Giant Fusiform Aneurysm by Circumferential Wrapping with Sutures-Reinforcement

Adirect intracranial operative approach with clipping the neck of the aneurysm is generally considered to be the ideal treatment for the intracranial arterial aneurysms. Several strategies exist for treating unclippable aneurysms. Intravascular techniques, proximal occlusion of the parent artery or trapping of the aneurysm, microsurgical bypass of the involved arterial segment, and reinforcement or wrapping of the aneurysmal wall are frequently used. The authors report a case with long term(6 years) follow-up results of the circumferential wrapping with sutures-reinforcement for giant fusiform aneurysm of the internal carotid artery. The giant fusiform aneurysm and ideal wrapping materials were discussed with review of literature.

Treatment of Fusiform Intracranial Aneurysm by Wrapping with Suture-Reinforcement: Technical Note

Several strategies exit for treating unclippable aneurysm, including intravascular techniques, proximal occlusion of the parent artery or trapping of the aneurysm, microsurgical bypass of the involved arterial segment and reinforcement of the aneurysmal wall. Reinforcement or wrapping is frequently used when the other techniques are thought to be unsafe. We report a technical modification of the traditional wrapping technique for treatment of the fusiform aneurysm of the internal carotid artery, which includes reinforced Daron-patch with traction sutures to the adjacent to prevent aneurysmal rupture and further expansion.

Experimental Scleral Grafting with Dacron Patch

We conducted experimental studies to evaluate the possibility of Dacron patch for artificial sclera and to gain basic data for practical approach. Forty eyes of twenty rabbits were randomly assigned to experimental or control eye in both eyes. The lamellar-thickness scleral resection was performed and followed by implantation of Dacron and homologous scleral patch respectively. We examined them after one, two, four and 12 weeks. Grossly adhesion of Dacron patch was stable after four weeks. Histologically Dacron graft evoked an outer capsule and a well-vascularized granulomatous foreign body reaction. There were fibrous and vascular ingrowth securety anchored graft to bed and adhesion was uniform and firm throughout the tissue. Attachment of homolgous graft to bed was poor after 1 week but stable after two weeks. Dacron patch appears to be a good alternative to homologous sclera for scleral reinforcement.