Artikel
Potato starch hemostasis in hypertensive intracerebral hemorrhage
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Veröffentlicht: | 4. Juni 2012 |
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Gliederung
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Objective: Effective hemostasis is mandatory for excellent results in Neurosurgery. Microporous polysaccharide hemospheres (MPH®, Arista-AH™) are already available as hemostatic substances for neurosurgical application. Here the safety and efficacy of Arista were evaluated for emergency surgery of intracerebral hypertensive hemorrhages.
Methods: Twenty-seven patients (mean age 68 y, range 43 to 84 y) underwent microsurgical evacuation of intracerebral hemorrhage. The final hemostasis was performed with Arista, a white powder compounded from potato starch. Hemostasis was video recorded and analyzed. Volume measurement of preoperative and postoperative bleeding size was done by CT-scans. Clinical examinations were focused on bleeding tendency, ingestion of blood thinning drugs and allergic reactions.
Results: After evacuation of the intracerebral blood, effective hemostasis was achieved very fast (30 seconds to 5 min) by exclusive use of Arista in all 27 patients. In 6 patients 1 g Arista was used, in 21 patients 2–3 g. Subjective ranking of the hemostasis effect resulted in excellent satisfaction of the neurosurgeons. During a follow-up period of 3 months, no Arista related postoperative neurological complication, signs of allergic reaction or embolic complication were seen. The postoperative and follow-up CT-scan excluded any expansive bleeding complication.
Conclusions: Arista allows fast and cost-effective hemostasis. The mechanism of hemostasis seems even to work in all cases of pathologically hemostasis. Hemostasis in eloquent areas or in the basal ganglia can be done safely without electrical coagulation. This white powder is very helpful for emergency surgery of intracerebral hemorrhages, especially in case of ingestion of blood thinning drugs.