Early reintervention for hemostasis following open abdominal aortic aneurysm repair using Ifabond surgical glue

TL;DR

This study examines how using Ifabond surgical glue affects the need for early reintervention after abdominal aortic surgery.

Contribution

The study evaluates the impact of Ifabond surgical glue on hemostasis and reintervention rates in open aortic surgery.

Findings

There was a trend toward lower reintervention rates for bleeding in patients using Ifabond glue.

Aortoaortic repairs had shorter operative durations and were more commonly performed via the retroperitoneal approach.

No significant differences were found in overall reintervention rates or early outcomes between groups.

Abstract

The aim of this study is to evaluate the rate and type of early reintervention and outcomes after open aortic surgery in a high-volume aortic center and to determine the impact of Ifabond surgical glue as an hemostatic barrier.

All patients who underwent aortic surgery at a single center between 2021 and 2023 were reviewed. The primary end point was a comparison of early reintervention rates for hemostasis between patients with and without Ifabond surgical glue application. Secondary end points included comparisons of early reintervention, early outcomes, and hemoglobin management. Additional subgroup analyses using the same variables were performed to assess the impact of the type of repair.

From January 2021 to December 2023, 383 patients underwent open aortic surgery at a single tertiary referral center. There were 159 patients who met the inclusion criteria, with surgical glue used in 130 cases (82%). Among these patients, 82 (63%) underwent aortoaortic repair. Five patients (3%) died, and six (4%) required early reintervention: three for hemostasis, two for thrombectomy, and one for both. No cases of bowel ischemia were reported. Although not statistically significant, there was a trend toward lower reintervention rates for bleeding in the glue group (1.5% vs 6.9%; P = .15), but there was no impact on transfusion requirements (18% vs 14%; P = .79). No difference was observed in overall reintervention rates (3.1% vs 6.9%; P = .31) or early outcomes. Comparing repair types (aortoaortic vs aortoiliac) revealed significant differences in operative duration (123.0 ±38.7 vs 149.0 ± 38.6 minutes; P < .001), with aortoaortic repairs being shorter and more commonly performed via the retroperitoneal approach (65% vs 10%; P < .001).

Application of glue appears to decrease reintervention rates for hemostasis and postoperative hemoglobin loss. Further prospective studies are warranted to better define the role of Ifabond surgical glue in abdominal aortic repair.

Figures