著者

Satoshi TANAKA Ryosuke TOMIO Norihiko AKAO Tsunemasa SHIMIZU Toshio ISHIKAWA Takeshi FUJIMOTO Terumasa NISHIMATSU

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.9, pp.177-181, 2022-12-31 (Released:2022-06-21)

参考文献数

19

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Gelatin-based hemostatic agents are widely used in neurosurgery. This is a case of postoperative aphagia strongly suspected to be caused by an allergic reaction to a gelatin-based hemostatic agent after anterior cervical decompression and fusion for central cervical cord injury. A 55-year-old man underwent cervical anterior decompression and fusion at the C3/4 and 4/5 levels for central cervical cord injury. Immediately after the surgery, he could not swallow saliva at all, but his voice was not hoarse. Postoperative cervical computed tomography and magnetic resonance imaging showed significant edema from the post-hypopharynx wall to the front of the vertebral body. The retropharyngeal space was remarkably enlarged to 15.8 mm with cervical spine X-rays. Without neurological symptom improvement, his condition was diagnosed as marked edema of the area where Surgiflo (porcine-derived gelatin-based hemostatic agent; Johnson & Johnson Wound Management, Somerville, NJ, USA) had been applied during the operation. It was strongly suspected to be caused by an allergic response to the porcine-derived gelatin. When methylprednisolone 1000 mg was administered for 3 days from the 5th postoperative day, swallowing became almost normal within a few hours after the initial administration, and his neurological symptoms improved. The patient left the hospital on the 12th day after the operation. Before using porcine-derived gelatin products during surgery, special consideration should be given to patients with an allergy history before surgery.

著者

Ryosuke Tomio Tsuyoshi Uesugi Kazunori Akaji

出版者

特定非営利活動法人 日本脳神経血管内治療学会

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

vol.14, no.3, pp.85-89, 2020 (Released:2020-03-20)

参考文献数

4

被引用文献数

1

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Objective: The optimal heating temperature and time for the Echelon10 and Excelsior SL-10 microcatheters using a heat gun was investigated. The durability of the microcatheters after heat gun shaping for the second and third times was also examined.Methods: HAKKO FV-310 was used as the heat gun in this study. This heat gun can be set to 115°C, 125°C, and others. We measured the temperature at 2.5 cm from the nozzle of the heat gun. The Echelon10 and SL-10 microcatheters were shaped under two temperature conditions (115°C and 125°C) and three heating times (30 sec, 60 sec, and 90 sec). The microcatheter shape before heating had twice the curvature of the targeted shape.Results: The temperatures at 2.5 cm from the nozzle were 120.6°C and 127.8°C with the heat gun set at 115°C and 125°C, respectively. There was no macroscopic difference in the results of heat gun shaping of the Echelon10 among temperature settings (115°C and 125°C) or heating times (30 sec, 60 sec, and 90 sec). As degeneration of the heated tip of the SL-10 at 125°C occurred in four of five trials, heat gun shaping was performed using the 115°C setting. There was no macroscopic difference in the results of heat gun shaping of the SL-10 among heating times. Shaping for the second and third times was successful at 115°C and 30-sec heating time.Conclusions: The Echelon10 and SL-10 can be successfully shaped from twice the curvature of the targeted shape using a heat gun at 120°C for 30 sec. Shaping for the second and third times was successful using the same settings. Degeneration of the SL-10 was noted at temperatures above 130°C.