Letter: Tissue-Glue-Coated Collagen Sponge (TachoSil) for Minor Cerebral Dural Venous Sinus Laceration: What is the Evidence?

We read with great interest the article by Gazzeri et al1 focusing on tissue-glue–coated collagen sponge (TachoSil) application to repair minor cerebral dural sinus lacerations. In their series, 57 consecutive patients were prospectively enrolled, and tears of the cerebral venous sinus were treated by TachoSil application directly to the site of the bleeding. In all patients, venous bleeding was managed initially by standard techniques for hemostasis such as compression, application of oxidized cellulose, or gelatin sponge. TachoSil application was used when standard measures failed to be effective, were excessively time- consuming or inadequate, or were considered risky. No complications related to the use of the hemostatic device were observed, and the authors concluded that the use of such an agent may shorten the surgical procedure and achieve hemostasis in potentially hazardous bleeding from minor tears of the cerebral venous sinus.