title: A combination of wrapping and clipping using a collagen-impregnated dacron fabric (Hemashield).
abstract: 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.
authors.affiliation: Department of Neurosurgery, Miyazaki Medical College, Miyazaki, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nakano
authors.forename: T
authors.initials: T
authors.lastname: Iseda
authors.forename: T
authors.initials: T
authors.lastname: Yoneyama
authors.forename: T
authors.initials: T
authors.lastname: Ikeda
authors.forename: T
authors.initials: T
authors.lastname: Goya
authors.forename: S
authors.initials: S
authors.lastname: Wakisaka
mesh_terms: 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
chemical_list: D011093:Polyethylene Terephthalates; D003094:Collagen