Neuropathological changes related to the transorbital application of ethyl 2-cyanoacrylate adhesive to the basal cerebral arteries of cats

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  • 1 Department of Pathology (Neuropathology), University of Massachusetts Medical School, Worcester, Massachusetts, and Department of Neurosurgery, University of Illinois at Chicago, College of Medicine, Chicago, Illinois
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✓ The long-term toxic effects of ethyl 2-cyanoacrylate adhesive were evaluated histologically in 25 cats. Fresh medical- or commercial-grade adhesive was introduced transorbitally into the subarachnoid space in the vicinity of the right middle cerebral artery. Three sham-operated animals served as controls. The animals were sacrificed at intervals ranging from 2 days to 6 months. For both medical- and commercial-grade adhesive, neuropathological examination disclosed acute and chronic granulomatous inflammation of the meninges and evidence of severe vascular damage, including vessel wall necrosis, inflammation, thrombosis, and occasionally hemorrhage. Most animals showed cerebral infarcts of variable size in the territories of distribution of the basal arteries which were in contact with adhesive. The results of this study show that ethyl 2-cyanoacrylate is capable of producing severe arterial and parenchymal damage. The risk of its deleterious effects should be weighed against its potential benefits. Clinical experience would suggest that ethyl 2-cyanoacrylate can be used in difficult situations as long as care is taken to protect the brain and local blood vessels.

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Contributor Notes

Address reprint requests to: Thomas W. Smith, M.D., Department of Pathology (Neuropathology), University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, Massachusetts 01605.
  • 1.

    Albin MS, , D'Agostino AN, & White RJ, et al: Nonsuture sealing of a dural substitute utilizing a plastic adhesive, methyl 2-cyanoacrylate. J Neurosurg 19:545550, 1962 Albin MS, D'Agostino AN, White RJ, et al: Nonsuture sealing of a dural substitute utilizing a plastic adhesive, methyl 2-cyanoacrylate. J Neurosurg 19:545–550, 1962

    • Search Google Scholar
    • Export Citation
  • 2.

    Araki C, , Handa H, & Ohta T: Coating and reinforcement of intracranial aneurysms with synthetic resins and rubbers, in: Second International Congress of Neurological Surgery. International Congress Series, No. 36. Amsterdam: Excerpta Medica, 1961, p E46 Araki C, Handa H, Ohta T: Coating and reinforcement of intracranial aneurysms with synthetic resins and rubbers, in: Second International Congress of Neurological Surgery. International Congress Series, No. 36. Amsterdam: Excerpta Medica, 1961, p E46

    • Search Google Scholar
    • Export Citation
  • 3.

    Bank WO, , Kerber CW, & Cromwell LD: Treatment of intracerebral arteriovenous malformations with isobutyl 2-cyanoacrylate: initial clinical experience. Radiology 139:609616, 1981 Bank WO, Kerber CW, Cromwell LD: Treatment of intracerebral arteriovenous malformations with isobutyl 2-cyanoacrylate: initial clinical experience. Radiology 139:609–616, 1981

    • Search Google Scholar
    • Export Citation
  • 4.

    Carton CA: Comment on Hood TW, Mastri AR, Chou SN: Neural and vascular tissue reaction to cyanoacrylate adhesives: a further report. Neurosurgery 11:366, 1982 Carton CA: Comment on Hood TW, Mastri AR, Chou SN: Neural and vascular tissue reaction to cyanoacrylate adhesives: a further report. Neurosurgery 11:366, 1982

    • Search Google Scholar
    • Export Citation
  • 5.

    Carton CA, , Heifetz MD, & Kessler LA: Patching of intracranial internal carotid artery in man using a plastic adhesive (Eastman 910 adhesive). J Neurosurg 19:887896, 1962 Carton CA, Heifetz MD, Kessler LA: Patching of intracranial internal carotid artery in man using a plastic adhesive (Eastman 910 adhesive). J Neurosurg 19:887–896, 1962

    • Search Google Scholar
    • Export Citation
  • 6.

    Chou SN: Use of cyanoacrylates. J Neurosurg 46:266, 1977 (Letter) Chou SN: Use of cyanoacrylates. J Neurosurg 46:266, 1977 (Letter)

  • 7.

