A combination of wrapping and clipping using a collagen-impregnated dacron fabric (Hemashield).
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.


CONCLUSIONS
In this early experience, there were no problems in the use of Hemashield for clip-reinforced wrapping or wrap-clipping.
Nakano
S
S
Department of Neurosurgery, Miyazaki Medical College, Miyazaki, Japan.
Iseda
T
T
Yoneyama
T
T
Ikeda
T
T
Goya
T
T
Wakisaka
S
S
D000368:Aged; D002533:Cerebral Angiography / Q000379:methods; D003094:Collagen / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004867:Equipment Design; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation*; D011093:Polyethylene Terephthalates / Q000627:therapeutic use
D011093:Polyethylene Terephthalates; D003094:Collagen