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Injury of polyester grafts by vascular clamps
Publikationstyp
Journal Article
Date Issued
2002-04-04
Sprache
German
Author(s)
Riepe, Gunnar
Meincke, J.
Seemann, D.
Chakfé, Nabil
Gross-Fengels, Walter
Imig, Herbert
Journal
Volume
127
Issue
2
Start Page
89
End Page
94
Citation
Zentralblatt für Chirurgie 127 (2): 89-94 (2002)
Publisher DOI
Scopus ID
Publisher
Thieme
Protected vascular clamps are not new. Clamp associated damage of human arteries has already been published over 20 years ago. The necessity of protective clamps seems to have been forgotten. In our explant archive (230 explants) we have observed an accumulation of graft ruptures in the groin (13 of 25 ruptures). We presume a multifactorial process. Clamp damage could be part of it. The aim of this study is to prove the clamp induced damage of polyester vascular grafts and to examine whether protected clamps can reduce this. Method: Five unprotected (Aesculap® FB512R, FB502, FB517, Ulrich CC1235, CV3535) and 5 protected vascular clamp types (Aesculap® FB667, FB668, Edwards® - formally Baxter® - Fogarty® CV5050, CV5201, Edwards® Cosgrove® CV1033) were tested. A longitudinal burst test was performed after maximal clamp closure on 6 different, multifilament polyester yarns of 2 different vascular grafts manufacturers (B. Braun®, Edwards®). Results: The yarn tests with protected clamps showed no difference to those of the unclamped yarns. After clamping with unprotected vascular clamps the stress-strain-diagrams differed significantly. The mean, maximum burst strength was up to 75% lower. Video documentation revealed filament ruptures. Damage of the yarn surface was seen on a simple woven graft in scanning electron microscopy (SEM). Discussion: The application of unprotected vascular clamps on polyester vascular grafts is common in Germany (56%). The observed damage of multifilament polyester yarns makes it necessary to re-consider the use of unprotected vascular clamps. The benefit for biological vessels has already been shown.
Subjects
Clamps
Damage
Polyester
Vascular grafts
DDC Class
610: Medicine, Health