Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (7)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Deb, S.
Right arrow Articles by Rhee, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Deb, S.
Right arrow Articles by Rhee, P.
(Chest. 2000;118:1762-1768.)
© 2000 American College of Chest Physicians

Comparison of Titanium Vascular Closure Staples With Suture Repair of the Thoracic Aorta in Swine*

Subrato Deb, MD; Barry Martin, MD; Leon Sun, MD; David Burris, MD; David Wherry, MD; Emmanuel Pikoulis, MD and Peter Rhee, MD, MPH

* From the Department of Surgery (Drs. Deb and Rhee), National Naval Medical Center, Bethesda, MD; Walter Reed Army Medical Center (Drs. Martin and Burris), Washington, DC; Uniformed Services University of the Health Sciences (Drs. Sun, Wherry, and Pikoulis), Bethesda, MD.

Correspondence to: Peter Rhee, MD, MPH, Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814; e-mail: prhee{at}usuhs.mil

Objective: Devices that reduce technical difficulty and anastigmatic time when repairing large vessels such as the thoracic aorta would be beneficial. The aim of this study was to determine if titanium vascular closure staples (3 mm) could be safely and quickly applied in the repair of large vessels such as the thoracic aorta.

Design: Through a left thoracotomy in 10 female swine (110 to 130 lb), an interposition graft (14 to 16 mm textile) was placed into the aorta distal to the left subclavian artery. Animals were randomized at the time of repair to either running sutures (n = 5; 6–0 polypropylene) or vascular closure staples (n = 5; 3 mm). The anastomosis was evaluated after 2 months with aortograms, and the aorta was harvested to evaluate healing.

Results: The clamp times (mean ± SD) were 30.8 ± 8.2 min for suture repair and 24.8 ± 5.1 min for vascular closure staple repair (p = 0.2). Anastomosis times were 20.0 ± 6.2 min for the suture group and 16.4 ± 6.4 min for the vascular closure staple group (p = 0.4). Arch aortograms at 2 months revealed no significant difference in luminal narrowing between the two groups. Gross and microscopic examination revealed no thrombosis, well-healed wounds with a continuous intimal layer, and no differences in intimal thickness or inflammation between the two groups.

Conclusion: Vascular closure staples were equivalent to sutures in terms of durability, graft patency, and wound healing at 2 months. Vascular closure staples may offer the trauma surgeon a quick and easy alternative when repairing large vessels such as the thoracic aorta.

Key Words: anastomosis • aorta • healing • graft • suture • swine • thorax • thrombosis • trauma • vascular closure staples






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2000 by the American College of Chest Physicians.