    Chou SN, , Ortiz-Suarez HJ, & Brown WE Jr: Technique and material for coating aneurysms. Clin Neurosurg 21:182193, 1974 Chou SN, Ortiz-Suarez HJ, Brown WE Jr: Technique and material for coating aneurysms. Clin Neurosurg 21:182–193, 1974

    • Search Google Scholar
    • Export Citation
  • 8.

    Coe JE, & Bondurant CP Jr: Late thrombosis following the use of autogenous fascia and a cyanoacrylate (Eastman 910 monomer) for the wrapping of an intracranial aneurysm. J Neurosurg 21:884886, 1964 Coe JE, Bondurant CP Jr: Late thrombosis following the use of autogenous fascia and a cyanoacrylate (Eastman 910 monomer) for the wrapping of an intracranial aneurysm. J Neurosurg 21:884–886, 1964

    • Search Google Scholar
    • Export Citation
  • 9.

    Collins JA, , Pani KC, & Lehman RA, et al: Biological substrates and cure rates of cyanoacrylate tissue adhesives. Arch Surg 93:428432, 1966 Collins JA, Pani KC, Lehman RA, et al: Biological substrates and cure rates of cyanoacrylate tissue adhesives. Arch Surg 93:428–432, 1966

    • Search Google Scholar
    • Export Citation
  • 10.

    Cromwell LD, & Harris AB: Treatment of cerebral arteriovenous malformations. A combined neurosurgical and neuroradiological approach. J Neurosurg 52:705708, 1980 Cromwell LD, Harris AB: Treatment of cerebral arteriovenous malformations. A combined neurosurgical and neuroradiological approach. J Neurosurg 52:705–708, 1980

    • Search Google Scholar
    • Export Citation
  • 11.

    Diaz FG, , Mastri AR, & Chou SN: Neural and vascular tissue reaction to aneurysm-coating adhesive (ethyl 2-cyanoacrylate). Neurosurgery 3:4549, 1978 Diaz FG, Mastri AR, Chou SN: Neural and vascular tissue reaction to aneurysm-coating adhesive (ethyl 2-cyanoacrylate). Neurosurgery 3:45–49, 1978

    • Search Google Scholar
    • Export Citation
  • 12.

    Duncan AW, , Rumbaugh CL, & Caplan L: Cerebral embolic disease: a complication of carotid aneurysms. Radiology 133:379384, 1979 Duncan AW, Rumbaugh CL, Caplan L: Cerebral embolic disease: a complication of carotid aneurysms. Radiology 133:379–384, 1979

    • Search Google Scholar
    • Export Citation
  • 13.

    Dutton J, & Yates PO: An experimental study of the effects of a plastic adhesive, methyl 2-cyanoacrylate monomer (M2 C-1), in various tissues. J Neurosurg 24:876882, 1966 Dutton J, Yates PO: An experimental study of the effects of a plastic adhesive, methyl 2-cyanoacrylate monomer (M2 C-1), in various tissues. J Neurosurg 24:876–882, 1966

    • Search Google Scholar
    • Export Citation
  • 14.

    Fisher M, , Davidson RI, & Marcus EM: Transient focal cerebral ischemia as a presenting manifestation of unruptured cerebral aneurysms. Ann Neurol 8:367372, 1980 Fisher M, Davidson RI, Marcus EM: Transient focal cerebral ischemia as a presenting manifestation of unruptured cerebral aneurysms. Ann Neurol 8:367–372, 1980

    • Search Google Scholar
    • Export Citation
  • 15.

    Hayes GJ, & Leaver RC: Methyl methacrylate investment of intracranial aneurysms. A report of seven years experience. J Neurosurg 25:7980, 1966 Hayes GJ, Leaver RC: Methyl methacrylate investment of intracranial aneurysms. A report of seven years experience. J Neurosurg 25:79–80, 1966

    • Search Google Scholar
    • Export Citation
  • 16.

    Hood TW, , Mastri AR, & Chou SN: Neural and vascular tissue reaction to cyanoacrylate adhesives: a further report. Neurosurgery 11:363366, 1982 Hood TW, Mastri AR, Chou SN: Neural and vascular tissue reaction to cyanoacrylate adhesives: a further report. Neurosurgery 11:363–366, 1982

    • Search Google Scholar
    • Export Citation
  • 17.

