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A combination of wrapping and clipping using a collagen-impregnated dacron fabric (Hemashield)
S Nakano1, T Iseda, T Yoneyama
1Department of Neurosurgery, Miyazaki Medical College, Miyazaki, Japan.
Background:
We describe techniques combining wrapping and clipping using a collagen-impregnated Dacron knitted fabric (Hemashield) for accidental arterial perforations and broad-based aneurysms. The results of these techniques in seven patients are presented.
Methods:
Clip-reinforced wrapping was performed to obtain hemostasis in two patients with arterial perforations and in a patient with a ruptured broad-based aneurysm in the internal carotid artery. Clipping of the broad neck of the aneurysm and wrapping with Hemashield (wrap-clipping) was performed in four patients with unruptured aneurysms (one internal carotid artery, two middle cerebral artery, one basilar artery).
Results:
In the three patients treated with clip-reinforced wrapping, complete hemostasis was obtained just after clip application. In the patient with a ruptured broad-based aneurysm, postoperative angiography demonstrated that the dome of the aneurysm was well compressed. In the four patients treated with wrap-clipping, postoperative angiography revealed successful clipping of the broad neck of the aneurysm.
Conclusion:
In this early experience, there were no problems in the use of Hemashield for clip-reinforced wrapping or wrap-clipping.