Effectiveness of Autologous Fibrin Glue in Femoral Vessel Reconstruction Using Great Saphenous Vein Grafts

Patients with sarcomas involving the femoral vessels have been treated with wide tumor resection and reconstruction using great saphenous vein (GSV) grafts. Several studies have reported on the application of fibrin glue (FG) at microvascular anastomosis sites. This study aimed to evaluate the effectiveness of autologous FG (AFG) in femoral vessel reconstruction using GSV grafts.

Five male patients with lower extremity sarcomas underwent revascularization using harvested GSV grafts, each 1.5 times longer than the resected femoral artery. Anastomoses were sutured using 8-0 nylon under a microscope. AFG was applied to the anastomosis sites and along the length of the grafts. Approximately 10 mL of AFG (excluding thrombin solution) was available and consequently used. Operative details and postoperative complications requiring re-exploration were assessed.

The mean tumor size was 10.2 cm, the mean vessel defect length was 11.1 cm, and the mean graft-to-defect ratio was 1.56. Among the patients, two underwent revascularization of the artery and vein, while three underwent arterial revascularization. One patient experienced distal-side necrosis due to arterial insufficiency based on severe size discrepancies.

The large volume, high fibrinogen content, and growth factors in AFG suggest its potential to support external vein grafts, prevent graft overdistention, enhance graft thickness, and minimize minor leakage from vein graft branches.