Introduction: Topical hemostatic agents made from collagen or gelatin and mixed with thrombin are commonly used to facilitate hemostasis in patients undergoing tumor resection. Association between the use of hemostatic agents and thromboembolic events in patients undergoing meningioma resection has been recently suggested.
Methods: The authors conducted a retrospective, multicenter, clinical review of all craniotomies between 2013 and 2014 to evaluate the relationship between flowable hemostatic matrix (with or without thrombin)application and deep vein thrombosis and pulmonary embolism in 932 patients treated for brain tumor removal.
Results: Thromboembolic events were identified in 24 patients in which gelatin matrix with thrombin was applied, in 19 patients in which gelatin matrix without thrombin and in 5 cases in which classical methods of hemostasis was used.
Conclusions: there were no significant differences in age, procedure duration and hemostatic use, while thromboembolic events increased according to tumor pathology, tumor location and application of hemostatic near venus sinuses.
Patient Care: Partecipants should be able to apply flowable hemostatic matrix correctly, avoiding postoperative thromboembolic events.
Learning Objectives: By the conclusion of this session, partecipants should be able to identify in which location is better not to apply flowable hemostatic matrix to avoid postoperative thromboembolic events.
References: 1)Minimal craniotomy and matrix hemostatic sealant for the treatment of spontaneous supratentorial intracerebral hemorrhage. Gazzeri R, Galarza M, Neroni M, Alfieri A, Esposito S. J Neurosurg. J Neurosurg. 2009 110 (5) 939-942 .
2) Hemostatic matrix sealant in neurosurgery: a clinical and imaging study. Gazzeri R, Galarza M, Neroni M, Alfieri A, Giordano M. Acta Neurochir (Wien). 2010 2011 Jan;153(1):148-54
3)The Safety and Biocompatibility of Gelatin Hemostatic Matrix (Floseal and Surgiflo) in Neurosurgical Procedures. Gazzeri R, Galarza M, Alfieri A. Surg Technol Int. 2012 Sep 1;XXII. doi:pii: sti22/3.