WRAPPING AND PLEDGETS OF TEFLON IN ANEURY SMAL SURGERY - TECHNICAL NOTE

Wrapping is a well-known alternative technique when clipping the aneur ysm is by no means possible or when it seems necessary to complete an imperfect clip. In 22 operated cases of intracranial aneurysm, we rece ntly experienced pledgets of Teflon arranged and then fixed by drops o f fibrin sealant. We used this technique in the following operative ci rcumstances : to reinforce the ectatic base of the clipped aneurysm (1 1 cases) to wrap a pre-aneurysmal ectasia distant from the ruptured an eurysm (5 cases) to minimize the compression due to the clip to an adj acent cranial nerve or artery (6 cases). So far no complication was no ted in relation to this technique. We then propose this technique of w rapping or interposing Teflon as an alternative to the other well-know n techniques using autogenous tissue, gelatin sponge, cotton or other synthetic coattings or glue. Up to now, no known material received a w orldwide approval for its complete innocuity and/or efficiency. Nowada ys, in neurosurgical microvascular decompression and in cardiovascular surgery Teflon is widely and satisfactorily used. Its biologic tolera nce is known to be good. This may apply in this. new indication, and w e would like recommend its practical use. However, for reliability and safety, there is an obvious need for a long-term clinical follow-up a nd an experimental controlled study as well.