Related Experiment Video
Updated: Oct 25, 2026
Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
Randomized pilot trial of intraoperative hemoadsorption in clopidogrel treated patients undergoing urgent coronary
Alireza Jahangirifard1,2, Seyed Bashir Mirtajani2, Is Haq Al-Aamri3
1National Heart Center, Royal Hospital, Muscat, Oman.
Background:
Patients receiving clopidogrel who undergo urgent CABG before the recommended 5-day washout period are at increased risk of perioperative bleeding. This study evaluated whether intraoperative hemoadsorption can reduce bleeding in such patients.
Methods:
Patients undergoing CABG within 24 h of clopidogrel discontinuation were randomized 1:1 to intraoperative hemoadsorption (Group 1) or control (Group 2). In the intervention group, the device was incorporated into the cardiopulmonary bypass (CPB) circuit. Efficacy was assessed by 24-hour chest tube drainage (CTD), blood product transfusions and surgical revisions for bleeding control.
Results:
A total of 50 patients were randomized (mean age 64 ± 8.6 years, 82% male). There were no differences in baseline characteristics between groups. Group 1 showed significantly reduced median 24-hr CTD of 300mL [250-400] vs. 500mL [400-700], p = 0.0003, transfusions of packed red blood cells 0 [0-1] vs. 1 [0-2] units, p = 0.047), fresh frozen plasma 0 [0-0] vs. 2 [2-3] units, p < 0.0001) and platelets 0 [0-0] vs. 2 [1-3] units, p < 0.0001 compared with Group 2. One revision for bleeding control occurred in Group 2 (4.0%). No device-related serious adverse events were observed.
Conclusion:
In this cohort of clopidogrel-treated patients undergoing CABG within 24 h of discontinuation, intraoperative hemoadsorption was associated with lower postoperative bleeding and transfusion requirements.