AUTOLOGOUS FIBRIN GLUE - CLINICAL USE AND SEALING OF HIGH-POROSITY VASCULAR PROSTHESES

Autologous fibrin glue was prepared in a new way by means of ethanol. From 42 patients 44 mL of blood with a mean plasma fibrinogen concentr ation of 3.7 mg/mL was drawn. The product of the preparation was a mea n of 2.5 mL of fibrinogen concentrate with a concentration of 28 mg/mL . After addition of 0.3 part of thrombin solution containing calcium c hloride and aprotinin, an antifibrinolytic agent, the total volume of two-component fibrin glue was 3.3 mL. The preparation was done in a cl osed system to ensure sterility and completed within ninety minutes. T wenty high-porosity double-velour vascular prostheses were sealed with autologous fibrin glue in the laboratory. The prostheses were tight f or blood up to a pressure higher than 300 mmHg, which was comparable t o vascular prostheses impregnated with collagen, but to more than twic e the pressure of 130 mmHg, where vascular prostheses preclotted with blood started leaking. Autologous fibrin glue imparts a nice white vas cular graft with superior handling characteristics, since it is nonsti cky compared with blood-clotted grafts and softer and more pliable tha n the vascular prostheses impregnated with collagen from the manufactu rer. In addition autologous fibrin glue has the obvious advantages of safety from transmission of viral diseases and from immunologic reacti ons.