A combination of wrapping and clipping using a collagen-impregnated Dacronfabric (Hemashield)

BACKGROUND We describe techniques combining wrapping and clipping using a c ollagen-impregnated Dacron knitted fabric (Hemashield) for accidental arter ial perforations and broad-based aneurysms. The results of these techniques in seven patients are presented. METHODS Clip-reinforced wrapping was performed to obtain hemostasis in two patients with arterial perforations and in a patient with a ruptured broad- based aneurysm in the internal carotid artery. Clipping of the broad neck o f the aneurysm and wrapping with Hemashield (wrap-clipping) was performed i n four patients with unruptured aneurysms (one internal carotid artery, two middle cerebral artery, one basilar artery). RESULTS In the three patients treated with clip-reinforced wrapping, comple te hemostasis was obtained just after clip application. In the patient with a ruptured broad-based aneurysm, postoperative angiography demonstrated th at the dome of the aneurysm was well compressed. In the four patients treat ed with wrap-clipping, postoperative angiography revealed successful clippi ng of the broad neck of the aneurysm. CONCLUSION In this early experience, there were no problems in the use of H emashield for clip-reinforced wrapping or wrap-clipping. (C) 2000 by Elsevi er Science Inc.