Acute Thrombogenic Effects of Fibrin Sealant on Microvascular Anastomoses in a Rat Model

Fibrin glue in coronary artery bypass grafting operations: casting out the Devil with Beelzebub?

“…Even if there is no anastomosis in close proximity to the applied sealant there might still be a considerable diffusion of thrombin through the wall of bypass grafts leading to early graft occlusion or in the native coronary arteries leading to myocardial ischemia. Animal studies have demonstrated the destruction of muscle flaps when thrombin was applied to the free flaps [12]. A further uncertainty in clinical settings is the fact that the release of thrombin from a Tissucol W clot is two times greater when the sealant is applicated sequentially with a syringe rather than when Duploject application is performed [13].…”

A Modified Technique of Renal Artery Anastomosis in Rat Kidney Transplantation

“…On the other hand, some authors have shown some deleterious effects after application of fibrin adhesives in microvascular anastomosis, such as increased thrombogenicity and aneurysm formation. A thrombin-based preparation of fibrin sealant has recently been shown to have deleterious effects on microvascular anastomosis in an animal model [11] . Fibrin sealant constructed with a high concentration of bovine thrombin (1,000 IU/ml) was detrimental to microvascular patency when applied to the anastomosis in a rat free flap model [12] .…”

Technology‐assisted and sutureless microvascular anastomoses: Evidence for current techniques

“…[52][53][54][55][56][57] However, concerns regarding the inherent thrombogenicity of these products and the potential for triggering intraluminial thrombosis exist. 58 Although promising animal studies have been published, [59][60][61][62][63][64] few clinical series exist. At least one large series of free tissue transfers in breast reconstruction (n 5 349) reports use of thrombin-based glues with no apparent increase in anastomotic failure.…”