Experience Using a Gelatin-Human Thrombin Absorbable Hemostatic Agent (Floseal<sup>®</sup>) in Carotid Endarterectomy

We report our experience with a gelatin-human thrombin matrix (Floseal®) as an intraoperative hemostatic agent, which provided effective hemostasis, in patients undergoing carotid endarterectomy (CEA). Angioplasty using a Hemashield patch graft was performed after intimal dissection in 15 consecutive patients undergoing CEA. Floseal was used at the suture site after resumption of vascular clamping and bleeding from the posterior surface of the carotid artery.No postoperative hemorrhagic complications or lower cranial nerve dysfunction developed. Floseal provided sufficient hemostasis even with intraoperative heparin administration using an internal shunt. Floseal could also be used in bleeding from tissues surrounding the lower cranial nerves without causing nerve dysfunction. Our experience indicates that Floseal is effective and safe in CEA.