A Survey of Anaesthetists’ Use of Tranexamic Acid in Vascular Surgery


This survey has been approved by the VASGBI Research and Audit Committee.

We would be grateful for your support in completing this survey looking at the use of Tranexamic Acid in Vascular Surgery. Please click here to complete the survey.

Tranexamic Acid (TXA) is an important component of perioperative patient blood management (PBM) [1]. Whilst routine use of TXA is an established practice in cardiac and orthopaedic surgery, the 2023 National Comparative Audit of Blood Transfusion found that only 13.5% of patients undergoing vascular surgery who may have been eligible to receive TXA actually received it [2]. The reasons for this are unclear but may, in part, be due a perceived increased risk of graft thrombosis and lack of efficacy. Our recent systematic review found no evidence of an effect of TXA on thromboembolic complications [11], but the certainty of evidence was low.

The aims of this survey are to:

(i) ascertain current patterns of TXA administration in vascular surgery
(ii) assess vascular anaesthetists’ understanding of the evidence base
(iii) obtain the views of the anaesthetic and peri-operative medicine community on the acceptability of conducting research, using alternative study designs, to increase the use of TXA in vascular surgery

The role of TXA in vascular surgery remains unclear at present, and it is unlikely that a large randomised controlled trial on TXA in vascular surgery will be funded. There is a need to identify and address barriers to use of TXA in vascular surgery.

If you require any further information, please do not hesitate to contact Dr Shah or his colleagues by using the contact details below.

Dr Akshay Shah, Consultant Anaesthetist, Hammersmith Hospital, Imperial College Healthcare NHS Trust
Senior Research Fellow, University of Oxford.

Dr Jeremy Fabes, Consultant Anaesthetist, University Hospitals Plymouth NHS Trust, Honorary Associate Professor, University of Plymouth, Post-Doctoral Fellow, NIHR Southampton Biomedical Research Centre.

Miss Karyna Atha, Medical Student, University of Oxford Medical School.

Miss Kasia Bera, Senior Clinical Fellow in Vascular Surgery, Honorary Senior Postdoctoral Research Fellow, Nuffield Department of Surgical Sciences.

References
1) National Institute for Health and Care Excellence. Blood transfusion: NICE Guideline [Internet]. 2015. Available from: https://www.nice.org.uk/guidance/ng24 [Accessed 30th September 2024]

2) 2023 National Comparative Audit of NICE Quality Standard QS138. Available from: https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/32833/2023-nice-qs138-final-audit-report.pdf [Accessed 30th September 2024]

3) Atha K, Corrigan L, Bera K, Shah A. Safety and efficacy of tranexamic acid in major non-cardiac vascular surgery: a systematic review and meta-analysis. J Vasc Soc GB Irel. 2024;3:194-202.

Thank you for your consideration.