Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Clips”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 721 records · Page 40Linked to original sources
PubMed1976

Concomitant prophylactic inferior vena caval clipping.

Fatal pulmonary embolism is a common complication of any major surgery, especially in high risk patients. Experimental work in animals showed definite impairment of myocardial function after inferior vena caval ligation, but no changes after clipping. During the last four years, we have used concomitant vena caval clipping as a prophylactic measure in major abdominal vascular procedures. No added mortality or morbidity has occurred because of clipping per se and no deaths were due to pulmonary embolism. We recommend concomitant prophylactic clipping as an adjunctive procedure for all laparotomy patients who are prone to pulmonary embolism.

Aged↗
PubMed2003

Clip-assisted endoscopic method for placement of a nasoenteric feeding tube into the distal duodenum.

Gastroenterologists are often frustrated in their efforts to deliver a feeding tube by endoscopic guidance into the small bowel because of retrograde migration during the withdrawal of the endoscope. We describe a clip assisted endoscopic method whereby a nasoenteric feeding tube can be reliably delivered into the distal duodenum. A nasoduodenal tube with a 3-0 silk suture sewn on its distal tip is inserted into the stomach. The suture on the feeding tube is grasped by a clip-fixing device. Then, the endoscope with feeding tube is advanced into the distal duodenum and the tube is fixed on a mucosal fold by clipping. We used this technique to successfully place nasoenteric tubes into the distal duodenum in 9 patients. There were no procedure-related complications, and no bleeding or perforation due to removal of the feeding tubes was observed. We conclude that this clip-assisted endoscopic method is a reliable modality for placing nasoenteric tubes.

Adult↗
PubMed2003

[Prostheto-prosthetic and aorto-prosthetic anastomosis using stents, threads, clips and staples. In vitro comparative study].

OBJECTIVE: --To evaluate mechanical strength of new potential systems of vascular prostheses anastomosis versus usual suture (4.0 yarn), --To advance objective quantified data in order to establish the specifications of a new quick and reliable mechanical anastomosis device for laparoscopic surgery. MATERIAL AND METHODS: Two experimental studies were conducted in order to quantify the mechanical resistance of anastomoses between two Dacron vascular prostheses and anastomoses between one Dacron vascular prosthesis and one cadaver abdominal aorta segment. Existing materials, which have generally used for other types of surgery, were applied for these studies (clips, staples, stents). These systems of anastomosis were compared to usual suture, used as reference. RESULTS: The mechanical strength of an anastomosis between two Dacron vascular prostheses performed with staples or the same number of stitches is of equivalent magnitude. Anastomoses made with clips or stent are ten to fifteen times weaker than those made with stitches. We did not succeed in performing an anastomosis with staples on cadaver aorta segments because aorta segments tear when staples are applied. In the experiments with a hand-sewn graft, the aorta always tor before the suture, without breakage of the suture. CONCLUSION: From these in vitro trials, we can advance that a continuous suture is probably far too resistant in relation to the aorta own resistance. As we do not know accurately the physiologic strength applied to a vascular prosthesis in vivo, one acceptance criterion from a safety point of view for a new anastomosis system must be that its strength will be equal to the well-proven continuous suture (greater than 150 N) or to the aorta breaking point (between 100 and 160 N). From that point of view, anastomoses performed with clips or a stent are not convenient, unless special clips or stents can be developed for this application. The mechanical strength is of staples sufficient but their design has to be adapted to this particular type of anastomosis.

Anastomosis, Surgical↗
PubMed2003

[A case of common bile duct stone developed due to a surgical clip as a nidus: an experience of successful management by endoscopy].

Surgical clips can migrate into the biliary tract and act as a nidus for stone formation. We report a case of common bile duct stone developed due to a surgical clip in a 48-year-old man. Endoscopic retrograde cholangiogram revealed a common bile duct stone a with metallic clip in it. He had laparoscopic cholecystectomy 10 years ago. The stone was removed endoscopically. The use of resorbable clips during laparoscopic cholecystectomy is recommended to avoid this type of complication.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed2003

A new clip device for the construction of vascular interrupted anastomoses in congenital cardiac surgery.

