VASCULAR ANASTOMOSIS IN BLOOD ACCESS SURGERY FOR HEMODIALYSIS USING VASCULAR CLOSURE STAPLES

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  • 器械吻合器VCSクリップを用いたブラッドアクセス手術の経験

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Abstract

The titanium Vascular Closure Staple (VCS) clip application system which had been established for peripheral vascular anastomosis was used in blood access surgery for hemodialysis in our center. Subjects were ten patients undergone blood access operation between February and May of 1997. Operative procedures included arteriovenous fistula in two patients, artificial graft implantation in six patients, reconstruction of the radial artery in one patient, and closure of an artificial graft in one patient. In all patients the vascular anastomosis was completed by using VCS clips, when it took 12 minutes in an average for the artificial graft anastomosis and 8.5 minutes in an average for arteriovenous fistula. No bleeding from the anastomosed site occurred during surgery and after declamping. VCS clip is easy to deal with and shortens the time for anastomosis. On the other hand, VCS clip is expensive and a problem in the cost-performance is still unsolved. In the blood access surgery for hemodialysis, the use of this VCS clip appears beneficial especially for implantation and repair of artificial grafts.

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