The technic of end-to-end arterial anastomosis : with report of a case / by Albert Ehrenfried ... and Walter M. Boothby.

  • Albert Ehrenfried
Date:
1911
Catalogue details

Licence: In copyright

Credit: The technic of end-to-end arterial anastomosis : with report of a case / by Albert Ehrenfried ... and Walter M. Boothby. Source: Wellcome Collection.

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    Eck, investigating the physiology of the liver, performed in 1877 successful lateral anastomoses between the vena cava and the portal vein of dogs. His technic resembled that of lateral intestinal anastomosis, except that the anastomotic openings were not made until all the stitches had been placed. He used for this purpose a pair of fine scissors, to each tip of which was soldered a length of silver wire terminating in a curved needle. After the posterior line of sutures had been made, these needles were passed through the vessels (one the vena cava and the other the portal vein) at points determining the length of the incision. The anterior line of sutures was then placed, the scissor-blades were pulled into the vessels by means of the wires, and the veins cut between the two lines of sutures. This technic was improved by Stolnikow (1882), Hahn, Massen, Nenchi, and Pawlow (1893), and others, and the subject of Eck fistula forms an important chapter in blood-vessel surgery. Von Horoch in 1888 tried to sew together the ends of an artery which had been cut across; he was unable to accom¬ plish this without interfering with its patency. Robert Abbe, 1894, of New York, was the first to successfully perform end-to-end anastomosis; he divided the abdominal aorta of a cat and “tied each end over a glass bobbin by a fine silk thread, and tied the ends together.” Queirolo and Masini, working on the Eck fistula, introduced in 1895 an appliance consisting of a tube of glass through which one cut end of the artery was threaded and cuffed back and then invaginated into the other end and held in place by a ligature. Nitze in 1897, demonstrated a similar anastomotic aid made of ivory, and Von Karltrew working also on the Eck fistula, improved the technic of its use in 1899. Payr in 1900, apparently without knowledge of the above methods, described in detail two appliances made of an absorbable material (magnesium) ; for a short time Payr’s protheses were quite popular, and from one form, similar to that of Queirolo, the Crile cannula has developed. While these men were perfecting anastomotic aids Murphy,
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