title: Gelfoam scaffold for vein prolapse during brain tumor surgery.
abstract: When resecting gliomas, extra-axial tumors, or their overlying cortex, cortical veins may become suspended over the resection cavity and ultimately prolapse and kink into the cavity, promoting venous thrombosis. To prevent this, we describe a technique to secure a Gelfoam scaffold beneath the cortical vein at the edge of the resection cavity to prevent kinking and possible thrombosis from taking place after tumor removal. Depending on the diameter of the resection cavity, this can be done at 1 or both edges of the resection cavity to prevent prolapse of the vein into the cavity. In our experience with this technique, during the past 10 years, there have been no cases of venous thrombosis after tumor removal on postoperative imaging or clinical examination.
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA. Electronic address: Hervey-JumperS@neurosurg.ucsf.edu.
authors.forename: Shawn L
authors.initials: SL
authors.lastname: Hervey-Jumper
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Breshears
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Mitchel S
authors.initials: MS
authors.lastname: Berger
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery*; D002550:Cerebral Veins / Q000601:surgery*; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D005910:Glioma / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*
keywords: Gelfoam; Glioma; Glioma surgery; Vein prolapse