Aa. Milne et al., FIBRIN SEALANT REDUCES SUTURE LINE BLEEDING DURING CAROTID ENDARTERECTOMY - A RANDOMIZED TRIAL, European journal of vascular and endovascular surgery, 10(1), 1995, pp. 91-94
Objectives: To determine whether topical fibrin sealant reduced suture
line bleeding during carotid endarterectomy with polytetrafluoroethyl
ene (PTFE) patch closure. Design: Prospective randomised non-blinded c
ontrol trial. Setting Regional vascular surgery unit. Materials: Seven
teen patients undergoing carotid endarterectomy were ramdomised either
to receive fibrin sealant as a topical haemostatic agent at the arter
iotomy suture line or to act as control. Outcome measures: Time taken
to achieve haemostasis at the suture line. Intraoperative blood loss.
Total operative time. Results: The median time to achieve haemostasis
was 5.5 min (range 4-31 min) in the treatment group and 19 min (range
10-47 min) in the control group. This difference was statistically sig
nificant p < 0.005 by Mann-Whitney test. There was no statistical diff
erence in total operative rime. Operative blood loss was lower in the
treatment group (median 420ml, range 300-500ml) than in the control gr
oup (median 550ml, range 350-1200ml) but this difference was not stati
stically significant. One patient in the control group suffered a peri
operative thrombo-embolic event. Conclusion: Fibrin sealant is an effe
ctive topical haemost atic agent for arteriotomy suture lines involvin
g PTFE material.