Comparison of imaging changes in pulmonary artery diameter at the occlusion site using silk or metal clamps for pulmonary artery troubles
Yoshiki Chiba, Masahiro Miyajima, Yuki Takahashi, Yuma Shindo, Kodai Tsuruta, Ryunosuke Maki, Atsushi Watanabe- Cardiology and Cardiovascular Medicine
- Pulmonary and Respiratory Medicine
- General Medicine
- Surgery
Abstract
OBJECTIVES
We analysed our clinical experience using silk sutures (the double-loop technique) or DeBakey clamp for pulmonary artery troubles during anatomical lung resection to validate its practicality and safety.
METHODS
We retrospectively reviewed the records of patients who underwent either of the above clamping techniques during anatomical lung resection at our hospital between April 2007 and August 2022. We measured the pulmonary artery diameter at the occlusion site on computed tomography images acquired within 1 year pre-and post-operatively. The difference between pre-and post-operative diameters of the occlusion sites was calculated as the change in the pulmonary artery diameter. We zoned the occlusion site of the pulmonary artery to adjust for variation. Pulmonary artery deformation was evaluated as an adverse event caused by clamping.
RESULTS
Ultimately, 27 and 26 patients who underwent the double-loop technique and DeBakey clamp, respectively, were included. No additional injury due to the clamp procedure was found in either group. For zone R1/L1, defined as the main pulmonary artery, the median changes in the pulmonary artery diameter were 0.02 (–0.7 to 0.27) mm for the double-loop technique and 0.36 (–0.28 to 0.89) mm for the DeBakey clamp. No significant differences were observed between the two groups (P = 0.106). Furthermore, no aneurysms, dissections, or stenoses were found in either group.
CONCLUSIONS
The double-loop technique and DeBakey clamp had only minimal effects on the occlusion site of the pulmonary artery. The double-loop technique is a practical thoracoscopic technique for pulmonary artery bleeding when primary haemostasis has been achieved.