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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Safety and efficacy of microporous polysaccharide hemospheres – Arista – in neurosurgery

Meeting Abstract

  • Christoph A. Tschan - Neurochirurgische Universitätsklinik, Johannes Gutenberg-Universität, Mainz, Germany
  • Meike Nieß - Neurochirurgische Universitätsklinik, Johannes Gutenberg-Universität, Mainz, Germany
  • Eike Schwandt - Neurochirurgische Universitätsklinik, Johannes Gutenberg-Universität, Mainz, Germany
  • Joachim Oertel - Neurochirurgische Universitätsklinik, Johannes Gutenberg-Universität, Mainz, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1740

DOI: 10.3205/10dgnc211, URN: urn:nbn:de:0183-10dgnc2114

Published: September 16, 2010

© 2010 Tschan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Effective hemostasis is mandatory for excellent results in brain tumor surgery. Microporous polysaccharide hemospheres (MPH®, Arista-AH™) are already available for surgical and emergency purposes. This is the first study evaluating the safety and efficacy of Arista in neurosurgery.

Methods: Thirty-three patients (mean age 58 y, range 22 to 84 y) underwent microsurgical brain tumor resection. The final hemostasis was performed with Arista. Arista is a white powder compounded from potato starch. Hemostasis was video-recorded and analyzed. Blood samples were taken before the operation, prior to Arista application and after the operation. Volume measurement of tumor size, resection cavity and postoperative hematoma were evaluated according to MRI- and CT-scans. Clinical examinations were focused on neurological outcome and allergic reactions.

Results: Effective hemostasis was achieved by the exclusive use of Arista in 32 patients. In one patient, a single arterial bleeding had to be treated with additional bipolar electrocautery. Mean operative time was 156.8 min (60 to 235 min). Complete hemostasis was achieved within an average time of 272 sec (range 28 to 944 sec). 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 or signs of allergic reaction or embolic complication were seen. Early postoperative MRI- or CT-scan and 3-month follow-up excluded any expansive bleeding complication. Arista was not detectable anymore and there was no tumor-mimicking contrast-enhancement.

Conclusions: In neurosurgery, Arista allows fast and effective, minimally-invasive and cost-effective hemostasis. In this small case series, no adverse reactions were found.