Fibrin glue as a biologic vascular patch-A comparative study

Fibrin glue is a biologic two component hemostatic adhesive. Fibrin glue acts as an effective vascular plus after arterial injury without suture at pressures twice systolic. It is also effective on vein at physiologic pressures, however, venous distensibility precludes its efficacy beyond these limits. Recent studies have documented its utility as a preclot material on vascular grafts and as a seal for sutured vascular anastamoses. This study was designed to characterize the glue's sealant ability when applied to open arterial and venous injuries, and to compare its efficacy with currently available hemostatic agents. Segments of canine peripheral artery and vein were isolated and perforated with a 16-gauge needle. This injury was treated by random application of either fibrin sealant (FS), oxidized cellulose (OC), microcrystalline collagen (MC), or MC plus thrombin (MCT). Five minutes after patch application, intralumenal pressure was increased progressively with saline infusion to ascertain bursting threshold. The arterial bursting threshold was significantly higher for FA (250 ± 59.7 mm Hg) than for OC (12.5 ± 6.1 mm Hg), MC (17.2 ± 21.9 mm Hg) or MCT (10.8 ± 13.8 mm Hg) (P < 10⁶). The bursting threshold of FS applied to vein (17.5 ± 11.7) was not significantly different from other agents (P > 0.05).