Initial experiences with the Hemopatch® as a hemostatic agent in zero-ischemia partial nephrectomy

Imkamp, Florian; Tolkach, Yuri; Wolters, M.; Jutzi, S.; Kramer, Mario W.; Herrmann, Thomas

doi:10.1007/s00345-014-1404-4

Cited by 24 publications

(26 citation statements)

References 14 publications

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“…The patch needs no prior preparation and is stored at room temperature [1], allowing rapid availability during surgery. The current case report confirms the patch's utility during surgery, standing alongside critical appraisals of [10,12,13], a shorter mean surgery time [11], and no postoperative complications due to bleeding [15]. Overall, the performance of the collagenbased hemostatic patch for closure of dural defects in cranial surgery was highly satisfactory.…”

Section: Discussionsupporting

confidence: 75%

“…A polyethylene glycol-coated, collagen-based, sealing hemostatic patch (Hemopatch Ò , Baxter Healthcare Ltd.) has been designed to stop bleeding during surgical procedures and to simultaneously induce hemostasis [1,2]. This collagen-based hemostatic patch was safe and performed well against other sealing hemostats when tested in vivo using various surgical models [3][4][5][6][7][8][9], and in a range of surgeries in patients [10][11][12][13][14][15][16][17]. This case report is the first to describe the use of the collagen-based hemostatic patch for repair of vascular injury in a neurosurgical case involving the removal of meningioma in the foramen magnum.…”

Section: Introductionmentioning

confidence: 99%

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Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery

Prasad¹,

Mukerji²

2019

Neurol Ther

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Surgery of complex cranial base lesions carries a high risk of damage to main vessels, often resulting in life-changing or even life-threatening injuries. We describe a rapid, effective, and noninvasive application of a collagen-based hemostatic patch to repair the vertebral artery during cranial surgery. A 61-year-old male patient underwent retrosigmoid craniotomy to remove a foramen magnum meningioma that encased the vertebral artery. A linear incision was made behind the ear and standard retrosigmoid craniotomy was performed with preservation of the transverse and sigmoid sinuses. The dura was opened in a Y-shaped fashion and the cerebellum was retracted with cerebrospinal fluid being released. Removing the exposed tumor from the artery resulted in a small arterial bleed. Two pieces of an N-hydroxysuccinimide-functionalized polyethylene glycol-coated collagen patch (Hemopatch Ò , Baxter Healthcare Ltd.) were applied sequentially and were pressed to the bleed site for 2 min each. Hemostasis of the vertebral artery was achieved at the patient's regular blood pressure. There was no postoperative bleeding, dissection or pseudoaneurysm. The patient recovered gradually with several cranial nerve deficits. There was no brain stem stroke. Twelve months on, the patient has made an excellent recovery from surgery, is independently mobile and has minimal cranial nerve deficits. Application of the collagen-based hemostatic patch proved to be an efficient, safe, and noninvasive technique that achieved rapid hemostasis, confirming its effectiveness in complicated surgery, where risk of hemorrhage can be critical for the surgery outcome.

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery

Prasad¹,

Mukerji²

2019

Neurol Ther

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“…To date, there are no data from large clinical studies, but several case reports describe the use of PCC to treat bleeding in patients [28][29][30][31]. Interestingly, Erdas et al demonstrated in a randomized controlled pilot trial that FTC is not superior to standard hemostasis (ligation and use of a harmonic scalpel) in preventing postoperative bleeding risk in patients on antithrombotic therapy with vitamin K antagonists or ASA undergoing thyroid surgery [32].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Severe Aortic Bleeding Using Hemopatch in Swine on Dual Antiplatelet Therapy

