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Randomized clinical trial of tranexamic acid-free fibrin sealant during vascular surgical procedures

✍ Scribed by R. T. A. Chalmers; R. C. Darling III; J. T. Wingard; I. Chetter; B. Cutler; J. A. Kern; J. C. Hart


Book ID
101749968
Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
126 KB
Volume
97
Category
Article
ISSN
0007-1323

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✦ Synopsis


Abstract

Background

This study evaluated the safety and haemostatic effectiveness of a fibrin sealant (EVICELβ„’ Fibrin Sealant (Human)) during vascular surgery.

Methods

This prospective randomized controlled trial compared the haemostatic effectiveness of fibrin sealant (75 patients) or manual compression (72) in polytetrafluoroethylene (PTFE) arterial anastomoses. The primary endpoint was the absence of bleeding at the anastomosis at 4 min after randomization. Secondary endpoints included haemostasis at 7 and 10 min, treatment failures and the incidence of complications potentially related to bleeding. Adverse events were recorded.

Results

A higher percentage of patients who received fibrin sealant versus manual compression achieved haemostasis at 4 min (85 versus 39 per cent respectively; odds ratio 11Β·34, 95 per cent confidence interval 4Β·67 to 27Β·52; P < 0Β·001). Similarly, a higher percentage of patients who received fibrin sealant achieved haemostasis at 7 and 10 min (both P < 0Β·001). The incidence of treatment failure was lower in the fibrin sealant group (P < 0Β·001). The rate of complications potentially related to bleeding was similar (P = 0Β·426). Some 64 per cent of patients who received fibrin sealant experienced at least one adverse event, compared with 71 per cent who received manual compression.

Conclusion

This fibrin sealant was safe, and significantly shortened the time to haemostasis in vascular procedures using PTFE. Registration number: NCT00154141 (http://www.clinicaltrials.gov).


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