Temporary microvascular occluder.
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Biomedical subjects
Publications and source records attributed to N Wackenhut.
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The force that a vascular clip exerts when it is applied to a vessel is a critical factor in its safe and proper use. Permanent occlusion effected in the obliteration of aneurysms requires clip closure forces great enough to resist sliping, yet low enough not to damage the neck of the aneurysm. The authors consider the need for a device that can readily measure clip closing forces just prior to pre-surgical sterilization (immediately prior to implantation), and an instrument that meets that need is presented.
Principle factors involved in effective vascular occlusion were identified and incorporated into a computer program designed to calculate the minimal occlusion force (MOF) in accordance with a modified version of Laplace's law. In vivo, the carotid arteries of 14 guinea pigs were occluded for one hour at an experimentally determined MOF or MOF + 50. A good correlation was found between the computed MOF and the experimentally determined MOF. Scanning electron microscopic (SEM) examination of the endothelium of the occluded vessels revealed extensive damage with forces greater than the MOF.
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Selected commercially designated temporary clips (Acland, Biemer, Kleinert-Kutz, Variangle, and Yasargil) were applied for 1 hour to rat common carotid arteries. Scanning electron and light microscopic studies revealed varying degrees of endothelial damage. The authors believe that further improvements are needed in the design of temporary clips.