Zusammenfassung
Bei 15 Patienten wurde eine Wandverstärkung von intrakraniellen Aneurysmen mit Biobond vorgenommen. 3 Patienten starben postoperativ. Eine erneute Aneurysmaruptur wurde nur bei einem Patienten beobachtet, bei dem die Aneurysmahinterwand aus operationstechnischen Gründen nicht mit dem Kunststoff beschichtet war. Die histologische Untersuchung dieses Aneurysmas ergab Hinweise auf einen Abbau von Biobond durch den Organismus. Bei überlebenden 10 Patienten waren in einem Nachuntersuchungszeitraum bis zu 8 Jahren keine Rezidivblutungen aufgetreten. 8 Patienten waren voll erwerbstätig. Nebenschädigungen durch Biobond wurden in keinem Fall beobachtet. Angiographien nach einem längeren Zeitraum nach der Operation bei 5 Patienten zeigten das Aneurysma bei 3 Patienten unverändert und bei 2 verkleinert. In keinem Fall traten Thrombosen oder Einengungen angrenzender Arterien ein. Biobond wird für die Behandlung von Aneurysmen für geeignet gehalten, welche sich nicht durch Clip oder Ligatur versorgen lassen. Im Hinblick auf den langsamen Abbau von Biobond durch den Organismus wird empfohlen, die Substanz in einer dickeren Schicht aufzutragen, als vom Hersteller empfohlen.
Summary
Fifteen patients with intracranial aneurysms have been treated by coating the aneurysms with Biobond. Three patients died in the postoperative period. Only one patient had recurrent haemorrhage one year after operation. In this case the sac had not been wrapped completely at operation. Histological examination of this aneurysm revealed macrophage reaction and signs of slow disappearance of the plastic. Ten patients, who were followed up for a period of 3 to 8 years after operation, had no recurrent haemorrhage and were in good clinical condition, 8 of them doing full-time work. No complications caused by the material have been encountered. In 5 patients carotid angiography was performed after operation. In 2 cases the size of the aneurysm was diminished and in 3 cases was unchanged. There were no signs of thrombosis or narrowing of the adjacent arteries. We believe that Biobond is suitable for coating intracranial aneurysms that cannot be treated by clipping or ligature. As Biobond in vivo seems partially to disappear after long periods, it should be applied in thick layers.
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Stöwsand, D., Buhl, K. Früh- und Spätbefunde nach Biobond-Beschichtung von Intrakraniellen Aneurysmen. Acta neurochir 32, 73–82 (1975). https://doi.org/10.1007/BF01405904
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DOI: https://doi.org/10.1007/BF01405904