Anastomosis of vessels less than 2 mm with the vascular clip system clip applier

Sutures may cause endothelial trauma and occlusion. The vascular clip syste m (VCS) dip applier may minimize endothelial injury. Fourteen carotid arter ies of nine adult rabbits were transected and re-anastomosed with either #7 -0 polypropylene (Group I, n=8) or VCS dips (Group II, n=6). The animals we re sacrificed at 1, 3, 8, 14, and 30 days postoperatively, The operation ti me and bleeding amount were checked for each anastomosis, Carotid angiogram s, photography, H&E staining and scanning electron microscopy (SEM) were pe rformed. Fibrin and thrombus, inflammatory cell infiltration, endothelial d isruption, luminal distortion, fibrosis, and wall thickening were compared. The luminal diameter was greater in group II. There were minimal differenc es in thrombosis, wall thickening and fibrosis between the two groups. Howe ver, fibrin, inflammatory cell infiltration, multinucleated giant cell form ation, endothelial disruption, and luminal distortion were greater in group I. On SEM, group I showed trans-mural penetration. In contrast. group II s howed suture margin eversion and no transmural penetration. Stenosis was gr eater in group I than in group II on carotid angiogram. The operation time was shorter in group II than in group I, i.e. 5+/-1.4 min vs. 11+/-3.8 min, respectively. The current data showed similar or superior results with VCS dips in comparison to conventional suturing with polypropylene.