Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery
AbstractSurgery of complex cranial base lesions carries a high risk of damage to
main vessels, often resulting in life-changing or even life-threatening injuries. We
describe a rapid, effective, and noninvasive application of a collagen-based
hemostatic patch to repair the vertebral artery during cranial surgery. A
61-year-old male patient underwent retrosigmoid craniotomy to remove a foramen
magnum meningioma that encased the vertebral artery. A linear incision was made
behind the ear and standard retrosigmoid craniotomy was performed with preservation
of the transverse and sigmoid sinuses. The dura was opened in a Y-shaped fashion and
the cerebellum was retracted with cerebrospinal fluid being released. Removing the
exposed tumor from the artery resulted in a small arterial bleed. Two pieces of anN-hydroxysuccinimide-functionalized
polyethylene glycol-coated collagen patch (Hemopatch®,
Baxter Healthcare Ltd.) were applied sequentially and were pressed to the bleed site
for 2 min each. Hemostasis of the vertebral artery was achieved at the patient’s
regular blood pressure. There was no postoperative bleeding, dissection or
pseudoaneurysm. The patient recovered gradually with several cranial nerve deficits.
There was no brain stem stroke. Twelve mont hs on, the patient has made an excellent
recovery from surgery, is independently mobile and has minimal cranial nerve
deficits. Application of the collagen-based hemostati...
Source: Neurology and Therapy - Category: Neurology Source Type: research
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