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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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Julius H. Jacobson II, Lester J. Wallman, George A. Schumacher, Martin Flanagan, Ernesto L. Suarez and R. M. Peardon Donaghy

described. 2. Two cases are reported in each of which an obstruction was removed from the middle cerebral artery for early hemiplegia. 3. The work presented is of a preliminary nature. No conclusions can be drawn as to ultimate value. Further clinical trial seems justified. REFERENCES 1. Carton , C. A. , Kessler , L. A. , Seidenberg , B. , and Hurwitt , E. S. A plastic adhesive method of small blood vessel surgery. World Neurol. , 1960 , 1 : 356 – 362 . Carton , C. A

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Cortisone in the Treatment of Postoperative Cerebral Edema Theodore Rasmussen Des Raj Gulati July 1962 19 7 535 544 10.3171/jns.1962.19.7.0535 Nonsuture Sealing of a Dural Substitute Utilizing a Plastic Adhesive, Methyl 2-Cyanoacrylate Maurice S. Albin Anthony N. D'Agostino Robert J. White John H. Grindlay July 1962 19 7 545 550 10.3171/jns.1962.19.7.0545 Orbital Tumours Harvey Jackson July 1962 19 7 551 567 10.3171/jns.1962.19.7.0551 Cortical Visual Disturbances Following Ventriculography and

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

to ensure a watertight dam is often difficult and laborious, bringing with it the added hazard of a foreign-body reaction about the site of the sutures which may encourage the formation of meningocerebral adhesions. During the past few years, synthetic plastic adhesives have been used in both experimental animals and humans for coating and reinforcement of intracranial aneurysms, 16 closure of arterial incisions and blood-vessel anastomoses, 4, 11, 14 closure of skin incisions, 11 and anastomoses of small bowel. 11 Inou and associates 11 reported using

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1962 19 10 877 883 10.3171/jns.1962.19.10.0877 Aneurysms at Middle Cerebral “Trifurcation”: Treatment with Adherent Plastics Bertram Selverstone October 1962 19 10 884 886 10.3171/jns.1962.19.10.0884 Patching of Intracranial Internal Carotid Artery in Man Using a Plastic Adhesive (Eastman 910 Adhesive) Charles A. Carton Milton D. Heifetz Laibe A. Kessler October 1962 19 10 887 896 10.3171/jns.1962.19.10.0887 The Use of Mannitol for the Reduction of Intracranial Pressure in Intracranial Surgery Henry A. Shenkin Bernard

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Charles A. Carton, Milton D. Heifetz and Laibe A. Kessler

. In earlier reports 4–6, 15 we have traced our interest in a nonsuture method of small-vessel surgery using a plastic adhesive (Eastman 910 Adhesive). As of this writing, approximately 390 arteriotomies have been repaired in the carotid, femoral and mesenteric arteries of the dog, using this method. These vessels have varied from 1.5 to 4 mm. in external diameter, the majority being 3–4 mm. Both linear incisions and holes in the vessels (roof-patch) have been patched. Patency has been achieved in 100 per cent of these patches, with verification by periodic

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April 1963 20 4 344 347 10.3171/jns.1963.20.4.0344 Ochronosis with Ruptured Lumbar Disc J. Rodney Feild George B. Higley Sr. R. L. DeSaussure Jr. April 1963 20 4 348 351 10.3171/jns.1963.20.4.0348 Paraparesis with Incontinence of Bowel and Bladder Roland J. Bortnick J. Peter Murphy April 1963 20 4 352 353 10.3171/jns.1963.20.4.0352 Post-Traumatic Carotid Thrombosis Ibrahim Higazi April 1963 20 4 354 359 10.3171/jns.1963.20.4.0354 Use of Plastic Adhesive for Reinforcement of a Ruptured Intracranial Aneurysm

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Henry D. Messer, Lawrence Strenger and Henry J. McVeety

the heart and aorta utilizing a plastic adhesive. Surgery , 1962 , 51 : 786 – 792 . Braunwald , N. S., and Awe , W. C. Control of hemorrhage from the heart and aorta utilizing a plastic adhesive. Surgery , 1962, 51: 786–792. 2. Carton , C. A. , Heifetz , M. D. , and Kessler , L. A. Patching of intracranial internal carotid artery in man using a plastic adhesive (Eastman 910 adhesive). J. Neurosurg. , 1962 , 19 : 887 – 895 . Carton , C. A., Heifetz , M. D., and Kessler , L. A

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David G. Kline and George J. Hayes

D uring the last several years, surgeons have demonstrated a good deal of interest in a new adhesive, methyl 2-cyanoacrylate (Eastman 910 adhesive). This plastic adhesive is a member of the alkyl 2-cyanoacrylate family. It sets rapidly, being polymerized by traces of water, and affords an exceptionally strong bond. 5 Furthermore, the adhesive appears to be self-sterilizing 6 and, to date, there have been no reported infections secondary to its use. 3, 8, 9 As a result, many investigators have used methyl 2-cyanoacrylate as a biological adhesive both

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Cerebral Deposition of Drugs at Low Temperatures Maitland Baldwin Robert Farrier Frances MacDonald A. K. Ommaya August 1963 20 8 637 646 10.3171/jns.1963.20.8.0637 An Experimental Evaluation of the Effect of a Plastic Adhesive, Methyl 2-Cyanoacrylate, on Neural Tissue Captain David G. Kline Colonel George J. Hayes August 1963 20 8 647 654 10.3171/jns.1963.20.8.0647 Indirect Cystometrography George Varughese August 1963 20 8 655 659 10.3171/jns.1963.20.8.0655 Transverse Diameter of Cervical Spinal