Hypersensitivity Reactions to Fibrin Glue during Epidural Blood Patching

• DOI: 10.3174/ajnr.a8568
• Publication Date: 2025-03-23T05:22:53Z
• Authors: Jennifer L. Smith; Myoung J. Kim; Linda Gray; Michael D. Malinzak; Samantha Morrison; Amy P. Stallings; Alaattin Erkanli; Peter G. Kranz; Timothy J. Amrhein
• Keywords: GLUE; Hypersensitivity reaction

Fibrin glue is increasingly incorporated as a component in epidural blood patching (EBP) for the treatment of spinal CSF leaks. Hypersensitivity reactions are potential complication its use but not well studied setting EBP. The purpose this study was to determine incidence hypersensitivity fibrin during EBP and identify any predisposing factors associated with increased patient risk. A single-center retrospective cohort nested case-control design included patients who received iatrogenic leaks or spontaneous intracranial hypotension over 13 years. Patient demographics multiple procedure-specific variables were collected. Cases identified from total those hypersensitive matched controls 1:3 ratio. calculated. Logistic regression models fit test associations between development reaction. 3065 CT-guided EBPs 1574 individual patients. 0.49% per procedure 0.95% never occurred first glue. Case-control analysis found higher odds lower BMI (OR 0.82 [0.71-0.96], P = .003), younger age 0.95 [0.91-0.99], .011), procedures inadvertent intravenous injections 5.44 [1.34-22.01], .014). We glue, none occurring exposure. Younger age, BMI, injection likelihood reactions. This provides data useful counseling on procedural risk identifies physicians be aware help prevent life-threatening