Patching of Intracranial Internal Carotid Artery in Man Using a Plastic Adhesive (Eastman 910 Adhesive)

Abstract

I NTRACRANIAL arterial hemostasis has undergone considerable evolution from the first muscle stamp to the present silver clip and cautery. These latter methods, however, do not permit reconstructive vascular surgery, such as closing of an accidental or elective artcriotomy (or venotomy), endto-end anastomosis, or by-pass graft. The difficulties of intracranial suturing have been discussed in a previous publication; 6 essentially, they are inaccessibility of the vessel, inability to rotate the vessel because of minute perforators, thinness of the wall of the vessel because of difference in structure from that of peripheral vessels, 2,~z and limitation of the time of occlusion. Certain of these factors may be modified by the use of mannitol or of urea for greater exposure, and of hypothermia to allow for a longer time of occlusion (distal perfusion still requires closure of an arteriotomy after removal of the perfusing tube).