The practice of surgery . becleaned out and the damaged artery re-paired; while in the case of fusiformaneurysm, all the arterial openings maybe closed without subsequent ill effectsso far as present knowledge teaches. Ina few selected cases of fusiform aneurysmit is possible to restore the arterial trunkby stitching up the sac so as to leave behind a channel. Progressivesurgeons with enthusiasm have followed the lead of Matas. More than80 cases of his operation have been reported with resulting cure ofthe aneur^^sm, preservation of the limb, and avoidance of gangrenein nearly all the cases. W
The practice of surgery . becleaned out and the damaged artery re-paired; while in the case of fusiformaneurysm, all the arterial openings maybe closed without subsequent ill effectsso far as present knowledge teaches. Ina few selected cases of fusiform aneurysmit is possible to restore the arterial trunkby stitching up the sac so as to leave behind a channel. Progressivesurgeons with enthusiasm have followed the lead of Matas. More than80 cases of his operation have been reported with resulting cure ofthe aneur^^sm, preservation of the limb, and avoidance of gangrenein nearly all the cases. We are justified in asserting, therefore, that 1 Ann. Surg., February, 1903; soo also Medical News, Philadelphia, October 27,1888, in which Matas described his first successful case, though he did not at thattime propose suture as Ihe routine treatment of Pig. 492.—Aneurysmorrhaphy:Final stage of operation. Thewalls of the aneurysm sac andthe integuments are sutured tothe floor of the sac over gauzerollers, thus firmly approximat-ing the former to the latter (Bick-ham, modified from Matas). ANEURYSM 791 Matas operation is the operation of choice whenever its performance ispossible. The standard text-books discuss sundry other methods of ligationof arteries for aneurysm—Anels method, which consists in placing asingle ligature immediately above the aneuiysm; Brasdors method,the ligation of the artery immediately below the sac; and Warchopsmethod, the ligation of the highest main branch given off below thesac. The last two methods may be our only resort in the case of certainaneurysms deeply placed and difficult of access—innominate aneurysm,for example, for which one might be forced to tie the subclavian, thecommon carotid, or both. When all is said, however, our operation ofchoice must be by Matass method or by excision. KALEVIMAG
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
