Abstract
Background: Microporous polysaccharide hemospheres (MPH) have been developed to promote hemostasis using controlled-porosity spherical particles made from potato. We investigated the initial clinical efficacy of MPH in peripheral vascular surgery in our institution. Methods: We enrolled 25 patients in this study. Between January 2008 and December 2009, 10 patients (group A) were given 1 g MPH (Arista AH®), while 15 (group B) were treated with 1 ml fibrin sealant (Beriplast P®) at the anastomosis between the prosthesis and native vessel intraoperatively. In group A, 6 patients demonstrated lower extremity revascularization and 4 patients showed vascular access. In group B, 10 patients demonstrated peripheral arterial revascularization and 5 required arteriovenous grafts. We evaluated the perioperative results and complications including graft patency, wound problems and postoperative general condition in both groups. Results: The amount of bleeding during surgery differed slightly between group A (10–80 ml; mean, 30.5 ml) and group B (10–300 ml; mean, 83.0 ml), but this difference was not statistically significant (p=0.051). In group A, major complications were non-infective wound edema in 1 case, seroma formation in 1 case, and reversible mild liver dysfunction in 1 case. In group B, fatal aspiration pneumonia occurred in 1 case and renal dysfunction deterioration occurred in 1 case. There was no wound infection in either group, and all prosthetic grafts in both groups remained patent without the development of stenosis or pseudoaneurysm at the anastomosis site in the early phase. Conclusion: Based on these results, the use of MPHs can be a safe and effective treatment for hemostasis during peripheral vascular surgery. Further studies will be needed to elucidate the precise clinical effects of MPH.
