. Manual of operative surgery. served its purpose. With very fine silk sutures (vaselined) on fine roundneedles stitch the sac on one edge of the groove (using healthy tissue) to the cor-responding edge on the other side of the groove, over the catheter. Extract MACE wens operation 831 the catheter and tighten the sutures. If an extra stitch seems indicated, insertsuch. Slowly remove the elastic constrictor (or temporary hemostatic agent).If any bleeding takes place at the line of suture, stop it by one or more extrasutures. Obliterate the rest of the sac as in the obliterative operation. W. J
. Manual of operative surgery. served its purpose. With very fine silk sutures (vaselined) on fine roundneedles stitch the sac on one edge of the groove (using healthy tissue) to the cor-responding edge on the other side of the groove, over the catheter. Extract MACE wens operation 831 the catheter and tighten the sutures. If an extra stitch seems indicated, insertsuch. Slowly remove the elastic constrictor (or temporary hemostatic agent).If any bleeding takes place at the line of suture, stop it by one or more extrasutures. Obliterate the rest of the sac as in the obliterative operation. W. J. Frick and the author have each performed this operation using catgutas recommended originally by Matas instead of vaselined silk, in both cases theaneurysm was cured, but as the ankle pulse was not to be felt either before orafter the operation there is no proof as to the success of the reconstructionof the artery. Personally, the author thinks that obliteration of the vesselprobably occurred due to the kind of catgut Fig. 993.—(Matas.) Fig. 994.—(Matas.) When applicable, the author believes one or other of the methods of Matassuperior to all others in the treatment of aneurysm. Macewens Operation.—In cases of otherwise inoperable aneurysm Mac-ewen has endeavored (successfully in some cases) to assist nature in forming awhite blood-clot on the walls of the sac. The operation consists in pushinglong, delicate, finely polished steel pins, like ladies hat pins, into the sac andthrough its cavity so as to touch but not penetrate the inner surface of the sac onthe opposite side. The current of blood acting on the pins, makes them quiverand continuously scratch the intima. On the scratched intima a firm whiteblood-clot is deposited which may become organized and result in a recommends that the scarification be carried out for about ten minutesat one spot and then that the pin be partly withdrawn and applied at anotherpoint. In large aneurysms several pins
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