Fibrin sealant reduces suture line bleeding during carotid endarterectomy: a randomised trial.

OBJECTIVES

To determine whether topical fibrin sealant reduced suture line bleeding during carotid endarterectomy with polytetrafluoroethylene (PTFE) patch closure.

DESIGN

Prospective randomised non-blinded control trial.

SETTING

Regional vascular surgery unit.

MATERIALS

Seventeen patients undergoing carotid endarterectomy were randomised either to receive fibrin sealant as a topical haemostatic agent at the arteriotomy 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 significant p < 0.005 by Mann-Whitney test. There was no statistical difference in total operative time. Operative blood loss was lower in the treatment group (median 420ml, range 300-500ml) than in the control group (median 550ml, range 350-1200ml) but this difference was not statistically significant. One patient in the control group suffered a perioperative thrombo-embolic event.

CONCLUSION

Fibrin sealant is an effective topical haemostatic agent for arteriotomy suture lines involving PTFE material.