Evolution of staples and clips for vascular anastomoses.

Because of the development of less invasive surgical techniques, there is an increasing demand for vascular anastomosing techniques that require less exposure of the operating field. This paper reviews the most important representatives of staples, clips, and other mechanical devices for vascular anastomosing described over the last five decades. This report is organized in three parts: (1) the history of clipping and stapling devices, (2) development of the Vessel Closure System (VCS) clips, and (3) current and potential status of mechanical vascular anastomotic devices.

Randomized clinical trial of continuous sutures or non-penetrating clips for radiocephalic arteriovenous fistula.

Background: Despite several modifications to the original design, patency rates of radiocephalic arteriovenous fistulas have changed little since the first report in 1966. The use of non-penetrating clips for vascular anastomosis on the outcome of such fistulas was studied.

Methods: Between January 2000 and August 2003, 107 primary radiocephalic fistulas were constructed in 98 patients.

Causes of limited survival of microencapsulated pancreatic islet grafts.

Successful transplantation of pancreatic tissue has been demonstrated to be an efficacious method of restoring glycemic control in type 1 diabetic patients. To establish graft acceptance patients require lifelong immunosuppression, which in turn is associated with severe deleterious side effects. Microencapsulation is a technique that enables the transplantation of pancreatic islets in the absence of immunosuppression by protecting the islet tissue through a mechanical barrier.

Five years' world experience with nonpenetrating clips for vascular anastomoses.

Background: A new sutureless technique has been introduced clinically to facilitate the process of vascular reconstruction and improve patency. The Vessel Closure System (VCS) is nonpenetrating, creates an elastomeric everted anastomosis, and is easily and reproducibly applied. The objective of this report is to review the published world experience that has accrued regarding these clips with attention to the assets, liabilities, and pitfalls associated with the new technology.

Treatment of short-necked infrarenal aortic aneurysms with fenestrated stent-grafts: short-term results.

Introduction: A proximal neck of 15 mm length is usually required to allow endovascular repair of abdominal aortic aneurysms (EVAR). Many patients have been refused EVAR due to a short neck. By customising fenestrated grafts to the patients' anatomy, we can offer an endovascular solution, especially for patients who are unsuitable for open repair.