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

angiography; some of the dogs have been followed for 2 years. A more detailed summary of patching, ring-anastomosis, stent anastomosis, and grafting, comprising 537 experiments in 164 dogs, is in preparation. This experimental work has been supported and amplified by other investigators. 13, 34 Nathan et al. 20 reported the use of a similar adhesive (Borden's Ad/Here) in sealing arteriotomies in the dog's aorta. Their histological studies were well done and agree with our own experience (to be reported). Healey et al. 10, 11 have worked out a slightly different

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Ghahreman Khodadad and William M. Lougheed

Glass tube 8, 9 Aluminum tube 8, 9 Gold-plate aluminum tube 8, 9 Paraffined silver tube 66 Eversion frame 40 Glass cannula with heparin 45 Vitallium tube 4, 20 Absorbalbe fibrin tube 65 Teflon ring 30 Polyethylene ring 55 Nylon stent 55 Tantalum ring 56 Stainless steel prosthesis 67 b) Adhesive technique Stainless-steel ring plus Eastman 910 (methyl 2-cyanoacrylate) 14, 15 Eastman 910 plus patch 14, 15 Contact Cement plus Teflon patch

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George C. Stevenson, Ronald J. Stoney, Roland K. Perkins and John E. Adams

the foramen magnum. The buccopharyngeal fascia was sutured to the prevertebral fascia to obliterate the retropharyngeal space. The soft tissue of the neck and the trachea and pharynx were allowed to fall together. The superficial layer of deep cervical fascia, platysma, and skin were closed with interrupted silk sutures. A foam rubber pack was placed in the nasopharynx as a stent to help ensure approximation of the superior pharyngeal constrictor muscle and the buccopharyngeal fascia against the basiocciput and the prevertebral fascia. In a further effort to

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Donald H. Wilson

the inner table of bone is thin enough to be depressed by a septal elevator or dissector. The disc can then be snapped out by using a periosteal elevator as a lever ( Fig. 4 right ). With reasonable care the dura will not be nicked. The brain has not been lacerated in any operation. At the end of surgery, the bone disc is replaced and fixed by two No. 32 stainless steel wires. Appropriate holes are drilled in the bone at the time of disc removal. The scalp is closed in two layers with silk sutures. The skin sutures are not cut but serve to secure a stent over the

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Jiro Suzuki and Takehide Onuma

have been studied by Yodh and Wright, 5 who found it much superior to the methyl-alpha-cyanoacrylates, with less toxicity and greater tensile strength. In our microscopic studies, the tissue reaction was slight. In 1940, Smith 4 used soluble dextrose rod as an internal split to simplify the suturing in vascular anastomosis, but there seemed to be much technical difficulty. Recently Ota, et al., 3 applied a soluble gelatin stent in vascular anastomosis using plastic adhesive. This stent was made of gelatin and heparin, but, as they stated, it swelled before

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Joseph C. Maroon and R. M. Peardon Donaghy

use. The venous graft required a more delicate technique. Immediately before removal, 8-0 marking sutures were placed proximally and distally in the hemisected anterior venous wall to mark the longitudinal position. A small polyethylene catheter was then gently inserted into the distal end, and the graft was irrigated with the heparinized saline and procaine solution to remove blood clots and also to check for leaks. The catheter was then threaded through the entire vein to serve as an internal stent and to prevent later twisting and rotation. To avoid the

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Sagittal sinus repair

Technical note

R. M. Peardon Donaghy, Lester J. Wallman, Martin J. Flanagan and Mitsuo Numoto

✓ A technique for reconstructing a venous dural sinus lacerated beyond the point of simple patching is described. The procedure involves immediate implantation of a vascular T-tube which is later replaced by an intima-lined stent. The method makes possible sinography and aspiration of clots, and a rapid replacement of continuity of blood flow.

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Harold P. Smith, John M. Russell, William H. Boyce and Eben Alexander Jr.

  (bilateral in 6)  reflux 3  hydroureter 2  pyelocaliectasis 2  nonfunctioning kidney 3 Operative Procedure The ileal loop diversions were classically performed with a short segment of terminal ileum normally supplied by two vessel arcades. The proximal loop was closed with two layers of absorbable catgut. The ureteroileal end-to-side anastomoses were performed with chromic catgut, and the ureteroileal anastomosis was placed retroperitoneally. Stents were usually left in each ureteroenteric anastomosis for 72 hours. For

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Milton D. Heifetz

of involving the opposite wall of the vessel, decreased trauma to the intima, and the elimination of the need of an internal stent. Operative Technique After the end stay sutures have been placed, it is usually easier to first suture the far side of the anastomosis ( Fig. 2 a ). The microfork is first inserted within the lumen of the cortical vessel. One then slightly elevates the edge of the vessel wall, which immediately separates the two walls of the vessel. Then locate the point for needle insertion and insert the needle while opposing its downward thrust

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Akira Hakuba, Choon Woong Huh, Satoshi Tsujikawa and Shuro Nishimura

sagittal sinus with venous or arterial autogenous grafts. Several clinical cases involving repair of a traumatic injury of the sinus with autogenous vein graft have been reported. 3, 6, 7, 9, 11 Donaghy, et al., 3 recommended a two-stage operative procedure to repair a traumatic injury of the sinus. The first step is immediate implantation of a vascular T-tube for making possible sinography, aspiration of the clot, and a rapid restoration of continuity of blood flow; at the second stage, the T-tube is replaced by an intima-lined stent. Kapp, et al., 6, 7 recommended