Comparison of a plasma-based composite biologic sealant with fibrin glue (Tisseel) for vascular anastomoses.

Biologic sealants are needed in numerous, more and more demanding, procedures--especially with developments occurring in endovascular and laparoscopic vascular techniques. An initial pilot study in dogs showed that a 4-cm aortotomy closed with a polyester patch sutured in place by a 4-mm-spaced running suture consistently led to massive hemorrhage. We then designed a study using five dogs where two aortotomies were done to compare the effect of Tisseel to that of an autologous sealant prepared in our laboratory. Arterial pressures and heparinization were maintained throughout the surgical procedure. Both biologic sealants prevented hemorrhage from the arteriotomy at unclamping. Macroscopic and histologic assessments were performed. At killing, one week later, the autologous sealant exhibited less blood saturation of the collagen sponge compared with Tisseel. The use of autologous plasma combined with other adhesive components could be an efficient alternative to allogenic fibrin glue. Further studies are needed to confirm these observations.