An alternative system for cerebrovascular reconstructions: non-penetratingarcuate-legged clips

Non-penetrating, arcuate-legged titanium clips (VCS(R)) have been utilized successfully over the past five years for a variety of cerebrovascular reco nstructions. These applications, including both micro and macrovascular rec onstructions, their clinical outcomes and technical considerations are desc ribed. Applications include patch angioplasty of cervical carotid endartere ctomies, superficial temporal to middle cerebral artery 'bypass' procedures , Takayasu's arteritis and cavernous carotid reconstructions. The non-penet rating clip has proven to be a safe and reliable alternative to suture for these demanding reconstructions. Clips provide the advantages of improved a nastomotic compliance, reduced operative time, and reduced incidence of pos t-operative anastomotic intimal hyperplasia and stenosis. Clip related pitf alls are discussed with recommendations regarding usage. (c) 2001 The Inter national Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.