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A comparison of para-anastomotic compliance profiles after vascular anastomosis: Nonpenetrating clips versus standard sutures  Mohamed S. Baguneid, FRCSa,

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Presentation on theme: "A comparison of para-anastomotic compliance profiles after vascular anastomosis: Nonpenetrating clips versus standard sutures  Mohamed S. Baguneid, FRCSa,"— Presentation transcript:

1 A comparison of para-anastomotic compliance profiles after vascular anastomosis: Nonpenetrating clips versus standard sutures  Mohamed S. Baguneid, FRCSa, Sean Goldner, MScb, Paul E. Fulford, FRCSa, George Hamilton, FRCSb, Michael G. Walker, ChM,FRCSa, Alexander M. Seifalian, PhDb  Journal of Vascular Surgery  Volume 33, Issue 4, Pages (April 2001) DOI: /mva Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

2 Fig. 1 Medium-sized arcuate-legged clips within its applicator (A) and specially designed everting forceps (B). Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

3 Fig. 2 CCA was imaged with specially adapted duplex color Doppler ultrasound system. Vessel wall movement was followed by tracking assigned points of induced radiofrequency signal deemed to be representative of anterior and posterior arterial walls. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

4 Fig. 3 Changes in arterial diameter (bottom ) and luminal pressure (top ) were recorded simultaneously. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

5 Fig. 4 Typical compliance profile around anastomosis demonstrating proximal and distal PHZs. Cref represents compliance of the vessel 20 mm from anastomosis (Ca). Cpeak represents maximum compliance recorded, and the difference between Cpeak and Cref and Ca and Cref is represented as Crise and Closs, respectively. Superscripts P and D denote proximal or distal sites. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

6 Fig. 5 Comparison of para-anastomotic compliance profiles among anastomoses constructed with clips (CL, top ), interrupted sutures (IS, middle ), and continuous suture (CS, bottom ). Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

7 Fig. 6 View of luminal surface of explanted clipped (A) and interrupted-sutured (B) anastomoses. No intimal penetration was observed when clips were used. However, fibrin and thrombus were seen around sutures. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

8 Fig. 7 Environmental scanning electron micrographs (original magnification, ×100) of luminal surface of explanted clipped (A) and sutured (B) anastomoses. Good intimal apposition was noted with clips, whereas intimal damage and fibrin were seen around exposed sutures. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

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