BACKGROUND: Many different mechanical vascular anastomotic devices have been developed recently, mostly rigid stenting mechanisms applicable only in coronary artery bypass grafting surgery. U-Clips, however, allow the precise construction of any vascular interrupted anastomosis, preserving pulsatility and perhaps growth potential. METHODS: We report the first use worldwide of U-Clips for congenital cardiac surgery in 10 pediatric patients (mean age, 2.3 +/- 1.7 years). The operations took place between July 2001 and July 2002 for coarctation repair (3 patients), Glenn shunt (5 patients), Blalock-Taussig shunt (1 patient), and arterial switch (1 patient). RESULTS: Device handling, primary hemostasis, and patency were excellent, and no device-related complications occurred. Because of the learning curve, aortic cross-clamp times were significantly longer for the repair of coarctation with U-Clips than with the running-suture technique (21.7 +/- 2.3 minutes versus 14.4 +/- 2 minutes; P = .012). Postoperative recoveries were uneventful in all patients except for a baby with pulmonary atresia with intact ventricular septum, who died after 62 days. After a mean follow-up period of 11.9 +/- 4.4 months, echocardiographic controls of all anastomoses showed nonturbulent flow without any restriction. CONCLUSION: The U-Clip device may be a useful adjunct in congenital cardiac surgery for facilitating the creation of interrupted vascular anastomoses. Further evaluation is warranted for determining the long-term benefits of these devices with respect to growth preservation and restenosis.

Anastomosis, Surgical↗
PubMed2003

U-clip anastomoses in coronary artery bypass grafting: initial clinical experience.

BACKGROUND: Recent studies suggest that the U-Clip interrupted coronary artery anastomosis is superior to continuous suture. However, clinical experience with this device is limited. AIM: To evaluate our initial clinical experience with the U-Clip technology. METHODS: Outcomes of 59 patients undergoing isolated coronary artery bypass grafting (CABG) using U-Clips (UCs) were compared to outcomes of 138 patients undergoing CABG using conventional sutures (Conv). RESULTS: The average number of distal anastomoses was similar in the groups (UC, 2.9; Conv, 3.2; P = .33). Also similar were the number of arterial grafts (1.6 versus 1.5, P = .4), percentage of sequential anastomoses (22% versus 12%, P = .058), and percentage performed off pump (27% versus 28%, P = .74). Cardiopulmonary bypass and aortic crossclamp times were longer in the UC group (98 +/- 27 versus 81 +/- 20 minutes, P = .001; 63 +/- 25 versus 54 +/- 24 minutes, P = .028). Rates of operative mortality (UC, 1.69%; Conv, 0.7%), postoperative myocardial infarction (0% each), stroke (0% each), renal failure (2% versus 1.4%), and blood transfusion (53% versus 58%) were not statistically different. Average follow-up in 36 (61%) of UC patients was 5 +/- 2 months (range, 1-7 months). One patient died from a non-cardiacrelated cause. At the time of follow-up 90% of patients were in angina class I-II. CONCLUSIONS: The U-Clip interrupted anastomosis technique is versatile and safe and is associated with excellent short-term outcomes.

Aged↗
PubMedDate not supplied

[A triple-stranded "clip" from the oligonucleotide 3'-(dA)10-pO(Ch2Ch2O)3p-(dT)10-pO(CH2CH2O)3-p-(dT)10(-5)].

