{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:46:07Z","timestamp":1754163967140,"version":"3.41.2"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We evaluated intimal damage at the histological level resulting from various clamp techniques in human pulmonary artery (PA) specimens obtained after lobectomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We prospectively analysed patients who underwent anatomical lung resection at 2 centres between April 2021 and March 2025. The double-loop technique (DLT), DeBakey vascular clamp (third and fourth notches), Fogarty vascular clamp (second notch), endovascular clips (gold and silver), and vessel loop technique (VLT) were evaluated. PA specimens with an external diameter \u226510 mm were included. We measured the burst pressure and evaluated the intimal damage in the human PA by using the modified Zhang\u2019s score (MZS; 0-5).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Thirty-six patients were enrolled, and 70 PA samples were obtained. DeBakey vascular clamp at the third notch (DeBakey 3rd) exerted a significantly higher burst pressure than did DLT (P\u2009=\u20090.022). No significant difference was found between DLT and VLT (P\u2009=\u20090.453). A burst pressure \u226530 mmHg was achieved in all DLT cases. None of the samples clamped with DLT and VLT exhibited MZS 3-5. The rate of MZS \u22652 with DeBakey 3rd, Fogarty vascular clamp at the second notch (Fogarty 2nd), gold and silver clips, and VLT was statistically comparable to that for DLT, whereas DeBakey vascular clamp at the fourth notch (DeBakey 4th) resulted in significantly higher MZS values than did DLT (P\u2009=\u20090.029).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The DLT is a feasible and safe for thoracoscopic clamping. Additionally, DLT, VLT, and gold clip are appropriate for clamping the peripheral PA. For DeBakey vascular clamp, notch selection should be carefully tailored to the vessel diameter.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf232","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T15:47:21Z","timestamp":1752508041000},"source":"Crossref","is-referenced-by-count":0,"title":["Histological Evaluation of Human Pulmonary Artery Intimal Damage Caused by Various Clamp Techniques"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0163-2598","authenticated-orcid":false,"given":"Yoshiki","family":"Chiba","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Sapporo Medical University School of Medicine and Hospital , Sapporo, 060-8543,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Miyajima","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sapporo Medical University School of Medicine and Hospital , Sapporo, 060-8543,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sapporo Medical University School of Medicine and Hospital , Sapporo, 060-8543,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kodai","family":"Tsuruta","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sapporo Medical University School of Medicine and Hospital , Sapporo, 060-8543,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryunosuke","family":"Maki","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sapporo Medical University School of Medicine and Hospital , Sapporo, 060-8543,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirofumi","family":"Adachi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, National Hospital Organization, Hokkaido Cancer Center , Sapporo, 003-0804,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sapporo Medical University School of Medicine and Hospital , Sapporo, 060-8543,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"2025073113214988300_ezaf232-B1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.ejcts.2006.10.017","article-title":"How to clamp the main pulmonary artery during video-assisted thoracoscopic surgery lobectomy","volume":"31","author":"Watanabe","year":"2007","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025073113214988300_ezaf232-B2","doi-asserted-by":"crossref","first-page":"S1620","DOI":"10.21037\/jtd.2018.05.50","article-title":"Management of complications in thoracoscopic surgery","volume":"10","author":"Kohno","year":"2018","journal-title":"J Thorac Dis"},{"key":"2025073113214988300_ezaf232-B3","doi-asserted-by":"crossref","first-page":"E317","DOI":"10.21037\/jtd.2016.03.56","article-title":"Precontrol of the pulmonary artery during thoracoscopic left upper lobectomy and systemic lymph node dissection","volume":"8","author":"Ma","year":"2016","journal-title":"J Thorac Dis"},{"key":"2025073113214988300_ezaf232-B4","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/j.juro.2008.06.018","article-title":"Laboratory evaluation of laparoscopic vascular clamps using a load-cell device\u2014are all clamps the same?","volume":"180","author":"Lee","year":"2008","journal-title":"J Urol"},{"key":"2025073113214988300_ezaf232-B5","first-page":"ivad119","article-title":"Experimental and histological evaluation of different clamp technique for pulmonary artery","volume":"37","author":"Chiba","year":"2023","journal-title":"Interdiscip Cardiovasc Thorac Surg"},{"key":"2025073113214988300_ezaf232-B6","doi-asserted-by":"crossref","first-page":"ezae034","DOI":"10.1093\/ejcts\/ezae034","article-title":"Comparison of imaging changes in pulmonary artery diameter at the occlusion site using silk or metal clamps for pulmonary artery troubles","volume":"65","author":"Chiba","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025073113214988300_ezaf232-B7","doi-asserted-by":"crossref","first-page":"35","DOI":"10.5761\/atcs.oa.11.01873","article-title":"Pressure controlled clamp using shape memory alloy for minimal vessel invasion in blood flow occlusion","volume":"19","author":"Zhang","year":"2013","journal-title":"Ann Thorac Cardiovasc Surg"},{"key":"2025073113214988300_ezaf232-B8","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1093\/ejcts\/ezv414","article-title":"Unequal pressure distribution along the jaws of currently available vascular clamps: do we need a new aortic clamp?","volume":"49","author":"Rylski","year":"2016","journal-title":"Eur J Cardiothorac Surg"}],"container-title":["European Journal of Cardio-Thoracic 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