open access

Vol 26, No 3 (2020)
Research paper
Published online: 2021-01-07
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Fibrin sealant injection through the drain with adjuvant compression as a treatment of groin lymphatic complications after vascular operation

Tadeusz Grochowiecki, Michał Macech, Tomasz Jakimowicz, Maciej Jędrasik, Sławomir Nazarewski
DOI: 10.5603/AA.2020.0015
·
Acta Angiologica 2020;26(3):85-89.

open access

Vol 26, No 3 (2020)
Original papers
Published online: 2021-01-07

Abstract

Introduction: Groin lymphatic complications after femoral artery operations are rare, but if developed, they
could be a source of severe complications that could be potentially fatal. The novel technique of combining
compression and application of Tisseel sealant (Baxter AG, Vienna, Austria) to treat lymphatic fistulas in the
groin region after common femoral artery exposure was evaluated.

Material and methods: Twelve groins from eleven patients with groin lymphatic complications were enrolled
into the study. Patients had femoral artery exposure during one of the following procedures: endovascular aortic
aneurysm repair, thrombendarterectomy or extra-anatomic by-pass. Postoperatively, average lymphatic drainage
through the drain was 140 ± 60 (range 48–300) mL per day. Intervention was performed at a median
of 12 (9–23) days after operation. The drain was cut off close to the skin, a thin double-channel catheter was
introduced as deep as possible through the drain and sealant was injected into the wound. Simultaneously,
the remaining part of the drain was removed, the orifice in the skin was sutured and a compression dressing
was kept in place for 24 hours. The median patient observation period was 13 months (range 2.5–23) and
surveillance of the groin was performed using ultrasonography.

Results: Early outcomes showed full technical success. None of the patients were readmitted due to lymphorrhea,
infection or poor wound healing during follow-up. No lymphoceles were detected by ultrasonography.

Conclusion: Fibrin glue injection augmented by compression is an effective method for treating postoperative
lymphatic fistulas and to prevent lymphorrhagia and lymphocele formation in the groin region after femoral
artery exposure.

Abstract

Introduction: Groin lymphatic complications after femoral artery operations are rare, but if developed, they
could be a source of severe complications that could be potentially fatal. The novel technique of combining
compression and application of Tisseel sealant (Baxter AG, Vienna, Austria) to treat lymphatic fistulas in the
groin region after common femoral artery exposure was evaluated.

Material and methods: Twelve groins from eleven patients with groin lymphatic complications were enrolled
into the study. Patients had femoral artery exposure during one of the following procedures: endovascular aortic
aneurysm repair, thrombendarterectomy or extra-anatomic by-pass. Postoperatively, average lymphatic drainage
through the drain was 140 ± 60 (range 48–300) mL per day. Intervention was performed at a median
of 12 (9–23) days after operation. The drain was cut off close to the skin, a thin double-channel catheter was
introduced as deep as possible through the drain and sealant was injected into the wound. Simultaneously,
the remaining part of the drain was removed, the orifice in the skin was sutured and a compression dressing
was kept in place for 24 hours. The median patient observation period was 13 months (range 2.5–23) and
surveillance of the groin was performed using ultrasonography.

Results: Early outcomes showed full technical success. None of the patients were readmitted due to lymphorrhea,
infection or poor wound healing during follow-up. No lymphoceles were detected by ultrasonography.

Conclusion: Fibrin glue injection augmented by compression is an effective method for treating postoperative
lymphatic fistulas and to prevent lymphorrhagia and lymphocele formation in the groin region after femoral
artery exposure.

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Keywords

vascular surgery, lymphatic fistula, mini-invasive treatment, tissue sealant, femoral artery

About this article
Title

Fibrin sealant injection through the drain with adjuvant compression as a treatment of groin lymphatic complications after vascular operation

Journal

Acta Angiologica

Issue

Vol 26, No 3 (2020)

Article type

Research paper

Pages

85-89

Published online

2021-01-07

DOI

10.5603/AA.2020.0015

Bibliographic record

Acta Angiologica 2020;26(3):85-89.

Keywords

vascular surgery
lymphatic fistula
mini-invasive treatment
tissue sealant
femoral artery

Authors

Tadeusz Grochowiecki
Michał Macech
Tomasz Jakimowicz
Maciej Jędrasik
Sławomir Nazarewski

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