Baumgartner

Draxler

Lewis

2016

Journal of Investigative Surgery

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Purpose: The perioperative management of patients on antithrombotic therapy is currently an unresolved problem as these therapies pose a considerable risk for perioperative hemorrhagic complications. The presented studies investigated the efficacy of a new collagen technology to achieve hemostasis. A polyethylene glycol-coated collagen pad (PCC) was compared to a marketed fibrinogen-thrombin coated collagen pad (FTC) for the treatment of an aortotomy incision in heparinized swine on dual antiplatelet therapy. Materials and Methods: Twenty-eight 3-mm aortotomy incisions were created in nine heparinized pigs without antiplatelet therapy and treated with PCC. Sixty-eight aortotomy incisions were created in ten heparinized pigs that received clopidogrel (10-11 mg/kg) and acetylsalicylic acid (8-11 mg/kg) orally for 5 days, and treated with either PCC or FTC (N = 34/group). Dual antiplatelet therapy resulted in significantly reduced platelet function. Aortotomy incisions resulted in lifethreatening bleeding of 35-292 ml/min. Results: In animals without antiplatelet treatment, PCC provided 96% immediate hemostatic success. In animals with antiplatelet treatment, FTC provided 18% immediate hemostatic success increasing to 74% after 10 min. Strikingly, PCC provided 94% immediate success increasing to 100% after 10 min. Controlling for differences in pretreatment bleeding rates, statistical model-estimated time to hemostasis was 12 times shorter in PCC-treated lesions (p < .02). Conclusion: The combination of a procoagulant collagen pad with a synthetic sealing component provides excellent hemostatic properties under a worst-case scenario. PCC rapidly and firmly adheres to tissue, thereby controlling severe arterial bleeding, even when platelet function is significantly reduced. Treatment with PCC provided superior time to hemostasis compared to FTC.

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“…FloSeal®, pıhtılaşma kaskatının son safhasını taklit eder. Sıfır iskemi tekniği ile yapılan laparoskopik parsiyel nefrektomide yeni bir hemostatik ajan olan Hemopatch®(polyethylene glycol-coated collagen patch, Baxter) kullanılmış ve çalışmalar küçük gruplarla sınırlı olsa da ilk izlenimlerde başarılı sonuçlar elde edilmiş [29].…”

Section: Kitle Eksizyonuunclassified

Laparoscopic Nephron Sparing Nephrectomy

Malkoç¹

2015

Surgical Treatment of Metastatic Renal Cell Carcinoma

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Derman Tıbbi Yayıncılık 55 GİRİŞ Böbrek tümörleri, genitoüriner sistem kanserleri gü-rülme sıklığı ve genitoüriner sistem kanserlerine bağlı-mortalitede üçüncüsırada yeralmaktadır [1]. Geçmişte büyük, semptomatik ve sıklıkla invaziv veya metastatik böbrek kitleleri olarak karşımıza çıkan böbrek tümör-leri günümüzde radyolojik tanıyöntemlerinin kullanım sıklığında artış ile birlikte rastlantısal olarak saptanan asemptomatik, küçük boyutlu böbrek kitleleri olarak karşımıza çıkmaktadır. Bununla birlikte günümüz-de böbrek kanserlerinin tedavisi, özellikle küçük böb-rek kitlelerine (KBK) yaklaşım kriterleri değişim gös-termiştir. KBK'leri genellikle 4 cm'den küçük, yavaş biyolojik davranışlı, düşük evre ve derecedeki kitleler olarak tanım-lanmaktadır [2] ve bu kitleler nefron koruyucu cerrahiye uygun olan kitlelerdir. Güncel çalışmalar düşük böb-rek fonksiyonları ile artmış kardiovasküler risk ve mortalite arasında güçlü bir bağlantı olduğunu göstermek-tedir [3]. Onkolojik cerrahide böbrek fonksiyonlarının korunmasıönem arz etmektedir ve bu nedenle parsiyel nefrektomi endikasyonları gün geçtikçe gelişmek-tedir [4].

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Initial experiences with the Hemopatch® as a hemostatic agent in zero-ischemia partial nephrectomy

Abstract: Although this study is limited to a small set of initial experiences with Hemopatch(®) in LPN, it proves the feasibility and reliability of this new hemostat. Following further evaluation in prospective randomized comparative studies, Hemopatch(®) might represent a promising tool in NSS.

Cited by 24 publications

References 14 publications

Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery

Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery

Treatment of Severe Aortic Bleeding Using Hemopatch in Swine on Dual Antiplatelet Therapy

Laparoscopic Nephron Sparing Nephrectomy

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