First clinical application of autologous fibrin sealant Vivostat for neurosurgery in Kazakhstan and Central Asia

BACKGROUND

Watertight dural closure and skull base reconstruction remain key challenges in neurosurgery. Autologous fibrin sealant Vivostat, produced from the patient’s own blood, provides high biocompatibility, elasticity, and reliable adhesion. The absence of clinical data on its use in Central Asian countries highlights the relevance of the present study.

OBJECTIVE

To evaluate the clinical efficacy and safety of autologous fibrin sealant Vivostat for dural sealing and skull base reconstruction.

MATERIAL AND METHODS

This retrospective-prospective study included 110 patients operated on at the National Center of Neurosurgery (Astana, Kazakhstan) between August 2024 and September 2025. The sealant, derived from autologous blood using the Vivostat system, was applied for dural defect sealing and fixation of reconstructive grafts. The primary outcomes were the incidence of postoperative cerebrospinal fluid (CSF) leakage, infectious complications, and the need for reoperation.

RESULTS

The mean patient age was 48.9±14.7 years; 60% were women. An endoscopic transnasal approach was used in 65 patients, craniotomy in 35, and other approaches in 10. Polymerization occurred almost instantly, reaching maximal strength within 1—2 minutes. Successful sealing was achieved in 109 (99.1%) patients, while 1 (0.9%) patient required reoperation due to nasal CSF leakage and epistaxis. No infectious, allergic, or thromboembolic complications were observed.

CONCLUSION

The use of autologous fibrin sealant Vivostat demonstrated high efficacy and safety for dural sealing and skull base reconstruction. The method reduced the risk of postoperative CSF leakage and reoperation. This study presents the first clinical experience with Vivostat in Central Asia.