Comparison of nonabsorbable polymer ligating and standard titanium clips with and without a vascular cuff

Purpose: To compare the efficacy of nonabsorbable polymer ligating (NPL) and titanium clips applied with and without a 1-mm vascular cuff at physiologic and supraphysiologic pressures. Materials and Methods: An in vitro equine-vessel model was created to test clip occlusion strength. Ten-millimeter NPL and standard Ti clips were applied to veins (10 mm) and arteries (10, 6, and 5 mm) with and without a 1-mm cuff and tested until they held a pressure of 300 mm Hg (veins) or 760 mm Hg (arteries) for 2 minutes or leaked. Results: The NPL clip was statistically more secure on 10-mm veins with and without a cuff, 10-mm arteries with and without a cuff, and 6-mm arteries with a cuff than was the Ti clip. Leaving a 1-mm cuff resulted in a statistically higher leak point in all vessels tested except the 6-mm arteries secured with the Ti clip. Conclusions: The NPL clip was more secure than the Ti clip on larger arteries and veins. A I-mm vascular cuff enhances the security of both NPL and Ti clips in vessels of all sizes. The NPL clip is secure and reliable in securing both arteries and veins.