Impact of nonpenetrating clips on intimal hyperplasia of vascular anastomoses

Non-penetrating, arcuate-legged titanium clips create an interrupted, non-p enetrated, yet compliant vascular anastomoses that is associated with signi ficantly reduced anastomotic neointimal hyperplasia. Recent experimental an d clinical studies provide evidence that the nonsuture alternative changes the biology of vessel-to-vessel and graft-to-vessel connections that reduce s the stimulus for hyperplasia at a number of critical points in the respon se to injury schema. The compliant, "blood-tight" characteristics of clippe d vascular reconstructions are associated with no endothelial injury or int raluminal foreign body, minimal platelet aggregation and laminal flow. Clin ical applications including vascular access, femoropopliteal bypass, and cl osure of carotid endarterectomies are remarkable for the absence of resteno sis and preserved anastomotic patency. (C) 2001 The International Society f or Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights re served.