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DOI: 10.1055/s-0038-1675565
TachoSil Dural Reconstruction in Extracranial-Intracranial Bypass Surgeries
Publikationsverlauf
05. Dezember 2017
14. Mai 2018
Publikationsdatum:
15. November 2018 (online)
Abstract
Background Superficial temporal artery to middle cerebral artery (STA-MCA) bypass is a treatment option for hemodynamic insufficiency in the anterior cerebral circulation. Complications associated with extracranial-intracranial bypass surgeries are ischemic strokes caused by bypass failure, wound-healing disorders, and further issues from cerebrospinal fluid (CSF) leakage. CSF leakage can provide pathways for infection. It is well known in general neurosurgery that watertight closure of the dura mater is necessary to prevent such complications.
Objective To provide a technical description of TachoSil dural reconstruction in standard STA-MCA bypasses and their follow-up analyses.
Methods In this technical report with observational follow-up, the dura mater was closed partially by adaptive sutures, and the perforation site of the donor vessel was sealed with TachoSil. TachoSil is a collagen sponge covered with clotting factors that provides hemostatic and sealing effects.
Results Our study included eight cases of standard STA-MCA bypasses that had been operated between July 2015 and September 2016. Follow-up examinations were completed for all patients at 1 month and 6 months after surgery. Duplex and Doppler ultrasound demonstrated regular bypass patency in all patients without increased flow velocity at the perforation sites, which is a possible sign of stenosis. No wound-healing disorders or CSF leakage occurred. No cerebrovascular stroke events were observed.
Conclusion Duraplasty with TachoSil enables the elastic reconstruction of the dura perforation gap in standard extracranial-intracranial bypass surgeries.
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References
- 1 Gratzl O, Schmiedek P, Spetzler R, Steinhoff H, Marguth F. Clinical experience with extra-intracranial arterial anastomosis in 65 cases. J Neurosurg 1976; 44 (03) 313-324
- 2 Mehdorn HM. Cerebral revascularization by EC-IC bypass—present status. Acta Neurochir Suppl (Wien) 2008; 103: 73-77
- 3 Rodríguez-Hernández A, Josephson SA, Lawton MT. Bypass surgery for the prevention of ischemic stroke: current indications and techniques. Neurocirugia (Astur) 2012; 23 (01) 5-14
- 4 Vajkoczy P. Revival of extra-intracranial bypass surgery. Curr Opin Neurol 2009; 22 (01) 90-95
- 5 Yasargil MG. Microsurgery Applied to Neurosurgery. 6th ed. Stuttgart, Germany: Thieme; 2007: 105
- 6 Abla AA, Gandhoke G, Clark JC. , et al. Surgical outcomes for moyamoya angiopathy at Barrow Neurological Institute with comparison of adult indirect encephaloduroarteriosynangiosis bypass, adult direct superficial temporal artery-to-middle cerebral artery bypass, and pediatric bypass: 154 revascularization surgeries in 140 affected hemispheres. Neurosurgery 2013; 73 (03) 430-439
- 7 Schubert GA, Biermann P, Weiss C. , et al. Risk profile in extracranial/intracranial bypass surgery—the role of antiplatelet agents, disease pathology, and surgical technique in 168 direct revascularization procedures. World Neurosurg 2014; 82 (05) 672-677
- 8 Spetzler RF, Schuster H, Roski RA. Elective extracranial-intracranial arterial bypass in the treatment of inoperable giant aneurysms of the internal carotid artery. J Neurosurg 1980; 53 (01) 22-27
- 9 Cosgrove GR, Delashaw JB, Grotenhuis JA. , et al. Safety and efficacy of a novel polyethylene glycol hydrogel sealant for watertight dural repair. J Neurosurg 2007; 106 (01) 52-58
