Trial reportJournal of cardiothoracic surgery2026
Randomized pilot trial of intraoperative hemoadsorption in clopidogrel treated patients undergoing urgent coronary artery bypass grafting.
Trial report in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
backgroundPatients 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.
methodsPatients 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.
resultsA 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.
conclusionIn this cohort of clopidogrel-treated patients undergoing CABG within 24 h of discontinuation, intraoperative hemoadsorption was associated with lower postoperative bleeding and transfusion requirements.
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