Sekhar Laligam N, Natarajan Sabareesh K, Manning Tom, Bhagawati Dolin
Department of Neurological Surgery, University of Washington, Seattle, Washington 98104, USA.
Neurosurgery. 2007 Sep;61(3 Suppl):E51; discussion E51. doi: 10.1227/01.neu.0000289711.95426.50.
Various techniques have been used to stop venous bleeding from the epidural space, vertebral venous plexus, and cavernous sinus. Here, we describe our experience with the use of fibrin glue to stop venous bleeding in these areas.
During the last 8 years, the senior author (LNS) has used injection of Tisseel fibrin glue (Baxter Healthcare Corp., Deerfield, IL) into the epidural space (n = 200 patients), anterior cavernous sinus (n = 46 patients), vertebral venous plexus (n = 20 patients), and superior petrosal sinus (n = 20 patients) to assist in hemostasis. The technical nuances are illustrated in three videos.
Injection of fibrin glue in the epidural space, anterior cavernous sinus, and vertebral venous plexus yielded good results in assisting with hemostasis. Two patients experienced complications caused by occlusion of veins draining the brainstem after fibrin glue was injected into the superior petrosal sinus.
Fibrin glue injection is an excellent option for hemostasis in the epidural space, anterior cavernous sinus, and vertebral venous plexus. However, based on our experience, fibrin glue injection into the superior petrosal sinus is not recommended.
已采用多种技术来阻止硬膜外间隙、椎静脉丛和海绵窦的静脉出血。在此，我们描述使用纤维蛋白胶来阻止这些部位静脉出血的经验。
在过去8年中，资深作者（LNS）已将Tisseel纤维蛋白胶（百特医疗保健公司，伊利诺伊州迪尔菲尔德）注入硬膜外间隙（200例患者）、海绵窦前部（46例患者）、椎静脉丛（20例患者）和岩上窦（20例患者）以辅助止血。三个视频展示了技术细节。
在硬膜外间隙、海绵窦前部和椎静脉丛注射纤维蛋白胶在辅助止血方面取得了良好效果。在将纤维蛋白胶注入岩上窦后，有两名患者出现因脑干引流静脉阻塞引起的并发症。
纤维蛋白胶注射是硬膜外间隙、海绵窦前部和椎静脉丛止血的极佳选择。然而，根据我们的经验，不建议将纤维蛋白胶注入岩上窦。
