The Use of Fibrin Glue to Stop Venous Bleeding in the Epidural Space, Vertebral Venous Plexus, and Anterior Cavernous Sinus

2008 ◽  
Vol 19 (2) ◽  
pp. 546-547
Author(s):  
Patrick Cole ◽  
Larry Hollier
Keyword(s):  
Fibrin Glue ◽  
Cavernous Sinus ◽  
Epidural Space ◽  
Venous Plexus ◽  
Venous Bleeding

The Use of Fibrin Glue to Stop Venous Bleeding in the Epidural Space , Vertebral Venous Plexus, and Anterior Cavernous Sinus: Technical Note

2007 ◽  
Vol 61 (suppl_3) ◽  
pp. ONS-E51-ONS-E51 ◽  
Author(s):  
Laligam N. Sekhar ◽  
Sabareesh K. Natarajan ◽  
Tom Manning ◽  
Dolin Bhagawati
Keyword(s):  
Fibrin Glue ◽  
Cavernous Sinus ◽  
Epidural Space ◽  
Senior Author ◽  
Technical Note ◽  
Venous Plexus ◽  
Baxter Healthcare ◽  
Superior Petrosal Sinus ◽  
Venous Bleeding ◽  
Glue Injection

Abstract Objective: Various techniques have been used to stop venous bleeding from the epidural space, vertebral venous plexus, and cavernous sinus. Here, we describe our experience with the use of fibrin glue to stop venous bleeding in these areas. Methods: During the last 8 years, the senior author (LNS) has used injection of Tisseel fibrin glue (Baxter Healthcare Corp., Deerfield, IL) into the epidural space (n = 200 patients), anterior cavernous sinus (n = 46 patients), vertebral venous plexus (n = 20 patients), and superior petrosal sinus (n = 20 patients) to assist in hemostasis. The technical nuances are illustrated in three videos. Results: Injection of fibrin glue in the epidural space, anterior cavernous sinus, and vertebral venous plexus yielded good results in assisting with hemostasis. Two patients experienced complications caused by occlusion of veins draining the brainstem after fibrin glue was injected into the superior petrosal sinus. Conclusion: Fibrin glue injection is an excellent option for hemostasis in the epidural space, anterior cavernous sinus, and vertebral venous plexus. However, based on our experience, fibrin glue injection into the superior petrosal sinus is not recommended.

scholarly journals Case Report: Internal Carotid Artery Thrombosis: A Rare Complication After Fibrin Glue Injection for Cavernous Sinus Hemostasis

2021 ◽  
Vol 8 ◽  
Author(s):  
Hugo Andrade-Barazarte ◽  
Zhongcan Chen ◽  
Chenyi Feng ◽  
Visish M. Srinivasan ◽  
Charuta G. Furey ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Skull Base ◽  
Fibrin Glue ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Rare Complication ◽  
Patient Consent ◽  
Venous Bleeding ◽  
Glue Injection

Background: Fibrin glue injection within the cavernous sinus (CS) is a demonstrably safe and simple technique to control venous bleeding with a low complication rate. However, this technique does have inherent risks. We illustrate 2 cases of internal carotid artery (ICA) thrombosis after fibrin glue injection in the CS for hemostasis.Methods: After encountering this complication recently, we conducted a retrospective review of the surgical database of 2 senior neurosurgeons who specialize in cerebrovascular and skull base surgery to identify patients with any complications associated with the use of fibrin glue injection for hemostasis. Approval was given by respective institutional review boards, and patient consent was obtained.Results: Of more than 10,000 microsurgery procedures performed by 2 senior neurosurgeons with a combined experience of 40 years, including procedures for aneurysms and skull base tumors, 2 cases were identified involving ICA thrombosis after fibrin glue injection in the CS for hemostasis. Both cases involved severe ischemic complications as a result of the ICA thrombosis. In this article, we present their clinical presentation, characteristics, management, and outcomes.Conclusion: Direct injection of fibrin glue into the CS for hemostasis can effectively control venous bleeding and facilitate complex dissections. However, it can be associated with ICA thrombosis, with subsequent serious ischemia and poor prognosis. Although this complication appears to be rare, increased awareness of this problem should temper the routine use of fibrin glue in anterior clinoidectomy and transcavernous approaches.

