Reactions of rabbit brain and peripheral vessels to plastics used in coating arterial aneurysms.

M ANY techniques have been applied to the surgical treatment of intracranial aneurysm. Hypothermia, hypotensive drugs, and hypertonic solutions for reducing brain volume have helped the surgeon, but some aneurysms cannot be clipped, ligated, or trapped because of their configuration. Muscle and gauze wrapping techniques have been used for a long time, but are now being replaced with synthetic adhesives.4,6, s, 9,12,17.21--27 Many different types of adhesives have been used experimentally and clinically. Ideally they require ease of application, rapid setting, and security of adhesiveness even in a moist environment. They should withstand elevated blood pressure and should be nontoxic. Untoward effects of Eastman 910 adhesive and monomer (methyl 2-cyanoactylate) have been reported on various occasions;3~ nevertheless there have been a number of reports of their successful use in the treatment of intracranial aneurysms. ~8,17 Histologic preparations have revealed epineural inflammation, increased vascularity and giant cells, destruction of neural tissue, thrombosis of small vessels, necrosis of arterial wall, as well as aneurysm formation. Other clinically applied synthetic adhesives include Selverstone's mixture (polyvinyl polyvinyledene chloride and epoxy polyamide resin), 21,24 Pudenz's mixture (Silastic RTV.502), 2~,27 Aneuroplastin (methyl methacrylate), 1~ Ad/Here (methyl alpha-cyanoacrylate), is and Biobond ("EDH adhesive"; a mixture of polyisocyanate and nitrile rubber with a small amount of methyl 2-cyanoacrylate monomer in a nitro-methane solution).l~, 25 Investigations of separate adhesives have been noted in individual reports. Our current investigation was directed toward comparison of seven such adhesives under similar conditions.