The temperature dependence of the UV- and CD-spectra of the oligonucleotides 3'-d(A)10-L-(T)10-5' [anti(AT)], 3'-d(A)10-L-d(T)10-3' [par(AT)] and 3'-d(A)10-L-(dT)10-L-(dT)10-5' [tripl(ATT)] (L = -PO(CH2CH2O) 3p-) in the phosphate buffer at pH 7 under different concentrations of NaCL and in the presence or absence of 0.01 M MgCl2 was studied. All registered structural changes are the result of intramolecular processes if the concentrations of the oligonucleotides is low (about 2.2.10(-5) M). Par(AT) and anti(AT) exist in the only two forms, transforming into each other: under low temperatures they exist as hairpins with the parallel or antiparallel orientation of chains accordingly which transform into unfolded chains when the temperature increased. In contrast trip(ATT) exists in the three different forms depending on the temperature and ion conditions. They are: the three- stranded clip, the two-stranded hairpin with a single stranded "tail" and completely unfolded chain. For the first time this work presents thermodynamic parameters of the triplex formation from deoxyoligonucleotides depending on NaCl concentration. We have registered the CD spectra to one-, two-, and three-stranded forms. Ethidium bromide binding to three-stranded "clip" was investigated, and it was established that molecules of the dye may intercalate into the "clip" with formation of stable complexes (the constant of association 10(6) M-1). It is maximum three molecules of ethidium bromid which may bound to one molecule of the three-stranded clip. It has been shown that the suggested synthetic model (three oligonucleotide blocks combined by hydroxyalkyl chains) is the most convenient for physico-chemical investigations of triplexes today.

Base Sequence↗
PubMed2004

[Endoscopic control of hemorrhage in the upper part of the digestive tract using hemostatic clips].

One of the endoscopy methods to stop upper gastrointestinal tract (GIT) bleeding in the limelight these days is hemostasis using metal clips. This method is indicated especially in patients with bleeding from an eroded artery and in patients where other hemostatic methods proved to be unsuccessful. Goal of our work was to assess successfulness of hemostasis, percentage of early rebleedings, and lethality of patients managed with this method. At the same time we present indications and locations of bleedings in these patients. We have retrospectively evaluated a group of 75 patients indicated for urgent endoscopy for GIT bleeding in a period from August 2000 till the end of February 2002. An average age of these patients was 69.7 years. We haven't managed to stop bleeding in 2 cases. In 12 patients (15.1%) rebleeding appeared within two days following intervention. From all the patients with early rebleeding: 4 patients had an ulcer and an eroded artery in stomach (4 died from bleeding, one of them undergone a surgery), 4 patients had an ulcer in duodenal bulb with artery at base (3 undergone surgery, 1 died), three patients had esophageal bleeding, and one patient had bleeding from the suture in stomach wall (undergone surgery and died). In majority of cases (82.8%) patients were managed with a combined technique (clip + adrenaline injection). With regard to a location of lesions treated with clip application, following locations were treated: esophagus 9.5%, stomach 40.5%, pylori channel 2.7%, duodenal bulb 39.2%, gastroenteroanastomosis 4.1%, D2 4.1%. Bleeding in 76% of patients was from an ulcer and artery (Forrest Ia, IIa). Results confirmed high effectiveness of hemostatic clips in primary hemostasis of GIT bleeding--in our sample more than 95%. An early rebleeding appeared in 15% of patients. Results presented correspond with data presented in world literature.

Aged↗
PubMedDate not supplied

Effect of indomethacin on the microvessel reactivity of two-kidney, one-clip hypertensive rats.

Endothelial cells modulate vascular tone by releasing endothelium-derived relaxing and contracting factors. An imbalance of these factors in hypertension could contribute to increased peripheral vascular resistance. To investigate whether an endothelium-derived contracting factor is involved in the altered reactivity of microvessels of two-kidney, one-clip hypertensive rats, mesenteric arterioles either perfused in vitro or studied in vivo were used. In two-kidney, one-clip hypertensive rats, a potentiation to noradrenaline was observed in preparations tested either in vitro or in vivo. Indomethacin treatment did not correct the increased response to noradrenaline in microvessel preparations. Thus the involvement of an endothelium-derived contracting factor which is sensitive to indomethacin blockade, could be discarded. A decreased response to acetylcholine, an endothelium-dependent vasodilator, was observed in in vitro and in vivo preparations. The responses to sodium nitroprusside, an endothelium-independent vasodilator, were not altered in microvessel preparations of hypertensive rats. In two-kidney, one-clip hypertensive preparations, indomethacin normalized the endothelium-dependent relaxations. Relaxations to sodium nitroprusside were not altered by indomethacin. It is suggested that endothelium-dependent relaxations are impaired in two-kidney, one-clip hypertension because of a cyclooxygenase-dependent substance interfering with the release and/or action of endothelium-dependent relaxing factor.

