TASALL - TachoSil® Against Liquor Leak
The primary objective is to demonstrate superiority of TachoSil® compared to current practice as an adjunct in sealing the dura mater. The efficacy of the dura mater sealing must be evaluated post-operatively. The secondary objective is to evaluate the safety of TachoSil® as an adjunct in sealing the dura mater.
The trial population will consist of 726 randomised (1:1) patients elected for skull base surgery. The trial duration consists of screening, surgery, efficacy follow-up after 7±1 weeks and safety follow-up 28±2 weeks after surgery.
Cerebrospinal Fluid Leaks
Procedure: Current Practice
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||TachoSil® Versus Current Practice in Dura Sealing Techniques for the Prevention of Post-operative Cerebrospinal Fluid (CSF) Leaks in Patients Undergoing Skull Base Surgery: An Open Label, Randomised, Controlled, Multi-centre, Parallel Group Efficacy and Safety Trial.|
- To evaluate the occurrence of a clinically evident cerebrospinal fluid leak or clinically evident pseudomeningocele [ Time Frame: Up to 7 weeks ] [ Designated as safety issue: No ]
The assessment will be performed daily from randomization to Day of Discharge and at the Efficacy Follow-up visit at week 7±1 week.
Clinically evident cerebrospinal fluid leak will be confirmed by
- Glucose concentration test and/or
- β-2-transferrin test
A clinically evident pseudomeningocele must be considered to be present post-operatively if the following criteria are fulfilled
- A subcutaneous, visible/palpable fluctuant fluid accumulation is noted at the site of the surgical incision or adjacent to it
- It is suspected the fluid accumulation is cerebrospinal fluid
- To evaluate the occurrence of non-clinical evident pseudomeningocele [ Time Frame: The participants will be assessed at least once prior to discharge from neurosurgical ward, with the expected discharge from neurosurgical ward after an average of 10 days ] [ Designated as safety issue: No ]
The secondary outcome measure is non-clinical evident pseudomeningocele only found at a post-operative scan until the Day of Discharge defined as a cerebrospinal fluid accumulation only found on a postoperative CT or MRI scan which fulfill the following criteria according to the radiologist
Assessment before Day of Discharge:
- CT Scan: Fluid accumulation seen as Hypodense signal
- MRI Scan: Fluid accumulation seen as Hypointense signal in T1-weighted image and/ OR Fluid accumulation seen as Hyperintense signal in T2-weighted image
|Study Start Date:||April 2011|
|Study Completion Date:||June 2013|
|Primary Completion Date:||June 2013 (Final data collection date for primary outcome measure)|
Primary suture must be performed. Duraplasty may be performed at the discretion of the investigator. TachoSil® must be applied under aseptic conditions during the closure of the dura.
|Active Comparator: Current practice group||
Procedure: Current Practice
Primary suture must be performed. Duraplasty may be performed at the discretion of the investigator.
In addition to primary suture, whatever means of dura closure deemed necessary by the investigator may be used with the exception of TachoSil®.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01355627
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|Study Chair:||Nycomed||Clinical Trial Operations|