gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Potato starch hemostasis in hypertensive intracerebral hemorrhage

Meeting Abstract

  • C.A. Tschan - Neurochirurgische Klinik und Poliklinik, Universitätskliniken des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg/Saar
  • G.R. Montibeller - Neurochirurgische Klinik und Poliklinik, Universitätskliniken des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg/Saar
  • M. Nieß - Neurochirurgische Klinik und Poliklinik, Universitätskliniken des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg/Saar
  • J. Oertel - Neurochirurgische Klinik und Poliklinik, Universitätskliniken des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg/Saar

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.06.07

DOI: 10.3205/12dgnc209, URN: urn:nbn:de:0183-12dgnc2092

Published: June 4, 2012

© 2012 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 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.