The use of fibrin glue to stop venous bleeding in the epidural space, vertebral venous plexus, and anterior cavernous sinus: technical note.
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.


CONCLUSIONS
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.
Sekhar
Laligam N
LN
Department of Neurological Surgery, University of Washington, Seattle, Washington 98104, USA. lsekhar@u.washington.edu
Natarajan
Sabareesh K
SK
Manning
Tom
T
Bhagawati
Dolin
D
D002426:Cavernous Sinus; D004824:Epidural Space; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006470:Hemorrhage / Q000628:therapy*; D006489:Hemostatic Techniques; D006801:Humans; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000628:therapy*
D015718:Fibrin Tissue Adhesive