A Clampless and Sutureless Aorto-Prosthetic End-to-Side Anastomotic Device: An Experimental Study

Abstract Objectives 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) gr...

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Bibliographic Details
Published in:European journal of vascular and endovascular surgery 2009-11, Vol.38 (5), p.597-602
Main Authors: Alimi, Y.S, Saint Lebes, B, Garitey, V, Afrapoli, A, Boufi, M, Hartung, O, Garcia, S, Mouret, F, Berdah, S
Format: Article
Language:English
Subjects:
Anastomosis
Anastomosis, Surgical
Animals
Aorta - pathology
Aorta - surgery
Aortic surgery
Aortography
Blood Loss, Surgical
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects
Blood Vessel Prosthesis Implantation - instrumentation
Feasibility Studies
Female
Iliac Artery - surgery
Ligation
Materials Testing
Models, Animal
Pigs
Polytetrafluoroethylene
Prosthesis Design
Stents
Study
Surgery
Swine
Time Factors
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Summary:Abstract Objectives 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. Conclusion 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.
ISSN:1078-5884
1532-2165
DOI:10.1016/j.ejvs.2009.07.003