Use of a Vascular Closure System for Bypass Grafting of Peripheral Arteries

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Abstract
Vascular anastomosis is generally done by the needle-and-suture technique. Recently, a vascular closure system (VCS) with nonpenetrating clips was developed. Its use for patients with arteriosclerosis obliterans has not been reported yet. Sixteen anastomoses in seven consecutive patients were done with VCS clips. All anastomoses were end-to-side with expanded polytetrafluoroethylene grafts. Use of the clips was abandoned intraoperatively at five anastomotic sites because the arterial walls were not pliable and because of thickness or calcification. These sites were anastomosed by the conventional needle-and-suture method. Anastomosis took a mean of 10 minutes. Anastomotic rupture, bleeding from the joined edge, and acute occlusion of the graft did not occur. The patency of all grafts was excellent 6 months after surgery. The system seemed to be useful and easy to handle.

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