Fibrinogen 5.5mg/square cm / Thrombin 2units/square cm sealant matrix 4.8cm x 4.8cm

BackgroundFibrin is a biocompatible, angiogenic biomaterial widely used in soft tissue engineering, with outcomes influenced by scaffold formulation and design.AimThis systematic review evaluates how fibrin scaffold composition and design affect angiogenesis in in vitro and in vivo soft tissue models.MethodsPubMed, Scopus, and OVID were searched on 28/Oct/2024. A two-step screening process by three independent researchers identified original studies on fibrin scaffolds assessing endothelial formation and/or migration. Studies without experimental data or focused solely on grafts were excluded. Data on scaffold composition, manufactured objects, cell-embedding strategies, angiogenic outcomes, and a subset of muscle-specific studies were narratively synthesised. Risk of bias (RoB) and study quality were assessed using SYRCLE's RoB tool and a modified CAMARADES checklist.Results & discussionThe 81 studies highlight the impact of scaffold composition on angiogenic outcomes, with human-derived fibrinogen and pre-embedding cells consistently supporting successful outcomes. While tube and network formation outcomes typically aligned, endothelial migration exhibited different patterns. Thrombin often contributed positively, but crosslinker effects were less clear. Muscle-focused studies mainly used hydrogels and often included non-endothelial cells.ConclusionsFibrin scaffolds are highly relevant for soft tissue engineering, with outcomes influenced by formulation, fibrinogen source, and cell embedding. However, experimental design variability and lack of standardised reporting hinder reproducibility and clinical translation. To support future research, a minimum information checklist was created to promote consistent reporting, while aggregated success rates across design parameters could guide scaffold design.Registration & fundingPROSPERO [CRD42025612994] and OSF [10.17605/osf.io/nvfdj]. No funding body was directly involved.

Abstract licence: CC BY

ObjectiveThe safety of endoscopic thrombin injection (ETI) for treating the bleeding of gastric varix (GV) in patients with portal hypertension requires further evaluation. This meta-analysis systematically reviews the available evidence on the efficacy and safety of ETI for GV bleeding.MethodsTwo researchers independently screened and extracted data from all relevant original articles published from database inception to May 2025. Study quality was assessed using the Methodological Index for Non-Randomized Studies tool. Meta-analysis was performed using RevMan 5.3 software, with risk of bias assessed via risk of bias plots and funnel plots.ResultsThirteen studies involving 417 patients were included. Meta-analysis revealed an initial hemostasis rate of 93% (95% confidence interval [CI]: 0.89-0.95), a 5-day rebleeding rate of 11% (95% CI: 0.07-0.17), a late rebleeding rate of 14% (95% CI: 0.11-0.19), a complete GV obliteration rate of 36% (95% CI: 0.11-0.73), and a 6-week GV-related mortality rate of 9% (95% CI: 0.06-0.15). The overall complication rate was 2.2% (9/417), with fever and leukocytosis being the most common events.ConclusionEndoscopic thrombin injection for GV bleeding appears to achieve high initial hemostasis with low rates of rebleeding in the available studies. Reported complication rates were low, though systematic assessment was not consistently described across studies. It is suggested the potential efficacy and an acceptable safety profile within the available evidences.

Abstract licence: CC BY