Taming the Cavernous Sinus: Technique of Hemostasis Using Fibrin Glue

Skull Base ◽  
2007 ◽  
Vol 17 (S 2) ◽  
Author(s):  
Ali Krisht ◽  
Niklaus Krayenbuhl ◽  
Ahmad Hafez ◽  
Juha Hernesniemi
Keyword(s):  
Fibrin Glue ◽  
Cavernous Sinus

scholarly journals Morphometrical Study of the Lumbar Segment of the Internal Vertebral Venous Plexus in Dogs: A Contrast CT-Based Study

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1502
Author(s):  
Valeria Ariete ◽  
Natalia Barnert ◽  
Marcelo Gómez ◽  
Marcelo Mieres ◽  
Bárbara Pérez ◽  
...  
Keyword(s):  
Epidural Space ◽  
Ct Images ◽  
Venous Plexus ◽  
Morphological Pattern ◽  
Vertebral Canal ◽  
Dural Sac ◽  
Internal Vertebral Venous Plexus ◽  
Adjacent Structures ◽  
Contrast Ct ◽  
Enhanced Computed Tomography

The internal vertebral venous plexus (IVVP) is a thin-walled, valveless venous network that is located inside the vertebral canal, communicating with the cerebral venous sinuses. The objective of this study was to perform a morphometric analysis of the IVVP, dural sac, epidural space and vertebral canal between the L1 and L7 vertebrae with contrast-enhanced computed tomography (CT). Six clinically healthy adult dogs weighing between 12 kg to 28 kg were used in the study. The CT venographic protocol consisted of a manual injection of 880 mgI/kg of contrast agent (587 mgI/kg in a bolus and 293 mgI/mL by continuous infusion). In all CT images, the dimensions of the IVVP, dural sac, and vertebral canal were collected. Dorsal reconstruction CT images showed a continuous rhomboidal morphological pattern for the IVVP. The dural sac was observed as a rounded isodense structure throughout the vertebral canal. The average area of the IVVP ranged from 0.61 to 0.74 mm2 between L1 and L7 vertebrae (6.3–8.9% of the vertebral canal), and the area of the dural sac was between 1.22 and 7.42 mm2 (13.8–72.2% of the vertebral canal). The area of the epidural space between L1 and L7 ranged from 2.85 to 7.78 mm2 (27.8–86.2% of the vertebral canal). This CT venography protocol is a safe method that allows adequate visualization and morphometric evaluation of the IVVP and adjacent structures.

Taming the Cavernous Sinus: Technique of Hemostasis Using Fibrin Glue

2007 ◽  
Vol 61 (suppl_3) ◽  
pp. ONS-E52-ONS-E52 ◽  
Author(s):  
Niklaus Krayenbühl ◽  
Ahmad Hafez ◽  
Juha A. Hernesniemi ◽  
Ali F. Krisht
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Fibrin Glue ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Cranial Base ◽  
Sinus Surgery ◽  
Microsurgical Anatomy ◽  
Glue Injection