- 10 Houkin K, Ishikawa T, Yoshimoto T, Abe H. Direct and indirect revascularization for moyamoya disease surgical techniques and peri-operative complications. Clin Neurol Neurosurg 1997; 99 (Suppl. 02) S142-S145
- 11 Kim GW, Joo SP, Kim TS. , et al. Arachnoid membrane suturing for prevention of subdural fluid collection in extracranial-intracranial bypass surgery. J Cerebrovasc Endovasc Neurosurg 2014; 16 (02) 71-77
- 12 Kumar A, Maartens NF, Kaye AH. Evaluation of the use of BioGlue in neurosurgical procedures. J Clin Neurosci 2003; 10 (06) 661-664
- 13 Takanari K, Araki Y, Okamoto S. , et al. Operative wound-related complications after cranial revascularization surgeries. J Neurosurg 2015; 123 (05) 1145-1150
- 14 Sawamura Y, Asaoka K, Terasaka S, Tada M, Uchida T. Evaluation of application techniques of fibrin sealant to prevent cerebrospinal fluid leakage: a new device for the application of aerosolized fibrin glue. Neurosurgery 1999; 44 (02) 332-337
- 15 Nishimura K, Kimura T, Morita A. Watertight dural closure constructed with DuraSeal TM for bypass surgery. Neurol Med Chir (Tokyo) 2012; 52 (07) 521-524
- 16 Yoshimoto T, Sawamura Y, Houkin K, Abe H. Effectiveness of fibrin glue for preventing postoperative extradural fluid leakage. Neurol Med Chir (Tokyo) 1997; 37 (12) 886-889 ; discussion 889–890
- 17 Kivelev J, Göhre F, Niemelä M, Hernesniemi J. Experiences with TachoSil® in microneurosurgery. Acta Neurochir (Wien) 2015; 157 (08) 1353-1357 ; discussion 1357
- 18 Matula C, Steiger C. Hemostasis and Fleece-Bound Sealing in Neurosurgery. Stuttgart, Germany: Thieme; 2005
- 19 George B, Matula C, Kihlström L, Ferrer E, Tetens V. Safety and efficacy of TachoSil (absorbable fibrin sealant patch) compared with current practice for the prevention of cerebrospinal fluid leaks in patients undergoing skull base surgery: a randomized controlled trial. Neurosurgery 2017; 80 (06) 847-853
- 20 Peña-Tapia PG, Kemmling A, Czabanka M, Vajkoczy P, Schmiedek P. Identification of the optimal cortical target point for extracranial-intracranial bypass surgery in patients with hemodynamic cerebrovascular insufficiency. J Neurosurg 2008; 108 (04) 655-661
- 21 Barth M, Tuettenberg J, Thomé C, Weiss C, Vajkoczy P, Schmiedek P. Watertight dural closure: is it necessary? A prospective randomized trial in patients with supratentorial craniotomies. Neurosurgery 2008; 63 (04) (Suppl. 02) 352-358 ; discussion 358
- 22 Nossek E, Langer DJ. How I do it: combined direct (STA-MCA) and indirect (EDAS) EC-IC bypass. Acta Neurochir (Wien) 2014; 156 (11) 2079-2084
- 23 Wanebo JE, Zabramski JM, Spetzler RF. Superficial temporal artery-to-middle cerebral artery bypass grafting for cerebral revascularization. Neurosurgery 2004; 55 (02) 395-398 ; discussion 398–399
- 24 Wintermantel E, Ha Suk-Woo. Medizintechnik mit biokompatiblen Werkstoffen und Verfahren. 3rd ed. Heidelberg, Germany: Springer; 2002: 190
- 25 Genyk Y, Kato T, Pomposelli JJ. , et al. Fibrin sealant patch (TachoSil) vs oxidized regenerated cellulose patch (Surgicel original) for the secondary treatment of local bleeding in patients undergoing hepatic resection: a randomized controlled trial. J Am Coll Surg 2016; 222 (03) 261-268
- 26 Birth M, Figueras J, Bernardini S. , et al. Collagen fleece-bound fibrin sealant is not associated with an increased risk of thromboembolic events or major bleeding after its use for haemostasis in surgery: a prospective multicentre surveillance study. Patient Saf Surg 2009; 3 (01) 13
- 27 Colombo GL, Bettoni D, Di Matteo S. , et al. Economic and outcomes consequences of TachoSil®: a systematic review. Vasc Health Risk Manag 2014; 10: 569-575