Usefulness of a Vascular Clipping System to Create an Arteriovenous Fistula

Abstract

Purpose: The vascular clipping system (VCS) is beneficial as it is simple and easy to apply formicrovascular suturing. Arteriovenous fistula (AVF) creation is a very basic standard technique ofmicrovascular surgery. In this study the VCS and the conventional suture methods were compared ina rabbit model using the carotid artery and vein to create an AVF. Methods: There were 28 rabbits assigned equally into 2 groups using the AVF creation method(conventional suturing or the VCS procedure). Histopathology was performed on fixed samples. Theprocedure time of the 2 methods and changes in histopathology of tissue samples after surgery werecompared. Results: The VCS procedure showed a lower degree of fibrosis and hyperplasia histologicallycompared with the conventional suture method. The VCS was quicker to perform and no significantanastomosis stricture was observed. Conclusion: In a rabbit model of AVF, the VCS has benefits over the conventional suture method. The VCS provides comparable patency rates, produces fewer side effects such as fibrosis andhyperplasia, and takes less operation time than suturing. The VCS is expected to be useful for caseswhere renal patients need periodic hemodialysis and thus repetitive access to a vessel.