Eur J Cardiothorac Surg. 2025 Jul 14:ezaf232. doi: 10.1093/ejcts/ezaf232. Online ahead of print.
ABSTRACT
OBJECTIVES: We evaluated intimal damage at the histological level resulting from various clamp techniques in human pulmonary artery specimens obtained after lobectomy.
METHODS: We prospectively analysed patients who underwent anatomical lung resection at two centres between April 2021 and March 2025. The double-loop technique (DLT), DeBakey vascular clamp (3rd and 4th notches), Fogarty vascular clamp (2nd notch), endovascular clips (gold and silver), and vessel loop technique (VLT) were evaluated. Pulmonary artery specimens with an external diameter ≥10 mm were included. We measured the burst pressure and evaluated the intimal damage in the human pulmonary artery by using the modified Zhang’s score (MZS; 0 – 5).
RESULTS: Thirty-six patients were enrolled, and 70 pulmonary artery samples were obtained. DeBakey 3rd exerted a significantly higher burst pressure than did DLT (P = 0.022). No significant difference was found between DLT and VLT (P = 0.453). A burst pressure ≥30 mmHg was achieved in all DLT cases. None of the samples clamped with DLT and VLT exhibited MZS 3 – 5. The rate of MZS ≥2 with DeBakey 3rd, Fogarty 2nd, gold and silver clips, and VLT was statistically comparable to that for DLT, whereas DeBakey 4th resulted in significantly higher MZS values than did DLT (P = 0.029).
CONCLUSIONS: The DLT is a feasible and safe for thoracoscopic clamping. Additionally, DLT, VLT, and gold clip are appropriate for clamping the peripheral pulmonary artery. For DeBakey vascular clamp, notch selection should be carefully tailored to the vessel diameter.
PMID:40658467 | DOI:10.1093/ejcts/ezaf232