Acetylcholine↗
PubMed1979

[Tubal sterilization with the tupla-clip per laparoscopiam (author's transl)].

This study refers about a newly developed plastic clip which has been used with good results for the past three years in tubal sterilization. By applying this method, heat or thermal injuries are avoided and a greater possibility of refertilization is indicated. This clinical evaluation consists of experimental data of 243 women who underwent sterilization in the local OB/GYN clinics at Fulda and at Bremerhaven. 59 women were sterilized during puerperium, and 184 were sterilized irrespective of pregnancy. As complications, 2 pregnancies were observed, further 3 hematomae within the broad ligament; 11 clips dropped into the free adbominal cavity while 5 clips broke during application. After the initial difficulties, the authors of this study recommend a sterilization with this tubal clip as an alternative to the usual methods of sterilization.

Adult↗
PubMed2004

[Remaining of a safety clip within the hub of the Surshield Surflow II i.v. catheter].

Terumo's Surshield Surflow II i.v. catheter automatically engages a stainless steel clip to shield its needle tip when the needle goes out from the catheter hub. However, in our experience the safety clip of Surshield Surflow II remains in the catheter hub in a high proportion of cases when the catheter hub is held with a pair of forceps. The hub wall is so thin that the force existed to hold the hub can be easily transmitted to the safety clip. Another factor is the loose attachment of the safety clip to the needle tip. To prevent needle stick injury, further improvement of safety i.v. catheters is necessary to lead their increased use.

Catheterization↗
PubMedDate not supplied

Efficacy of endoscopic clipping and long-term follow-up of bleeding Dieulafoy's lesions in the upper gastrointestinal tract.

BACKGROUND/AIMS: Dieulafoy's lesion is a rare cause of upper gastrointestinal hemorrhage. The aim of this prospective study was to assess the efficacy and safety of endoscopic clipping for upper gastrointestinal bleeding due to Dieulafoy's lesion. METHODOLOGY: From January 1998 to March 2001, 21 patients (9 women and 12 men; mean age 66 +/- 16 yrs) with bleeding Dieulafoy's lesion have been admitted. Endoscopic clipping was performed in all patients using a clipping device consisting of a clip applicator device and stainless steel hemoclips (Olympus, Japan). A follow-up endoscopy was performed within the following 24-48 hours to confirm the success of hemostasis. Hemostatic rate, rebleeding rate, amount of blood transfusion, and duration of hospital stay were analyzed. RESULTS: The initial hemoclip therapy was successful in 20 out of 21 (95.2%) patients. Two patients had recurrent bleeding. One patient in whom recurrent bleeding occurred died. The successful surgical treatment was done in one patient in whom initial hemoclip therapy was unsuccessful. Therefore, the overall hemostasis was observed in 19 out of 21 patients (90.5%). There were no complications related to endoscopic therapy. CONCLUSIONS: Endoscopic hemoclipping provided a very effective and safe modality for hemostasis in patients with bleeding Dieulafoy's lesions.

Adult↗
PubMed1987

[Absorbable synthetic clips and pulmonary excision. Our clinical experience].

Analysis of the first 50 clinical cases confirmed conclusions of experimental studies in large animals with respect to the use of absorbable synthetic clips formed of lactomer and polydioxanone. The advantages of clips when compared with ligatures include rapidity and simplicity of use and ease of insertion, even in regions difficult to approach surgically with the fingers. The advantages of clips of the absorbable synthetic type over conventional metallic material are: safety and reliability due to their locking system and the conservation of sufficient residual resistance, improved behavior in biologic media, radio-transparency and total inertia in magnetic fields compatible with postoperative radiation and modern medical imaging procedures (CT scan, IRM), and finally progressive resorption predictable by simple hydrolysis and then total disappearance after 6 to 7 months. With staplers of the TA and GIA type these clips make sutures and ligatures during lung resection surgery entirely automatic.

