Efficacy of Tachosil as Dural Sealant Compared to Standard Treatment
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Purpose
Main objective of this trial is to assess the hypothesis whether the application of TachoSil® as a dural sealant improves the quality of craniotomy procedure and outcome in general compared with standard dural closure techniques in a controlled and randomized way. As a primary endpoint the investigators look at possible postoperative occurrence of CSF pads or leakages needing any kind of intervention until day 30 after the primary craniotomy. Furthermore, the investigators will look at other surgery-related complications and at pharmacoeconomic endpoints such as hospital stay or cost of the implant. Overall, the results of this study will provide important information on whether or not the adjunct of a relatively expensive implant on a routinely basis for the closure of elective craniotomies is safe and effective, or not.
To date, TachoSil® is often used in neurosurgery and other surgical disciplines in a non-standardized fashion also to prevent CSF leakage after dural closure. So far, adverse events directly related to the product have not been reported. Theoretically, any implant may be associated with a higher incidence of postoperative infections (e.g. epidural, subdural or subgaleal empyema). On the other hand, it is not known whether or not the application of TachoSil® on the dural suture may reduce CSF leakage.
| Condition | Intervention | Phase |
|---|---|---|
|
Subjects Scheduled for Supra-/Infratentorial Craniotomy |
Procedure: Craniotomy supra- or infratentorial, dural closure |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Fleece Bound Tissue Sealing With TachoSil® to Assist in Closing of the Dura Mater After Elective Craniotomy to Reduce Postoperative CSF Leakage. |
- Occurence of CSF pad or leakage needing any kind of intervention. [ Time Frame: 30 days ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 226 |
| Study Start Date: | October 2009 |
| Estimated Study Completion Date: | August 2012 |
| Estimated Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Standard
Standard dural closure
|
Procedure: Craniotomy supra- or infratentorial, dural closure
After dural closure with a water-tight suture, randomization is performed. Depending on the randomization outcome, the study drug Tachosil is applied on the dural suture or omitted.
|
|
Experimental: Experimental
Experimental dural closure, adding of IMP
|
Procedure: Craniotomy supra- or infratentorial, dural closure
After dural closure with a water-tight suture, randomization is performed. Depending on the randomization outcome, the study drug Tachosil is applied on the dural suture or omitted.
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Neurosurgical indication for craniotomy and opening of dura to access cerebral structures/pathologies (discussed in the indication conference of board certified neurosurgeons at the University Hospital of Basel).
The list of pathologies includes:
- primary or secondary benign/malignant brain tumors
- aneurysms
- arterious-venous malformations
- cavernomas
- pituitary adenomas
- temporal lobectomy (epilepsy surgery)
- longterm posttraumatic revisions.
Exclusion Criteria:
- Presence of subdural empyema/abscess or any kind of infection affecting/infiltrating the dura mater
- Emergency for trauma
- Previous surgery on the same site
- Cases, where water-tight dural suture is not possible (intraoperative exclusion decision)
- Known hypersensitivity to TachoSil®
- Participation in another study
- Pregnancy
- Inability to read and understand the participant's information
Contacts and Locations| Contact: Luigi Mariani, MD | marianil@uhbs.ch | |
| Contact: Hutter Gregor, MD PhD | hutterg@uhbs.ch |
| Switzerland | |
| University Hospital Basel | Recruiting |
| Basel, Basel-Stadt, Switzerland, 4031 | |
| Contact: Luigi Mariani, MD marianil@uhbs.ch | |
| Contact: Gregor Hutter, MD PhD hutterg@uhbs.ch | |
| Principal Investigator: Luigi Mariani, MD, Prof. | |
| Sub-Investigator: Hutter Gregor, MD PhD | |
| Principal Investigator: | Mariani Luigi, Prof. | University Hospital, Basel, Switzerland |
More Information
No publications provided
| Responsible Party: | University Hospital, Basel, Switzerland |
| ClinicalTrials.gov Identifier: | NCT00999999 History of Changes |
| Other Study ID Numbers: | Tachousb-1, EKBB 182/09, Swissmedic 2009DR4198 |
| Study First Received: | October 21, 2009 |
| Last Updated: | June 12, 2012 |
| Health Authority: | Switzerland: Swissmedic |
Keywords provided by University Hospital, Basel, Switzerland:
|
Craniotomy outcome CSF leakage Dural sealant |
ClinicalTrials.gov processed this record on May 22, 2013