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Experimental Studies in Surgery of Small Blood Vessels

II. Patching of Arteriotomy Using a Plastic Adhesive

Charles A. Carton, Laibe A. Kessler, Bernard Seidenberg and Elliott S. Hurwitt

develop a nonsuture method of anastomosing small vessels applicable to both arteries and veins and to the peculiar prerequisites of intracranial vascular surgery. The possibility of using plastics as an adhesive material for purposes of vascular surgery was considered. After some trials, methyl 2-cyanoacrylate adhesive was employed (both as the monomer and as Eastman 910 Adhesive). ‡ This report presents primarily the results of 85 arterial patches using this plastic adhesive; other technical applications of this method now under study are also mentioned. (1

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Maurice S. Albin, Anthony N. D'Agostino, Robert J. White and John H. Grindlay

arteriotomy using a plastic adhesive. J. Neurosurg. , 1961, 18: 188–194. 5. Coover , H. W. , Jr. , Joyner , F. B. , Shearer , N. H. , Jr. , and Wicker , T. H. , Jr. Chemistry and performance of cyanoacrylate adhesives. Soc. Plastics Engrs. J. , 1959 , 15 : 413 – 417 . Coover , H. W., Jr. , Joyner , F. B., Shearer , N. H., Jr. , and Wicker , T. H., Jr. Chemistry and performance of cyanoacrylate adhesives. Soc. Plastics Engrs. J. , 1959, 15: 413–417. 6. Dodge , H

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David G. Kline and George J. Hayes

, T. H. , Jr. Chemistry and performance of cyanoacrylate adhesives. Soc. Plastics Engrs. J. , 1959 , 15 : 413 – 417 . Coover , H. W., Jr., Joyner , F. B., Shearer , N. H., Jr. , and Wicker , T. H., Jr. Chemistry and performance of cyanoacrylate adhesives. Soc. Plastics Engrs. J. , 1959, 15: 413–417. 6. Fassett , D. W. , Rondabush , R. L. , Emley , I. C. , and Graulich , L. B. Microbiological growth from Eastman 910 monomer and adhesive. Cohesivenews , 1961 , 1

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D. Yashon, J. A. Jane, M. C. Gordon, J. L. Hubbard and O. Sugar

more infiltrated with reactive membrane, in a manner comparable to that described in the central nervous system. Fig. 3. Femoral artery with erosion into wall—longitudinal section. (1) necrotic media; (2) intact media; (3) internal elastic membrane; (4) arterial lumen. The toxic effects of cyanoacrylate adhesives were local and did not damage any tissue more than 2 mm. from the site of application. This is probably due to the rapid setting since there were no differences in basic histologic appearance that correlated with the length of survival time

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William F. McCormick John D. Nofzinger May 1966 24 5 865 875 10.3171/jns.1966.24.5.0865 An Experimental Study of the Effects of a Plastic Adhesive, Methyl 2-Cyanoacrylate Monomer (M 2 C-1) in Various Tissues J. Dutton P. O. Yates May 1966 24 5 876 882 10.3171/jns.1966.24.5.0876 Effects of Methyl 2-Cyanoacrylate Adhesives on the Somatic Vessels and the Central Nervous System of Animals D. Yashon J. A. Jane M. C. Gordon J. L. Hubbard O. Sugar May 1966 24 5 883 888 10.3171/jns.1966.24.5.0883 Fatality from Ruptured Intracranial Aneurysm after Coating with

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Ralph A. W. Lehman, George J. Hayes and Albert N. Martins

rhinorrhea and vision is returning in the right eye. Discussion There have been several unsuccessful attempts to repair cerebrospinal fluid fistulae with methyl cyanoacrylate. 3 Successful treatment in our cases involved gluing a patch over the site of cerebrospinal fluid leakage with isobutyl cyanoacrylate. Various details of the procedure are worthy of emphasis. 1. The use of a cyanoacrylate adhesive . This rapidly forms a leak-proof seal and avoids needle holes. A seal can be created in areas covered with friable dura as well as in regions poorly

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Shyam B. Yodh and R. Lewis Wright

Sugar , O. Effects of methyl 2-cyanoacrylate adhesives on the somatic vessels and the central nervous system of animals. J. Neurosurg. , 1966 , 24 : 883 – 888 . Yashon , D., Jane , J. A., Gordon , M. C., Hubbard , J. L., and Sugar , O. Effects of methyl 2-cyanoacrylate adhesives on the somatic vessels and the central nervous system of animals. J. Neurosurg. , 1966, 24: 883–888. * Supported in part by United States Public Health Services Grant HE-10911 and Trainee Grant 2-T1 NB-05406. † Presented in part at the annual meeting of

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Goro Tsuchiya, Oscar Sugar, David Yashon and John Hubbard

plastic material itself stayed over the arachnoid, but inflammatory cells infiltrated into the cortex through the pia mater ( Fig. 1 left ). These changes were markedly attenuated in the brains examined 60 and 90 days after application of plastic ( Fig. 1 right ). The only prominent finding was thickening of the arachnoid. There were no pathological findings in the small pial vessels. Cortical cellular infiltration was limited to the grey matter; no pathological changes were seen in the white matter. Fig. 1. Methyl 2-cyanoacrylate adhesive, rabbit brain

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David Yashon, Robert J. White, Belisario A. Arias and William E. Hegarty

vessels, adhesive investment has been used. 1, 3, 4, 8–10 In such patients, we have used several available adhesives and have found that the cyanoacrylate adhesives are particularly effective. Contrary to a previously published case report, 7 our results have been excellent, and we have found that this substance has unique qualities that make it well-suited for the treatment of otherwise inoperable intracranial aneurysms. This report presents our technique of application and long-term results in five patients. Technique Under magnification, the aneurysm is

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K. Maurits Persson, William A. Roy, John A. Persing, George T. Rodeheaver and H. Richard Winn

roughened with the point of a needle. Experimental craniosynostosis of the coronal suture was produced by immobilization of the suture with glue. Thin layers of methyl-2-cyanoacrylate adhesive * were applied bilaterally across the coronal suture in 15 animals, avoiding the sagittal suture. Radiopaque markers, consisting of dental amalgam, were inserted into the left parietal and frontal bones in holes made with a dental burr. The periosteal flaps were replaced over the markers and a topical antibiotic powder (Neomycin sulfate) was applied to the open wound. The skin