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Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis
BACKGROUND: Evidence comparing fibrin sealants (FSs) in surgery are limited. This study evaluated the efficacy and safety of FSs, and manual compression in peripheral vascular surgery. METHODS: A systematic review of randomized trials was conducted in Medline, Embase, and Cochrane databases within t...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7782199/ https://www.ncbi.nlm.nih.gov/pubmed/33425351 http://dx.doi.org/10.1016/j.amsu.2020.12.003 |
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author | Danker III, Walter DeAnglis, Ashley Ferko, Nicole Garcia, David Hogan, Andrew |
author_facet | Danker III, Walter DeAnglis, Ashley Ferko, Nicole Garcia, David Hogan, Andrew |
author_sort | Danker III, Walter |
collection | PubMed |
description | BACKGROUND: Evidence comparing fibrin sealants (FSs) in surgery are limited. This study evaluated the efficacy and safety of FSs, and manual compression in peripheral vascular surgery. METHODS: A systematic review of randomized trials was conducted in Medline, Embase, and Cochrane databases within the last 15 years. Data were available to conduct a network meta-analysis (NMA) in peripheral vascular surgery. Fibrin sealant treatment arms were further broken-down and assessed by clotting time (i.e., 2-min [2C] or 1-min [1C]). The primary efficacy outcome was the proportion of patients achieving hemostasis by 4 min (T4). Treatment-related serious and non-serious adverse events (AEs) were qualitatively assessed. RESULTS: Five studies (n = 693), were included in the NMA. Results predicted VISTASEAL 2C, followed by EVICEL 1C, had the highest probability of achieving T4. Compared with manual compression, significant improvements in T4 were found with VISTASEAL 2C (relative risk [RR] = 2.67, 95% CrI: 2.13–3.34), EVICEL 1C (RR = 2.58, 95% CrI: 2.04–3.23), VISTASEAL 1C (RR = 2.00, 95% CrI: 1.45–2.65), and TISSEEL 2C (RR = 1.99, 95% CrI: 1.48–2.60). TISSEEL 1C was not significantly different than manual compression (RR = 1.40, 95% CrI: 0.70–2.33). Among FSs, VISTASEAL 2C was associated with a significant improvements in T4 compared with VISTASEAL 1C (RR = 1.33, 95% CrI: 1.02–1.82), TISSEEL 2C (RR = 1.34, 95% CrI: 1.05–1.77), and TISSEEL 1C (RR = 1.90, 95% CrI: 1.18–3.74). Treatment-related serious and non-serious AE rates were typically lower than 2%. CONCLUSIONS: In peripheral vascular surgeries, VISTASEAL 2C and EVICEL 1C were shown to have the highest probabilities for achieving rapid hemostasis among the treatments compared. Future studies should expand networks across surgery types as data become available. |
format | Online Article Text |
id | pubmed-7782199 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-77821992021-01-08 Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis Danker III, Walter DeAnglis, Ashley Ferko, Nicole Garcia, David Hogan, Andrew Ann Med Surg (Lond) Review Article BACKGROUND: Evidence comparing fibrin sealants (FSs) in surgery are limited. This study evaluated the efficacy and safety of FSs, and manual compression in peripheral vascular surgery. METHODS: A systematic review of randomized trials was conducted in Medline, Embase, and Cochrane databases within the last 15 years. Data were available to conduct a network meta-analysis (NMA) in peripheral vascular surgery. Fibrin sealant treatment arms were further broken-down and assessed by clotting time (i.e., 2-min [2C] or 1-min [1C]). The primary efficacy outcome was the proportion of patients achieving hemostasis by 4 min (T4). Treatment-related serious and non-serious adverse events (AEs) were qualitatively assessed. RESULTS: Five studies (n = 693), were included in the NMA. Results predicted VISTASEAL 2C, followed by EVICEL 1C, had the highest probability of achieving T4. Compared with manual compression, significant improvements in T4 were found with VISTASEAL 2C (relative risk [RR] = 2.67, 95% CrI: 2.13–3.34), EVICEL 1C (RR = 2.58, 95% CrI: 2.04–3.23), VISTASEAL 1C (RR = 2.00, 95% CrI: 1.45–2.65), and TISSEEL 2C (RR = 1.99, 95% CrI: 1.48–2.60). TISSEEL 1C was not significantly different than manual compression (RR = 1.40, 95% CrI: 0.70–2.33). Among FSs, VISTASEAL 2C was associated with a significant improvements in T4 compared with VISTASEAL 1C (RR = 1.33, 95% CrI: 1.02–1.82), TISSEEL 2C (RR = 1.34, 95% CrI: 1.05–1.77), and TISSEEL 1C (RR = 1.90, 95% CrI: 1.18–3.74). Treatment-related serious and non-serious AE rates were typically lower than 2%. CONCLUSIONS: In peripheral vascular surgeries, VISTASEAL 2C and EVICEL 1C were shown to have the highest probabilities for achieving rapid hemostasis among the treatments compared. Future studies should expand networks across surgery types as data become available. Elsevier 2020-12-09 /pmc/articles/PMC7782199/ /pubmed/33425351 http://dx.doi.org/10.1016/j.amsu.2020.12.003 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Review Article Danker III, Walter DeAnglis, Ashley Ferko, Nicole Garcia, David Hogan, Andrew Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis |
title | Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis |
title_full | Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis |
title_fullStr | Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis |
title_full_unstemmed | Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis |
title_short | Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis |
title_sort | comparison of fibrin sealants in peripheral vascular surgery: a systematic review and network meta-analysis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7782199/ https://www.ncbi.nlm.nih.gov/pubmed/33425351 http://dx.doi.org/10.1016/j.amsu.2020.12.003 |
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