fibrin and Fistula

CSF-to-venous fistulas contribute to spontaneous intracranial hypotension. CT-guided fibrin occlusion has been described as a minimally invasive treatment strategy; however, its reproducibility across different institutions remains unclear. This multi-institution study evaluated the clinical and radiologic outcomes of CT-guided fibrin occlusion, hypothesizing a correlation among cure rates, fibrin injectate spread, and drainage patterns.. A retrospective evaluation was conducted on CT-guided fibrin glue treatment in patients with CSF-to-venous fistulas from 6 US and UK institutions from 2020 to 2023. Patient information, procedural characteristics, and injectate spread and drainage patterns were examined. Clinical improvement assessed through medical records served as the primary outcome.. Of 119 patients at a mean follow-up of 5.0 months, fibrin occlusion resulted in complete clinical improvement in 59.7%, partial improvement in 34.5%, and no improvement in 5.9% of patients. Complications were reported in 4% of cases. Significant associations were observed between clinical improvement and concordant injectate spread with the fistula drainage pattern (. Fibrin occlusion performed across various institutions shows cure when associated with injectate spread matching the CVF drainage pattern and shorter pretreatment symptom duration, emphasizing the importance of accurate injectate placement and early intervention.

Topics: Cross-Sectional Studies; Fibrin; Fibrin Tissue Adhesive; Fistula; Humans; Reproducibility of Results; Retrospective Studies; Tomography, X-Ray Computed

Topics: Child; Fibrin; Fibrin Tissue Adhesive; Fistula; Humans; Lasers, Solid-State; Pyriform Sinus

Fibrin glue is a promising alternative for low-output enterocutaneous fistula closure. Bacterial flora colonizing inside the fistula tract, however, may limit the glue application. Single-donor-derived, platelet-rich materials were hypothesized in this study to have antimicrobial activity against Gram-negative microorganisms. Platelet-leukocyte fibrin (PLF), platelet-rich plasma (PRP), and platelet-poor plasma (PPP) were obtained from healthy volunteers. The amounts of platelet, leukocyte, and complement/antibody were determined. In vitro laboratory susceptibility to PLF and plasmas was determined by the Kirby-Bauer disc-diffusion method. Antimicrobial activity of PLF, PRP, and PPP against three Gram-negative ATCC strains was determined in a bacterial kill assay. Levels of complement and antibody did not significantly differ among PLF, PRP, and PPP (p > 0.05), while platelet and leukocyte counts in platelet-rich biomaterials were significantly higher than those in PPP (p < 0.001). The bactericidal effects produced by PLF and PRP were more pronounced than those by PPP in both qualitative and quantitative aspects. No inhibitory zones against three Gram-negative organisms were observed in the Bioseal®. In conclusion, our homemade PLF, as compared with commercial products, had remarkable antimicrobial activity against Gram-negative bacteria relevant to fistula colonization. The presence of platelets and leukocytes may play an important role in bacterial defense. This is the first study to demonstrate the antibacterial properties of single-unit PLF for fistula closure, presenting a new opportunity for glue sealing.

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents; Blood Platelets; Disk Diffusion Antimicrobial Tests; Female; Fibrin; Fistula; Healthy Volunteers; Humans; Leukocytes; Male; Middle Aged; Platelet-Rich Plasma; Young Adult

Topics: Anterior Eye Segment; Conjunctiva; Cornea; Eye Diseases; Fibrin; Fistula; Humans; Microsurgery; Sclera; Tissue Adhesives; Wound Healing

The bronchial stump insufficiency after lung resection specially after pneumonectomy is known as a dangerous complication. The occlusion of an experimentally produced bronchial stump fistula after pneumonectomy on the left succeeded in all cases (n = 7) by means of a fibrin adhesive. The adhesive was applied in the endoscopic way by a plastic catheter. This method appeared to us as the treatment of choice for the so-called early fistulas. This method was applied successfully in one clinical case.

Topics: Adhesives; Animals; Disease Models, Animal; Fibrin; Fistula; Lung; Pneumonectomy; Postoperative Complications; Swine

Topics: Adult; Crohn Disease; Female; Fibrin; Fistula; Humans; Perineum; Postoperative Complications; Tissue Adhesives

Fibrin glue Beriplast was used during cardiovascular surgery in 97 patients. The fibrin seal was used for hemostasis on anastomoses, patches and suture lines. Moreover, the glue was applied for epicardial fixation of aorto-coronary vein grafts to prevent postoperative graft kinking. Following extrapleural ligation of patent duct in premature infants, the parietal pleura was fastened to the thoracic wall to prevent extrapleural pneumothorax or hemorrhage. After accidental dissection of the thoracic duct in infants, leakage of chyle could be sealed successfully in 6 cases. Hemorrhage from the sealed surfaces of suture lines was not observed. Viral hepatitis occurred postoperatively in 2 patients (3% of the operations for acquired heart disease), both of whom had also received clotting factor concentrate and blood transfusion because of postoperative hemorrhage not related to fibrin sealed surfaces. A causal relation between the hepatitis and application of the pasteurized fibrin glue seems very unlikely. Although fibrin glue certainly cannot replace the surgical suture, it appears to be a valuable aid under special conditions.

