULTS
  The NPL clip was statistically more secure on 10-mm veins with and without a cuff, 10-mm arteries with and without a cuff, and 6-mm arteries with a cuff than was the Ti clip. Leaving a 1-mm cuff resulted in a statistically higher leak point in all vessels tested except the 6-mm arteries secured with the Ti clip.
  
  
  CONCLUSIONS
  The NPL clip was more secure than the Ti clip on larger arteries and veins. A 1-mm vascular cuff enhances the security of both NPL and Ti clips in vessels of all sizes. The NPL clip is secure and reliable in securing both arteries and veins.
authors.affiliation: Division of Urologic Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
authors.forename: Forrest C
authors.initials: FC
authors.lastname: Jellison
authors.forename: D Duane
authors.initials: DD
authors.lastname: Baldwin
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Berger
authors.forename: Lincoln J
authors.initials: LJ
authors.lastname: Maynes
authors.forename: Premal J
authors.initials: PJ
authors.lastname: Desai
mesh_terms: D000818:Animals; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006736:Horses; D008026:Ligation / Q000295:instrumentation; D008422:Materials Testing; D023421:Models, Animal; D011108:Polymers; D013314:Stress, Mechanical; D014025:Titanium
chemical_list: D011108:Polymers; D014025:Titanium