Super glue and vascular graft surgery

Got a broken teacup, an art project, or a leaky blood vessel? “Super glue” it.

Surgeons at Baylor College of Medicine in Houston are studying whether a liquid sealant, similar to common household “super glue,” forms a tight seal around blood vessels used in vascular graft surgery.

“When you sew blood vessels together for a graft, they sometimes leak,” said Dr. Alan Lumsden, chief of the vascular surgery section of the Michael E. DeBakey Department of Surgery and principal investigator for the clinical trial. “In this trial, we will seal that leak, or basically “super glue” it together.”

Doctors currently use the glue to close skin wounds instead of using sutures, and are now studying it for vascular grafts. The sealant, manufactured by Closure Medical Corporation, is designed to provide a strong physical seal that remains in place longer than the graft takes to heal naturally. Over time, the seal will break down into smaller absorbable fragments.

Lumsden is the principal investigator of the international clinical trial, which will enroll up to 150 patients at 14 institutions in the United States and Europe. Surgeries will be performed at The Methodist Hospital and the Michael E. DeBakey Houston VA Medical Center. Candidates for the study are patients who are having femoral-popliteal bypass or AV access shunt surgery, two procedures that improve blood flow. Ideal candidates for the surgery are those who will be receiving artificial grafts, which bleed more, leading to surgical complications.

Other methods currently available to seal leaky blood vessels use biological agents to clot the blood. Since the vascular sealant is synthetic, it carries no risk of viral contamination or rejection that may occur with biological agents.

“The idea is that we can use this glue to join two blood vessels which allows blood to flow from one to the other--something we currently cannot do,” Lumsden said.

Patients in the trial will either receive the procedure using the glue, or sutures alone. Researchers will then compare the procedures to measure blood loss and the time the procedure takes to complete.

“Because we cannot create a tight, leak-proof seal between blood vessels, vascular surgeons are unable to perform laparascopic vascular surgery, a minimally invasive form of surgery,” Lumsden said. “The glue opens up all types of possibilities in terms of vascular graft surgery.”