Absorption↗
PubMedDate not supplied

Ultrastructural changes in the rabbit epididymis following vasectomy and clip occlusion.

Adult male rabbits were subjected to vasectomy, tantalum clip occlusion and sham operations. Caput and cauda regions of epididymis were studied with electron microscope at intervals of 15 days and 15 months after operation. Vasectomized and clip occluded subjects revealed similar changes when compared with sham operated animals. The epithelium remained functionally active even after vasectomy and clip occlusion as indicated by the presence of all characteristic complements of cellular organelles. Increased number of vacuoles and electron dense bodies indicated enhanced absorptive and digestive mechanisms at 15 months of vasectomy and clip occlusion. Disposal of continuously producing spermatozoa following vas occlusion may take place by intraluminal disintegration of sperm and subsequent phagocytosis by epididymal epithelium as evidenced by presence of identifiable parts of spermatozoa and flocculent material in caput and cauda regions.

Animals↗
PubMed1985

Study of renovascular hypertension in rat. II. Effects of converting enzyme inhibitor (captopril) in the acute and chronic stages of two-kidney one-clip Goldblatt hypertension in rat.

Two-kidney, one-clip Goldblatt models were produced in Wistar rats by placing a stenotic clip around the left renal artery. The animals were classified into three groups according to the time when captopril was started. In group 1 rats captopril was begun on the day following the operation and was continued for 6 weeks. During this period hypertension did not develop. In group 2 in which captopril was started 4 weeks after placement of the renal arterial clip, the blood pressure remained high as late as 12 weeks despite of continued administration of the drug. However, in group 3, captopril which was started 12 weeks postoperatively was very effective in correcting high blood pressure. In the sham operated group the blood pressure was unchanged by captopril administration. These results suggest that the role of renin-angiotensin system seems to vary according to the stages of experimental hypertension and that at least in the acute and chronic stage of two-kidney one-clip Goldblatt hypertension angiotensin II may play a major role in initiation and maintenance of high blood pressure.

Acute Disease↗
PubMedDate not supplied

[Absorbable synthetic clips and pulmonary excision].

From the beginning of this decade, two new, 2nd generation, resorbable synthetic materials--polydioxanone and lactomer--have been able to be molded into clips which, in contrast to metallic clips, are fitted with an original locking system preventing any slipping, either transversal or longitudinal, on the vessels. An experimental study was conducted to confirm their great reliability and perfect safety on large vessels (up to 8-9 mm) of large laboratory animals--both pulmonary and systemic vessels. Positive results justified their application to pulmonary vessels in humans during surgery, the pulmonary vessel being at a much lower pressure than in the main circulatory system. These new clips possess the advantages of metallic clips and resorbable synthetic threads without their inconveniences: rapidity, simplicity and ease of application, radio-transparency and complete inertia in magnetic fields enabling radiotherapy and modern postoperative investigations (scanner, NMR...) to be carried out.

Absorption↗
PubMed1985

Allergic reaction to Hulka clips.

Hulka clip sterilization has become a popular method of tubal occlusion. A case is presented in which the gold covering the Hulka clip resulted in an allergic reaction, evidenced by sterile abscess formation and resulting in exploratory laparotomy for removal of the Hulka clips, sterile abscess, and resultant adhesions. To the authors' knowledge, no previous case has been presented of this type of gold allergy. It would appear that careful screening for gold allergy should be undertaken before tubal sterilization with Hulka clips.

Abscess↗
PubMed1979

A comparative study of performance characteristics of cerebral aneurysm clips.

The authors have developed a procedure to evaluate the performance of cerebral aneurysm clips as a function of intravascular pressure and aneurysm neck diameter. Numerous models of Mayfield, Scoville, Variangle, Heifetz and Yasargil clips were tested. The various clips demonstrated decreasing capabilities for secure occlusion of a vessel as vascular diameters and intravascular pressure increased. These findings are in record with predictions based upon La Place's Principle and indicate that the size of an aneurysm must be considered in the choice of an appropriate aneurysm clip.

Animals↗