    Hoppenstein R, , Weissberg D, & Goetz RH: Fusiform dilatation and thrombosis of arteries following the application of methyl 2-cyanoacrylate (Eastman 910 monomer). J Neurosurg 23:556564, 1965 Hoppenstein R, Weissberg D, Goetz RH: Fusiform dilatation and thrombosis of arteries following the application of methyl 2-cyanoacrylate (Eastman 910 monomer). J Neurosurg 23:556–564, 1965

    • Search Google Scholar
    • Export Citation
  • 18.

    Kerber CW, , Bank WO, & Cromwell LD: Cyanoacrylate occlusion of carotid-cavernous fistula with preservation of carotid artery flow. Neurosurgery 4:210215, 1979 Kerber CW, Bank WO, Cromwell LD: Cyanoacrylate occlusion of carotid-cavernous fistula with preservation of carotid artery flow. Neurosurgery 4:210–215, 1979

    • Search Google Scholar
    • Export Citation
  • 19.

    Kline DG, & Hayes GJ: An experimental evaluation of the effect of a plastic adhesive, methyl 2-cyanoacrylate, on neural tissue. J Neurosurg 20:647654, 1963 Kline DG, Hayes GJ: An experimental evaluation of the effect of a plastic adhesive, methyl 2-cyanoacrylate, on neural tissue. J Neurosurg 20:647–654, 1963

    • Search Google Scholar
    • Export Citation
  • 20.

    Lehman RAW, & Hayes GJ: The toxicity of alkyl 2-cyanoacrylate tissue adhesives: brain and blood vessels. Surgery 61:915922, 1967 Lehman RAW, Hayes GJ: The toxicity of alkyl 2-cyanoacrylate tissue adhesives: brain and blood vessels. Surgery 61:915–922, 1967

    • Search Google Scholar
    • Export Citation
  • 21.

    Leonard F: Hemostatic applications of alpha cyanoacrylates: bonding mechanism and physiological degradation of bonds, in Manly RS (ed): Adhesion in Biological Systems. New York: Academic Press, 1970, pp 185199 Leonard F: Hemostatic applications of alpha cyanoacrylates: bonding mechanism and physiological degradation of bonds, in Manly RS (ed): Adhesion in Biological Systems. New York: Academic Press, 1970, pp 185–199

    • Search Google Scholar
    • Export Citation
  • 22.

    Margolis MT, , Freeny PC, & Kendrick MM: Cyanoacrylate occlusion of a spinal cord arteriovenous malformation. Case report. J Neurosurg 51:107110, 1979 Margolis MT, Freeny PC, Kendrick MM: Cyanoacrylate occlusion of a spinal cord arteriovenous malformation. Case report. J Neurosurg 51:107–110, 1979

    • Search Google Scholar
    • Export Citation
  • 23.

    Mazur JB, & Salazar JL: Late thrombosis of middle cerebral artery following clipping and coating of aneurysms. Surg Neurol 10:131133, 1978 Mazur JB, Salazar JL: Late thrombosis of middle cerebral artery following clipping and coating of aneurysms. Surg Neurol 10:131–133, 1978

    • Search Google Scholar
    • Export Citation
  • 24.

    Messer HD, , Strenger L, & McVeety HJ: Use of plastic adhesive for reinforcement of a ruptured intracranial aneurysm. J Neurosurg 20:360362, 1963 Messer HD, Strenger L, McVeety HJ: Use of plastic adhesive for reinforcement of a ruptured intracranial aneurysm. J Neurosurg 20:360–362, 1963

    • Search Google Scholar
    • Export Citation
  • 25.

    Sachs E Jr, , Erbengi A, & Margolis G, et al: Fatality from ruptured intracranial aneurysm after coating with methyl 2-cyanoacrylate (Eastman 910 monomer, M2 C-1). Case report. J Neurosurg 24:889891, 1966 Sachs E Jr, Erbengi A, Margolis G, et al: Fatality from ruptured intracranial aneurysm after coating with methyl 2-cyanoacrylate (Eastman 910 monomer, M2 C-1). Case report. J Neurosurg 24:889–891, 1966

    • Search Google Scholar
    • Export Citation
  • 26.