Abstract Objective: Improved understanding of the microsurgical anatomy of the cranial base region has made surgery in and through the cavernous sinus safer. However, continuous venous oozing that occurs during cavernous sinus surgery can cause significant blood loss and poor visualization. We describe a technique that will help minimize cavernous sinus bleeding and improve the safety of the surgical steps. Methods: The lateral wall of the cavernous sinus is exposed. Cavernous sinus access windows between the V1 and V2 branches of the trigeminal nerve and posterior to the clinoidal internal carotid artery are used to inject fibrin glue into the different cavernous sinus compartments. Postoperative follow-up cerebral angiography in basilar apex aneurysms clipped using the transcavernous approach were evaluated for cavernous sinus patency during the venous phase. Results: Fibrin glue injection between V1 and V2 obliterated the lateral cavernous sinus compartment. Fibrin glue injection posterior to the clinoidal segment of the internal carotid artery obliterated the medial compartment of the cavernous sinus. These steps were used in 217 surgical procedures (95 benign and 9 malignant neoplastic lesions; 113 aneurysms). There were no significant clinical side effects. Follow-up angiographic controls of basilar aneurysms operated on via the transcavernous approach consistently showed the reestablishment of flow within the cavernous sinus as early as 2 to 3 months postoperatively. Conclusion: Presently, the use of hemostatic agents and the better understanding of the microsurgical anatomy of the cranial base and cavernous sinus enable us to tame the cavernous sinus and operate in and around it with a high degree of safety.

scholarly journals New method of stopping bleeding from the presacral venous plexus during the rectal cancer operation: a case report

2018 ◽  
Vol 8 (3) ◽  
pp. 42-45
Author(s):  
E. M. Parfir’eva ◽  
A. O. Ivchenko ◽  
O. A. Ivchenko
Keyword(s):  
Rectal Cancer ◽  
Case Report ◽  
Pore Size ◽  
Reliable Method ◽  
Pelvic Surgery ◽  
Bleeding Control ◽  
Venous Plexus ◽  
Fatal Complication ◽  
Rectal Cancer Operation ◽  
Venous Bleeding

Presacral venous bleeding is a rare but potentially fatal complication in pelvic surgery. This type of bleeding is difficult to control. Existing methods are not without shortcomings, therefore, the search for a more reliable method. We are present a case of successful bleeding control using by plates of medium-porous nitinol (pore size of 300–450 μm, permeability of 12 × 10–9). Hemostasis was carried out by pressing  a plate to the bleeding zone for 4 minutes.

scholarly journals Spinal Epidural Arteriovenous Fistula: A Unique Pathway into the Perimedullary Vein

2009 ◽  
Vol 15 (4) ◽  
pp. 466-469 ◽  
Author(s):  
S.M. Lim ◽  
I.S. Choi
Keyword(s):  
Epidural Space ◽  
Clinical Symptoms ◽  
Vascular Malformations ◽  
Venous Pressure ◽  
Venous Plexus ◽  
Previous Surgery ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Spinal Dural Arteriovenous Fistulas ◽  
Spinal Epidural

Spinal dural arteriovenous fistulas (AVFs) are rare vascular malformations in the spinal dura, fed by dural branches of the radicular arteries, and drain primarily into intradural venous plexuses. They may cause elevated medullary venous pressure and produce a progressive myelopathy. We describe a case of AVF in the epidural space of the previous surgery site of L3 and it showed a unique complex venous pathway into the perimedullary vein, leading to classic clinical symptoms of venous congestion in the spinal cord. The shunt was draining into bilateral epidural venous plexus and then to the paravertebral veins at the level of L2. The venous outflow entered to the epidural space again and finally refluxed into the intradural perimedullary vein.

Merits of intralesional fibrin glue injection in surgery for the cavernous sinus cavernous hemangiomas

2002 ◽  
Vol 97 (3) ◽  
pp. 718-721 ◽  
Author(s):  
Il-Man Kim ◽  
Man-Bin Yim ◽  
Chang-Young Lee ◽  
Eun-Ik Son ◽  
Dong-Won Kim ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Fibrin Glue ◽  
Cavernous Sinus ◽  
Content Type ◽  
Cavernous Hemangiomas ◽  
Novel Method ◽  
Glue Injection ◽  
Tumor Bleeding ◽  
Fine Print ◽  
Intratumoral Injections

