Journal of vascular surgery
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Prolonged anastomotic and needle hole bleeding from synthetic vascular prostheses is a common surgical problem in heparinized patients and in the patient with a coagulopathy. The relative effectiveness of various hemostatic agents has not previously been determined by controlled comparisons. In this study 6 mm polytetrafluoroethylene (PTFE) vascular prostheses were used to perform carotid-carotid and femorofemoral bypasses in eight heparinized dogs. ⋯ Although application of isobutyl 2-cyanoacrylate resulted in the shortest MTH in each experimental group, the reported inflammatory response that it induces and its possible carcinogenicity limits its availability for clinical use. Application of fibrin adhesive prepared from single-donor hepatitis-screened plasma resulted in a significantly shorter MTH in each experimental group when compared with oxidized regenerated cellulose. We recommend clinical use of fibrin adhesive to control needle hole and anastomotic bleeding from PTFE vascular prostheses.