Use of a complete autologous blood recovery system (the Sorin Xtra® Autotransfusion System) during mechanical thrombectomy of extensive cerebral venous sinus thrombosis

Abstract

<jats:sec><jats:title>Background</jats:title><jats:p> The endovascular therapy for cerebral venous sinus thrombosis (CVST) is currently accepted as a second-line treatment for patients who have failed or those in whom systemic anticoagulation is contraindicated or in a subgroup of patients presenting with rapid neurologic deterioration. A number of different mechanical and pharmacologic endovascular strategies have been reported, either as separate or combined approaches. These new catheters and aspiration systems have a high power and vacuum capacity, which carries a risk of anemization of the patient and hypovolemic shock, being necessitating the transfusion of the patient. </jats:p></jats:sec><jats:sec><jats:title>Material and methods</jats:title><jats:p> Because of the problems that donor blood transfusion can bring, we describe the use of a Sorin Xtra® Autotransfusion System (ATS). This complete autologous blood recovery system was designed for use in procedures where medium- to high-volume blood loss occurs, such as major surgeries. We have adapted it to recover all the blood aspirated during the mechanical thrombectomy procedures of the dural cerebral venous sinuses, since they are procedures that can cause a significant loss of blood. One advantage to this is the patient receives his or her own blood instead of donor blood, so there is no risk of contracting outside diseases or transfusion reactions. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> This technical note describes a novel and previously unpublished technical approach to CVST that can be immediately applied to clinical practice. It also raises awareness among the interventional neuroradiologist and anesthesiologist communities about novel, potentially lifesaving endovascular treatments in patients with extensive CVST. </jats:p></jats:sec>

Flexible circumferential bioelectronics to enable 360-degree recording and stimulation of the spinal cord

“…The parylene-C–based array with titanium and gold electronics was fabricated using photolithography techniques ( 16 ). Conducting polymer poly(3,4-ethylene) dioxythiophene (PEDOT) with poly(styrene sulfonate) (PSS) acting as counterion to PEDOT was used to decrease the impedance of the electrodes and thus enhance performance in both recording and stimulation ( 17 ). The low thickness of the parylene-C devices (4 μm) renders them highly flexible ( 18 ) allowing for minimal disturbance of movements of the spinal cord.…”

“…The conducting polymer PEDOT is combined with PSS, which acts as a counterion to PEDOT to increase the conductivity of the electrodes ( 17 ). The PEDOT:PSS is prepared according to previously described methods ( 42 ) with 19 ml of CLEVIOS PH 1000 PEDOT:PSS (Heraeus Holding, GmbH, Hanau, Germany) mixed with 1 ml of ethylene glycol which improves film conductivity and two drops of 4-dodecylbenzenesulfonic acid to increase the homogeneity of the spin-coated film.…”

Flexible Circumferential Bioelectronics to Enable 360-degree Recording and Stimulation of the Spinal Cord

“…The parylene-C-based array with titanium and gold electronics was fabricated using photolithography techniques [16]. Conducting polymer Poly (3,4-ethylene) dioxythiophene (PEDOT) with poly (styrene sulfonate) (PSS) acting as counterion to PEDOT was used to decrease the impedance of the electrodes and thus enhance performance in both recording and stimulation [17]. The footprint of the electrode interconnect was minimized to allow the device to be implanted through the interval between the exiting nerve roots.…”

“…Poly(styrene sulfonate) (PSS) which acts as a counterion to PEDOT to increase the conductivity of the electrodes [17]. The PEDOT: PSS is prepared according to previously described methods [34] with 19ml of CLEVIOS™ PH 1000 PEDOT: PSS (Heraeus Holding, GmbH, Hanau, Germany) mixed with 1ml of Ethylene Glycol (EG) which improves film conductivity and two drops of 4-Dodecylbenzenesulfonic acid (DBSA) to increase the homogeneity of the spin-coated film.…”