Angiographic, ultrasonographic, and macroscopic assessment of aortic growth after VCS clips, interrupted polypropylene, or running polyglycolic acid anastomosis

Background/PurposeLack of growth after surgery is still an unsolved issue in growing vessels. Aortic surgery is an integral part of vascular pediatric surgery. As an alternative to address this lack of growth in this scenario, we propose the use of titanium clips for vascular anastomosis.MethodsThirty-two domestic swine were used in this study. Animals entered the study when they were 55 days old and were subjected to an end-to-end aortic anastomosis using vasular closure stapler (VCS) clips, interrupted polypropylene, or running polyglycolic acid suture. Control group animals were sham-operated. Pigs were allowed to grow for 6 months, during which time they were subjected to serial ultrasonographic and angiographic studies to assess vascular growth.ResultsVCS clip anastomosis outcome was comparable with polypropylene or polyglycolic acid suture anastomosis. No significant differences in either longitudinal or transversal vascular growth were seen between the 3 studied suturing techniques and the control group.ConclusionsOur vascular growth and patency results suggest that VCS clips may provide a suitable alternative to conventional suture in pediatric aortic vascular surgery.