Plastic Coating of Intracranial Aneurysms with “EDH-Adhesive”

T hE hazards of operation on intracranial aneurysms are well known; for some, there is as yet insufficient technical answer (e.g., rupture of the aneurysm during the exposure). The goal of operation has always been the prevention of repeated bleeding. In the past, the favored technic has been clipping or ligature of the stalk or pedicle bearing the aneurysm and, in most instances, this is still the most satisfactory technic. However, there are broad-based aneurysms whose necks cannot be clipped, and other cases in which at tack on the neck means destruction of a potentially important branch of the vessel. These circumstances are particularly important with aneurysms of the middle cerebral artery, and it is for these sacs that the use of materials for wrapping the aneurysm has been particularly important. Hammered muscle, gauze, and other foreign materials have been used in the past, but there has been no certainty that the wall of the vessel actually would become stronger or less likely to rupture. Various plastic materials have been employed in recent years, including methyl methacrylate (Dutton2), synthetic resins (Selverstone4,5), and silicone polymer (Todd et al3). Handa a has investigated a number of plastic materials, separately and in combination, and reported his results in a lecture at the University of Illinois en route to a formal presentation in Washington, D. C. in 1961.1 Through him and by courtesy of Yoshitomi Pharmaceutical Industries, Ltd. of Osaka, Japan, we have been fortunate to receive samples of EDH-adhesive, which he had found useful. Up to now, we have used this plastic material in 4 humans with intracranial aneurysms.