    Sakaki T, , Kinugawa K, & Tanigake T, et al: Embolism from intracranial aneurysms. J Neurosurg 53:300304, 1980 Sakaki T, Kinugawa K, Tanigake T, et al: Embolism from intracranial aneurysms. J Neurosurg 53:300–304, 1980

    • Search Google Scholar
    • Export Citation
  • 27.

    Samson D, , Ditmore QM, & Beyer CW Jr: Intravascular use of isobutyl 2-cyanoacrylate: Part 1. Treatment of intracranial arteriovenous malformations. Neurosurgery 8:4351, 1981 Samson D, Ditmore QM, Beyer CW Jr: Intravascular use of isobutyl 2-cyanoacrylate: Part 1. Treatment of intracranial arteriovenous malformations. Neurosurgery 8:43–51, 1981

    • Search Google Scholar
    • Export Citation
  • 28.

    Samson D, , Ditmore QM, & Beyer CW Jr: Intravascular use of isobutyl 2-cyanoacrylate: Part 2. Treatment of carotidcavernous fistulas. Neurosurgery 8:5255, 1981 Samson D, Ditmore QM, Beyer CW Jr: Intravascular use of isobutyl 2-cyanoacrylate: Part 2. Treatment of carotidcavernous fistulas. Neurosurgery 8:52–55, 1981

    • Search Google Scholar
    • Export Citation
  • 29.

    Sugar O, & Tsuchiya G: Plastic coating of intracranial aneurysms with “EDH-adhesive.” J Neurosurg 21:114117, 1964 Sugar O, Tsuchiya G: Plastic coating of intracranial aneurysms with “EDH-adhesive.” J Neurosurg 21:114–117, 1964

    • Search Google Scholar
    • Export Citation
  • 30.

    Tsuchiya G, , Sugar O, & Yashon D, et al: Reactions of rabbit brain and peripheral vessels to plastics used in coating arterial aneurysms. J Neurosurg 28:409416, 1968 Tsuchiya G, Sugar O, Yashon D, et al: Reactions of rabbit brain and peripheral vessels to plastics used in coating arterial aneurysms. J Neurosurg 28:409–416, 1968

    • Search Google Scholar
    • Export Citation
  • 31.

    Yashon D: Comment on Diaz FG, Mastri AR, Chou SN: Neural and vascular tissue reaction to aneurysm-coating adhesive (ethyl 2-cyanoacrylate). Neurosurgery 3:49, 1978 Yashon D: Comment on Diaz FG, Mastri AR, Chou SN: Neural and vascular tissue reaction to aneurysm-coating adhesive (ethyl 2-cyanoacrylate). Neurosurgery 3:49, 1978

    • Search Google Scholar
    • Export Citation
  • 32.

    Yashon D, , Jane JA, & Gordon MC, et al: Effects of methyl 2-cyanoacrylate adhesives on the somatic vessels and the central nervous system of animals. J Neurosurg 24:883888, 1966 Yashon D, Jane JA, Gordon MC, et al: Effects of methyl 2-cyanoacrylate adhesives on the somatic vessels and the central nervous system of animals. J Neurosurg 24:883–888, 1966

    • Search Google Scholar
    • Export Citation
  • 33.

    Yashon D, , White RJ, & Arias BA, et al: Cyanoacrylate encasement of intracranial aneurysms. Technical note. J Neurosurg 34:709713, 1971 Yashon D, White RJ, Arias BA, et al: Cyanoacrylate encasement of intracranial aneurysms. Technical note. J Neurosurg 34:709–713, 1971

    • Search Google Scholar
    • Export Citation
  • 34.

    Yodh SB, & Wright RL: Experimental evaluation of four synthetic adhesives for possible treatment of aneurysms. J Neurosurg 26:504510, 1967 Yodh SB, Wright RL: Experimental evaluation of four synthetic adhesives for possible treatment of aneurysms. J Neurosurg 26:504–510, 1967

    • Search Google Scholar
    • Export Citation
  • 35.

    Zumpano BJ, , Jacobs LR, & Hall JB, et al: Bioadhesive and histotoxic properties of ethyl 2-cyanoacrylate. Surg Neurol 18:452457, 1982 Zumpano BJ, Jacobs LR, Hall JB, et al: Bioadhesive and histotoxic properties of ethyl 2-cyanoacrylate. Surg Neurol 18:452–457, 1982

    • Search Google Scholar
    • Export Citation

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