Albumin-impregnated polyester vascular prosthesis for abdominal aortic surgery: an improvement?
OBJECTIVE
To compare the peroperative blood loss and the postoperative systemic inflammatory reaction in patients receiving either a Vasculour II Albumin pre-impregnated prosthesis (VA group, n = 32) or a preclotted Vasculour II prosthesis (V group, n = 33) for elective surgery of the abdominal aorta.


METHODS
University Hospital.


METHODS
Prospective, randomised study.


METHODS
Peroperative blood loss was measured over two different periods: Phase I from the beginning of the operation to the completion of the proximal anastomosis, when blood loss cannot be related to the model of prosthesis implanted and phase II after the completion of the proximal anastomosis to the end of the operation. Postoperative blood loss was evaluated by the determination of the retroperitoneal drainage volume over a period of 2 days immediately following the operation. The presence of periprosthetic fluid was measured with echography at days 4, 9, 30 and 60. The postoperative systemic inflammatory reaction was evaluated by measuring the sedimentation rate and the C reactive protein levels daily from day 1 to day 9, and at days 14, 21, 28, 45, and 60, and by measuring the body temperature daily from day 1 to day 9.


RESULTS
No significant differences of peroperative blood loss were observed. The same proportion of patients (35%) in both groups received homologous transfusion. The mean number of units of homologous blood transfused per patient was respectively 0.77 and 0.91 for the VA and the V group. The retroperitoneal drainage volume and the percentage of patients with periprosthetic fluid did not differ significantly. No significant differences in systemic postoperative inflammatory reaction were observed.


CONCLUSIONS
There were no benefits in using albumin-impregnated prosthesis as opposed to preclotted prosthesis in terms of peroperative and postoperative blood loss, or by looking at the incidence of homologous blood transfusion. However, the glutaraldehyde cross-linked albumin did not induce any systemic inflammatory reaction.
Chakfe
N
N
Department of Cardio-Vascular Surgery, Les Hôpitaux Universitaires de Strasbourg, France.
Kretz
J G
JG
Petit
H
H
Epailly
E
E
Nicolini
P
P
Levy
F
F
Pasquali
J L
JL
Eisenmann
B
B
D000368:Aged; D000418:Albumins / Q000008:administration & dosage; D000714:Anastomosis, Surgical; D001012:Aorta, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000601:surgery*; D001777:Blood Coagulation; D016063:Blood Loss, Surgical; D001799:Blood Sedimentation; D001803:Blood Transfusion; D001807:Blood Vessel Prosthesis; D001831:Body Temperature; D002097:C-Reactive Protein / Q000032:analysis; D017558:Elective Surgical Procedures; D005122:Exudates and Transudates; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011091:Polyesters; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D011474:Prosthesis Design; D013499:Surface Properties; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology
D000418:Albumins; D011091:Polyesters; D002097:C-Reactive Protein