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To the Editor.—Most partial occlusion vascular clamps used for end-to-side infrarenal aortic anastomoses will not reliably control bleeding unless the base, or heel, of the clamp is directed cephalad. This clamp position requires the handle of the clamp to protrude from the upper end of the wound. An assistant must retract the superior end of the incision, and steady the handle of the clamp. Furthermore, the handle of the clamp interferes with the suturing at the cephalad end of the anastomosis.
We have found that the Ochsner partial occlusion aortic clamp (Codman Shurtleff Co, Randolph, Mass), which was designed for proximal aortocoronary anastomoses, is ideally suited for end-to-side aortofemoral grafting (Figure). The jaws are sufficiently heavy, so that no blood loss occurs even with the heel of the clamp directed caudad. The depth of the jaws is adequate to permit an oblique end-to-side anastomosis with even the largest aortic
CUTLER BS, CANTELMO NL. New Use for an Old Clamp. Arch Surg. 1980;115(9):1136-1137. doi:10.1001/archsurg.1980.01380090100027