Topics: Adult; Ductus Arteriosus, Patent; Female; Fibrin; Fistula; Hemorrhage; Humans; Intraoperative Complications; Male; Middle Aged; Thrombin; Tissue Adhesives

A simple, effective and safe method is proposed to liquidate a persistent residual pleural cavity by a biological filling prepared ex tempore from a solution of fibrinogen with antibacterial drugs. The method was used in 24 patients after pleura empyema. The method of filling is described as well as the conditions for a successful use of the new means of liquidation of the residual pleural cavity and prevention of recurrent pleura empyemas.

Topics: Adolescent; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bronchial Fistula; Combined Modality Therapy; Empyema; Fibrin; Fistula; Humans; Lung Diseases; Male; Pleural Diseases; Postoperative Complications; Prostheses and Implants; Skin Diseases

The effects of locally deposited fibrin and of tranexamic acid-induced antifibrinolysis on forming granulation tissue were studied in the light of a recently developed method for treatment of postoperative fistulas by occlusion with a fibrin clot. Perforated teflon cylinders, either empty or fibrin-filled, were implanted subcutaneously in rats and extracted after 2 weeks. Fibrin deposition was found to stimulate granulation tissue ingrowth into the cylinders but it did not change the fibrinolytic activity in the granulation tissue. A significantly higher fibrinolytic activity was, however, found in the tissue fluid collected from the space between the granulation tissue and the implanted fibrin clot compared to tissue fluid from cylinders implanted empty. Tranexamic acid significantly reduced the fibrinolytic activity on the granulation tissue and delayed lysis of the implanted fibrin clot. It also reduced granulation tissue ingrowth but it did not abolish the positive effects of the clot on granulation tissue formation.

Topics: Animals; Cyclohexanecarboxylic Acids; Drug Evaluation, Preclinical; Drug Implants; Fibrin; Fibrinolysis; Fistula; Granulation Tissue; Histocytochemistry; Male; Postoperative Complications; Rats; Rats, Inbred Strains; Tranexamic Acid

Topics: Adult; Aged; Female; Fibrin; Fistula; Humans; Ileal Diseases; Intestinal Fistula; Jejunal Diseases; Male; Middle Aged; Perineum; Postoperative Complications; Rectal Fistula; Sigmoid Diseases; Urinary Bladder Fistula; Vesicovaginal Fistula

To examine the influence of fibrin clots, perforated Teflon cylinders have been implanted subcutaneously in rats. Fibrin clots made from both species specific fibrinogen and from an non-species specific preparation, together with ingrowing granulation tissue, kept the implanted cylinder filled during the four week study period. This was valid for both concentrations investigated. Interaction between granulation tissue and fibrin clot differed between the two fibrin types.

Topics: Animals; Fibrin; Fibrinogen; Fistula; Granulation Tissue; Humans; Male; Rats; Rats, Inbred Strains; Species Specificity

Topics: Adhesives; Adult; Aged; Female; Fibrin; Fistula; Gastrointestinal Diseases; Humans; Male; Middle Aged; Postoperative Complications; Radiography

In 3 cats artificial bony and dural defects of the posterior frontal sinus walls facing the frontal brain were closed with the help of a physiologic fibrin-based adhesive system (FAS) and a synthetic tissue adhesive (N-butylcyanoacrylate) in an attempt at comparing the relative merits and demerits of the 2 techniques. The bony and dural defects were partially covered with fascial tissue. Subsequently, the defects were sealed with adhesive using cyanoacrylate for the left frontal sinus and FAS for the right one. Unless healing was complicated by wound infection, fibrous tissue was found to have bridged the defects on either side 14 days after surgery, ensuring cerebrospinal fistula tight closure. Wound infection occurred in 2 cases involving the frontal sinuses closed with FAS. Micro-organisms had apparently been introduced from the respiratory tract and, in one case, spread to the contralateral frontal sinus treated with cyanoacrylate. Thus, the risk of infection associated with FAS appears to be higher than that of conventional techniques. Germ growth was found to be inhibited in vitro by adding an antibiotic to the FAS. For this reason, we would recommend the admixture of an antibiotic to the FAS whenever the adhesive is used in surgical fields which are exposed to infection. Further sutdies are needed to find the best suited antibiotic, its optimum dosage and mode of applications.

Topics: Animals; Cats; Cyanoacrylates; Dura Mater; Fibrin; Fistula; Frontal Sinus; Granulation Tissue; Methods; Tissue Adhesives

Topics: Aneurysm; Arteries; Blood Vessel Prosthesis; Collagen; Elasticity; Endothelium; Fibrin; Fibroblasts; Fistula; Humans; Infections; Intestinal Fistula; Plastics; Polyethylene Terephthalates; Postoperative Complications; Textiles; Thrombosis; Vascular Diseases

Topics: Adult; Body Weight; Chyle; Diet Therapy; Female; Fibrin; Fistula; Humans; Kidney Diseases; Lymphatic Diseases; Lymphatic System; Urine; Urography