✓ In planning surgical treatment for extraaxial cavernous hemangiomas, care should be taken to control severe tumor bleeding. The authors present a case of a large cavernous hemangioma of the cavernous sinus, which was completely removed with the aid of multiple intratumoral injections of fibrin glue. This novel method is very effective for preventing excessive blood loss during surgery for this type of lesion.

scholarly journals Surgical management of presacral bleeding

2014 ◽  
Vol 96 (4) ◽  
pp. 261-265 ◽  
Author(s):  
V Celentano ◽  
JR Ausobsky ◽  
P Vowden
Keyword(s):  
Rectal Surgery ◽  
Alternative Methods ◽  
Primary Data ◽  
Venous Plexus ◽  
Presacral Bleeding ◽  
Creative Solutions ◽  
Life Threatening ◽  
Venous Bleeding ◽  
Comprehensive Classification

Introduction Presacral venous bleeding is an uncommon but potentially life threatening complication of rectal surgery. During the posterior rectal dissection, it is recommended to proceed into the plane between the fascia propria of the rectum and the presacral fascia. Incorrect mobilisation of the rectum outside the Waldeyer’s fascia can tear out the lower presacral venous plexus or the sacral basivertebral veins, causing what may prove to be uncontrollable bleeding. Methods A systematic search of the MEDLINE® and Embase™ databases was performed to obtain primary data published in the period between 1 January 1960 and 31 July 2013. Each article describing variables such as incidence of presacral venous bleeding, surgical approach, number of cases treated and success rate was included in the analysis. Results A number of creative solutions have been described that attempt to provide good tamponade of the presacral haemorrhage, eliminating the need for second operation. However, few cases are reported in the literature. Conclusions As conventional haemostatic measures often fail to control this type of haemorrhage, several alternative methods to control bleeding definitively have been described. We propose a practical comprehensive classification of the available techniques for the management of presacral bleeding.

Effect of Fibrin Glue Injection Into the Cavernous Sinus for Hemostasis During Transcavernous Surgery on the Cerebral Venous Draining System

2017 ◽  
Vol 13 (2) ◽  
pp. 224-231 ◽  
Author(s):  
Terushige Toyooka ◽  
Naoki Otani ◽  
Kojiro Wada ◽  
Arata Tomiyama ◽  
Hideaki Ueno ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Cavernous Sinus ◽  
Venous Drainage ◽  
Oxidized Cellulose ◽  
Brain Swelling ◽  
Drainage Pattern ◽  
Injection Volume ◽  
3 Dimensional ◽  
Glue Injection ◽  
Computed Tomography Venography

Abstract BACKGROUND: The extradural temporopolar transcavernous approach can be used to treat central skull base pathologies, but control of bleeding from the opened cavernous sinus is essential. Oxidized cellulose cotton packing and fibrin glue injection can be used, but the effect on the postoperative venous draining pattern remains unclear. OBJECTIVE: To investigate changes in the venous drainage pattern immediately after transcavernous surgery with and without fibrin glue injection into the bleeding cavernous sinus. METHODS: A total of 82 patients treated via the transcavernous approach were retrospectively divided into 2 groups based on the hemostasis methods. Both pre- and postoperative angiography and/or 3-dimensional computed tomography venography were available for 24 patients in the cotton packing group and 12 patients in the fibrin glue group. RESULTS: Postoperative change in the venous draining pattern was observed in 5 of the 24 patients in the cotton packing group and in 3 of the 12 patients in the fibrin glue group. One of the 82 patients showed postoperative brain swelling due to obstruction of the sphenoparietal sinus. The volume of injected fibrin glue ranged from 0.5 to 2.5 mL (mean, 1.1 ± 0.5 mL), but none of the patients had brain swelling. CONCLUSION: Direct fibrin glue injection into the opened cavernous sinus is relatively safe, but a change in the venous draining pattern occurs in 25% of patients. The study indicates the potential danger of the change in the venous draining pattern and recommends limiting the injection volume of fibrin glue in transcavernous surgery to avoid complications related to venous congestion.

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