title: Watertight dural closure constructed with DuraSeal TM for bypass surgery.
abstract: Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is a common procedure for the treatment of cerebral ischemia and is useful for cerebral aneurysms and tumors. The STA has to pass through the dura and the dura cannot be sutured tightly around the STA to prevent vessel narrowing, so subcutaneous cerebrospinal fluid (CSF) collection is common. This study analyzed the feasibility of using a synthetic dural sealant in the STA-MCA anastomosis to establish watertight closure. Twenty-four patients underwent STA-MCA anastomosis for cerebral ischemia or cerebral aneurysm. After creation of a standard STA-MCA anastomosis, the dura was reapproximated closely, leaving a small defect around the STA. Then, DuraSeal(TM) was sprayed over the dural defect, and a negative-pressure drain was positioned before closing the skin. Only two patients developed subcutaneous CSF collection, which was managed conservatively. The patency of the anastomosis was proven by magnetic resonance angiography in all cases, and no ischemic complication suggesting chemical spasm of the STA due to the sealant occurred. With DuraSeal(TM), watertight dural closure can be obtained easily and safely in bypass surgery.
authors: Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan.
authors: Kengo
authors: K
authors: Nishimura
authors: Toshikazu
authors: T
authors: Kimura
authors: Akio
authors: A
authors: Morita
mesh_terms: D002545:Brain Ischemia / Q000601:surgery*; D002548:Cerebral Revascularization / Q000379:methods*; D004338:Drug Combinations; D004388:Dura Mater / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D020768:Middle Cerebral Artery / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods*; D009842:Oligopeptides / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D013699:Temporal Arteries / Q000601:surgery
chemical_list: D004338:Drug Combinations; C570829:DuraSeal spinal sealant; D009842:Oligopeptides; D011092:Polyethylene Glycols