A clampless and sutureless aorto-prosthetic end-to-side anastomotic device: an experimental study.
OBJECTIVE
A feasibility study.


METHODS
Eight pigs (all females; mean weight: 29 kg) underwent a conventional transperitoneal aortic approach with implantation of an aorto-prosthetic end-to-side anastomosis using a Clampless device and deployment of a 5-mm polytetrafluoroethylene (PTFE) graft. After proximal ligature, a conventional end-to-end anastomosis was then performed between the graft and the left iliac artery.


RESULTS
The first pig died during the procedure due to graft misplacement. The seven other procedures were successful with a mean operative and anastomosis time of 101 min (range: 81-115 min) and 3.35 min (range: 2.25-4.25 min), respectively; mean blood loss was 152 ml (range: 30-235 ml). Another pig with a patent graft died at day 4 as a result of a severe unrelated pneumonopathy. The angiogram performed during the procedure and before sacrifice, at 2 (n=2), 4 (n=2) and 6 weeks (n=2), showed no graft stenosis or thrombosis. Microscopic examination revealed a tissue covering the intraluminal stent, which evolved over time, with no visible endothelial proliferation or inflammation.


CONCLUSIONS
An aorto-prosthetic anastomosis can be performed safely and efficiently with our new clampless and sutureless device. The next step will be a laparoscopic Clampless implantation.
Alimi
Y S
YS
Service de chirurgie vasculaire, Centre hospitalo-universitaire Nord, Marseille, France. yves.alimi@ap-hm.fr
Saint Lebes
B
B
Garitey
V
V
Afrapoli
A
A
Boufi
M
M
Hartung
O
O
Garcia
S
S
Mouret
F
F
Berdah
S
S
D000714:Anastomosis, Surgical; D000818:Animals; D001011:Aorta / Q000473:pathology / Q000601:surgery*; D001027:Aortography; D016063:Blood Loss, Surgical; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D007083:Iliac Artery / Q000601:surgery; D008026:Ligation; D008422:Materials Testing; D023421:Models, Animal; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D015607:Stents; D013552:Swine; D013997:Time Factors
D011138:Polytetrafluoroethylene