The Hilar Snare, an Improved Technique for Securing Rapid Vascular Control of the Pulmonary Hilum

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Abstract
Massive hemorrhage from pulmonary injuries is often refractory to hilar crossclamping. We report a simple technique, the hilar snare, to control such injuries and compared it to the standard technique of hilar occlusion with a vascular clamp. Standardized lacerations were made in the lung in each of six adult dogs. Blood loss from the injured lung was measured before and after placement of the hilar snare and compared to that following hilar occlusion with a Satinsky clamp (occlusive surface, 5.5 cm). The rate of blood loss before control was not significantly different between the two groups. Blood loss from the lacerated lung was significnatly less (p < 0.05) in the Hilar Snare group (9 .+-. 4 ml/min) when compared to the Satinsky groiup (46 .+-. 14 ml/min). The snare''s flexible nature ensures complete occlusion of the hilar vessels and is a useful adjunctive technique to present methods of controlling severe pulmonary hemorrhage.

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