title: Arterial clamping leads to stenosis at clamp sites after femoropopliteal bypass surgery.
abstract: BACKGROUND
  To date, the incidence and clinical relevance of arterial stenosis at clamp sites after femoropopliteal bypass surgery is unknown.
  
  
  METHODS
  Ninety-four patients underwent a femoropopliteal bypass in which the arterial inflow and outflow clamp sites were controlled by the Fogarty-Soft-Inlay clamp and marked with an hemoclip. The number of pre-existing atherosclerotic segments, clamp force, and clamp time were recorded and the occurrence of a stenosis at the clamp site was determined.
  
  
  RESULTS
  After a mean follow-up of 83 months, a significant stenosis was confirmed at 23 of the 178 clamp sites (12.9%; 95% confidence interval 8.4 to 18.8). The mean number of pre-existing atherosclerotic segments (P = .28) and the mean clamp force (P = .55) was similar between the groups with and without a stenosis. There was a significant difference regarding clamp time between the group with and without a stenosis (38 minutes and 26 minutes, P = .001).
  
  
  CONCLUSIONS
  Arterial clamping, even with the Fogarty-Soft-Inlay clamp, can lead to clamp stenosis and seems to be related to the duration of clamping, but not to pre-existent atherosclerotic burden.
authors.affiliation: Department of Vascular Surgery, Medical Spectrum Twente, Enschede, The Netherlands.
authors.forename: Bianca H R
authors.initials: BH
authors.lastname: Vriens
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: pol.chirurgie@gmail.com.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Pol
authors.affiliation: Department of Surgery, Medical Center Alkmaar, Alkmaar, The Netherlands.
authors.forename: Robin G
authors.initials: RG
authors.lastname: Hulsebos
authors.affiliation: Department of Venous Surgery, Helder Clinic, Enschede, The Netherlands.
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van Det
authors.affiliation: Department of Epidemiology, Medical Spectrum Twente, Enschede, The Netherlands; Department of Research Methodology, Measurement & Data Analysis, University of Twente, Enschede, The Netherlands.
authors.forename: Job
authors.initials: J
authors.lastname: van der Palen
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Clark J
authors.initials: CJ
authors.lastname: Zeebregts
authors.affiliation: Department of Vascular Surgery, Medical Spectrum Twente, Enschede, The Netherlands.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Geelkerken
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D050197:Atherosclerosis / Q000601:surgery; D001807:Blood Vessel Prosthesis; D003250:Constriction; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D011446:Prospective Studies; D013997:Time Factors
keywords: Artery wall damage; Atherosclerosis; Clamp force; Stenosis; Vascular clamping