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Comparison of polyurethane with cyanoacrylate in hemostasis of vascular injury in guinea pigs.

Kubrusly LF, Formighieri MS, Lago JV, Graça YL, Sobral AC, Lago MM - Rev Bras Cir Cardiovasc (2015 Jan-Mar)

Bottom Line: In group III, 100% of the animals had mild/severe fibrosis, while in group II only 12.5% showed this degree of fibrosis (P=0.001).Polyurethane derived from castor oil showed similar hemostatic behavior to octyl-2-cyanoacrylate.There was less perivascular tissue response with polyurethane when compared with cyanoacrylate.

View Article: PubMed Central - PubMed

Affiliation: Instituto do Coração de Curitiba, Curitiba, PR, Brazil.

ABSTRACT

Objective: To evaluate the behavior of castor oil-derived polyurethane as a hemostatic agent and tissue response after abdominal aortic injury and to compare it with 2-octyl-cyanoacrylate.

Methods: Twenty-four Guinea Pigs were randomly divided into three groups of eight animals (I, II, and III). The infrarenal abdominal aorta was dissected, clamped proximally and distally to the vascular puncture site. In group I (control), hemostasis was achieved with digital pressure; in group II (polyurethane) castor oil-derived polyurethane was applied, and in group III (cyanoacrylate), 2-octyl-cyanoacrylate was used. Group II was subdivided into IIA and IIB according to the time of preparation of the hemostatic agent.

Results: Mean blood loss in groups IIA, IIB and III was 0.002 grams (g), 0.008 g, and 0.170 g, with standard deviation of 0.005 g, 0.005 g, and 0.424 g, respectively (P=0.069). The drying time for cyanoacrylate averaged 81.5 seconds (s) (standard deviation: 51.5 seconds) and 126.1 s (standard deviation: 23.0 s) for polyurethane B (P=0.046). However, there was a trend (P=0.069) for cyanoacrylate to dry more slowly than polyurethane A (mean: 40.5 s; SD: 8.6 s). Furthermore, polyurethane A had a shorter drying time than polyurethane B (P=0.003), mean IIA of 40.5 s (standard deviation: 8.6 s). In group III, 100% of the animals had mild/severe fibrosis, while in group II only 12.5% showed this degree of fibrosis (P=0.001).

Conclusion: Polyurethane derived from castor oil showed similar hemostatic behavior to octyl-2-cyanoacrylate. There was less perivascular tissue response with polyurethane when compared with cyanoacrylate.

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Fibrosis absent/mild in polyurethane group (left) and moderate/severe inthe cyanoacrylate group (right) stained with Masson’s trichrome
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f02: Fibrosis absent/mild in polyurethane group (left) and moderate/severe inthe cyanoacrylate group (right) stained with Masson’s trichrome

Mentions: We used pairwise group comparisons to test the hypothesis that thelikelihood of a moderate/severe rating was the same for the two groups comparedvs. the alternative hypothesis that the likelihood was different. Group II hadstatistically less fibrosis than group III (P=0.001), as shownin Figure 2. There was a trend towardincreased fibrosis in group III relative to group I (P=0.07).No statistical significance was found between groups I and II.


Comparison of polyurethane with cyanoacrylate in hemostasis of vascular injury in guinea pigs.

Kubrusly LF, Formighieri MS, Lago JV, Graça YL, Sobral AC, Lago MM - Rev Bras Cir Cardiovasc (2015 Jan-Mar)

Fibrosis absent/mild in polyurethane group (left) and moderate/severe inthe cyanoacrylate group (right) stained with Masson’s trichrome
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4389526&req=5

f02: Fibrosis absent/mild in polyurethane group (left) and moderate/severe inthe cyanoacrylate group (right) stained with Masson’s trichrome
Mentions: We used pairwise group comparisons to test the hypothesis that thelikelihood of a moderate/severe rating was the same for the two groups comparedvs. the alternative hypothesis that the likelihood was different. Group II hadstatistically less fibrosis than group III (P=0.001), as shownin Figure 2. There was a trend towardincreased fibrosis in group III relative to group I (P=0.07).No statistical significance was found between groups I and II.

Bottom Line: In group III, 100% of the animals had mild/severe fibrosis, while in group II only 12.5% showed this degree of fibrosis (P=0.001).Polyurethane derived from castor oil showed similar hemostatic behavior to octyl-2-cyanoacrylate.There was less perivascular tissue response with polyurethane when compared with cyanoacrylate.

View Article: PubMed Central - PubMed

Affiliation: Instituto do Coração de Curitiba, Curitiba, PR, Brazil.

ABSTRACT

Objective: To evaluate the behavior of castor oil-derived polyurethane as a hemostatic agent and tissue response after abdominal aortic injury and to compare it with 2-octyl-cyanoacrylate.

Methods: Twenty-four Guinea Pigs were randomly divided into three groups of eight animals (I, II, and III). The infrarenal abdominal aorta was dissected, clamped proximally and distally to the vascular puncture site. In group I (control), hemostasis was achieved with digital pressure; in group II (polyurethane) castor oil-derived polyurethane was applied, and in group III (cyanoacrylate), 2-octyl-cyanoacrylate was used. Group II was subdivided into IIA and IIB according to the time of preparation of the hemostatic agent.

Results: Mean blood loss in groups IIA, IIB and III was 0.002 grams (g), 0.008 g, and 0.170 g, with standard deviation of 0.005 g, 0.005 g, and 0.424 g, respectively (P=0.069). The drying time for cyanoacrylate averaged 81.5 seconds (s) (standard deviation: 51.5 seconds) and 126.1 s (standard deviation: 23.0 s) for polyurethane B (P=0.046). However, there was a trend (P=0.069) for cyanoacrylate to dry more slowly than polyurethane A (mean: 40.5 s; SD: 8.6 s). Furthermore, polyurethane A had a shorter drying time than polyurethane B (P=0.003), mean IIA of 40.5 s (standard deviation: 8.6 s). In group III, 100% of the animals had mild/severe fibrosis, while in group II only 12.5% showed this degree of fibrosis (P=0.001).

Conclusion: Polyurethane derived from castor oil showed similar hemostatic behavior to octyl-2-cyanoacrylate. There was less perivascular tissue response with polyurethane when compared with cyanoacrylate.

Show MeSH
Related in: MedlinePlus