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J Neurol Surg B Skull Base 2017; 78(03): 215-221
DOI: 10.1055/s-0036-1597277
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Nano-hemostats and a Pilot Study of Their Use in a Large Animal Model of Major Vessel Hemorrhage in Endoscopic Skull Base Surgery

Autoren

  • Alistair Jukes

    1   Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, Australia
    2   Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, Australia

  • Jae Murphy

    1   Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, Australia
    2   Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, Australia

  • Sarah Vreugde

    1   Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, Australia
    2   Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, Australia

  • Alkis Psaltis

    1   Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, Australia
    2   Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, Australia

  • P. J. Wormald

    1   Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, Australia
    2   Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, Australia
Weitere Informationen

Publikationsverlauf

05. Juni 2016

25. Oktober 2016

Publikationsdatum:
12. Dezember 2016 (online)

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Abstract

Nano-hemostats are synthetic amino acid chains that self-assemble into a scaffold under certain conditions. These have been shown to be effective in stopping bleeding in small animal models of hemorrhage. Proposed mechanisms for their effect are that they form a mesh analogous to the fibrin plug in native hemostasis and that they may potentiate both platelet activation and the coagulation cascade. These may potentially become valuable adjuncts to endoscopic skull base surgery where there is the potential for both major vessel injury and smaller perforator injury to eloquent areas where bipolar cautery may not be suitable. We present a summary of the clinical studies to date and a small pilot study of nano-hemostat in an endoscopic sheep model of major vessel hemorrhage to determine its efficacy in stopping bleeding in this potentially catastrophic complication.

Keywords

endoscopic transsphenoidal surgery - hemorrhage control - nano-medicine - pituitary surgery - internal carotid artery injury