Autologous Fibrin Glue—Clinical Use and Sealing of High-Porosity Vascular Prostheses

Abstract

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 concentration of 3.7 mg/mL was drawn. The product of the preparation was a mean 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 chloride and aprotinin, an antifibrinolytic agent, the total volume of two-component fibrin glue was 3.3 mL. The preparation was done in a closed system to ensure sterility and com pleted within ninety minutes. Twenty high-porosity double-velour vascular prostheses were sealed with autologous fibrin glue in the laboratory. The pro stheses were tight for blood up to a pressure higher than 300 mmHg, which was comparable to vascular prostheses impregnated with collagen, but to more than twice the pressure of 130 mmHg, where vascular prostheses preclotted with blood started leaking. Autologous fibrin glue imparts a nice white vascular graft with superior handling characteristics, since it is nonsticky compared with blood-clotted grafts and softer and more pliable than the vascular prostheses impregnated with collagen from the manufacturer. In addition autologous fi brin glue has the obvious advantages of safety from transmission of viral dis eases and from immunologic reactions.