Watertight Dural Closure Constructed With DuraSeal (TM) for Bypass Surgery -Technical Note-

作者：Nishimura Kengo; Kimura Toshikazu^*; Morita Akio

来源：Neurologia Medico-Chirurgica, 2012, 52(7): 521-524.

DOI：10.2176/nmc.52.521

• DuraSeal
• watertight closure
• cerebrospinal fluid leak
• pseudomeningocele
• superficial temporal artery-middle cerebral artery anastomosis

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.

• 出版日期2012-7