Comparison of nonabsorbable polymer ligating and standard titanium clips with and without a vascular cuff.
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.
Jellison
Forrest C
FC
Division of Urologic Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
Baldwin
D Duane
DD
Berger
Kenneth A
KA
Maynes
Lincoln J
LJ
Desai
Premal J
PJ
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
D011108:Polymers; D014025:Titanium