A RANDOMIZED TRIAL OF FIBRIN SEALANT IN PERIPHERAL VASCULAR-SURGERY

In a prospective randomised trial 39 patients undergoing either arteri al bypass surgery with a polytetrafluoroethylene (PTFE) bypass graft ( n = 18) or aortic aneurysm repair with a woven Dacron graft (n = 21) w ere randomised either to receive fibrin sealant as a topical haemostat ic agent at the arterial anastomosis or to act as control. The main ou tcome measure was the time taken to achieve haemostasis at the suture line. The median time to achieve haemostasis was 0.5 min (range 0-11 m in) in the treatment group and 4 min (range 0-21 min) in the control g roup. This difference was statistically significant p < 0.014 by the M ann-Whitney test. Immediate haemostasis on release of the clamps was a chieved in 13/21 patients in the treatment group and in 4/18 patients in the control group (p = 0.023 by Fisher's exact test). There was no difference in total operative time or operative blood loss. No patient s in the treatment group suffered any perioperative thromboembolic eve nt and 1 patient in the control group suffered an early graft occlusio n. There was no evidence of transmission of hepatitis B or C, or parvo virus B19. In conclusion, fibrin sealant is an effective topical haemo static agent for arterial suture lines involving PTFE or woven Dacron.