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Modified method of vascular repair with autologous fascia and synthetic adhesive: an animal experiment.

Subsequent to arteriotomy of the common carotid artery on both sides in rats, the right common carotid was repaired by microvascular suture, and the left with autologous fascia and synthetic adhesive; the results of both types of repair were compared. The rats were sacrificed at weekly intervals for up to two months, and the arteries were examined for patency and histopathologic changes. The initial inflammation and wound healing were similar in both types of repair. Vessels repaired by fascia and adhesive had a prolonged period of perivascular inflammation and formation of a microcyst containing crystallized adhesive. After two months, the vessels were grossly normal showing only mild perivascular inflammation and residual microcysts. Microvascular suture was followed by medial displacement and fibrosis of the wall, resulting in marked narrowing of the lumen after two months. In our series, the results of repair with fascia and adhesive were considered satisfactory, and the pathologic changes were less severe than those reported in the literature. This could be ascribed to the use of a minimal amount of adhesive and of covering the vasculotomy opening with fascia before applying the adhesive so as to avoid contact between the adhesive and the cut edges of the vessel wall. This modified technique may be considered in the repair of intracranial vessels in emergency situations when microvascular suture is difficult or impossible.