Microvascular clamp technique as a reversible simulation of parathyroid gland excision.

INTRODUCTION

This study demonstrates the effectiveness of a microvascular clamp to simulate parathyroid adenoma excision with respect to intraoperative parathyroid hormone (ioPTH) changes in vivo.

METHODS

Cases in which microvascular clamps were employed intraoperatively in conjunction with intraoperative parathyroid hormone(ioPTH) assays were reviewed. ioPTH values were recorded throughout these procedures to assess the efficacy and reversibility of tissue ischemia using microvascular clamps.

RESULTS

Application of a microvascular clamp across the vascular pedicle of a parathyroid adenoma resulted in a significant ioPTH drop in 95% of cases (N = 20). Removal of the clamp resulted in complete or partial rebound of ioPTH in 90% of cases (N = 20).

CONCLUSION

The use of a microvascular clamp to temporarily occlude a parathyroid gland's vascular pedicle is an effective simulation of gland excision with respect to ioPTH changes. Rebound of ioPTH levels after clamp removal demonstrates that this technique is generally reversible.

LEVEL OF EVIDENCE: 2b, Retrospective cohort study.