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Antisense preproET-1 oligodeoxynucleotide treatment, when combined with clot lysis caused by rtPA, reduced vasospasm in the canine model of SAH, and this effect appeared to be related to reduced ET-1 synthesis. The results of this experiment support a causative role for ET-1 early in the course of vasospasm development in dogs. The apparent additive therapeutic effects of antisense and fibrinolytic treatments could be due to clot lysis, which allows better delivery of oligodeoxynucleotides to arteries within the subarachnoid space.

As a result of this small study, we determined that clip closure of carotid arteriotomies was feasible, but it remains questionable whether the increased speed of a sutureless closure is clinically important for this procedure. Concerns regarding the strength of clip closure of an endarterectomized vessel and the cost of clip closure compared with standard suture techniques suggest that there may be no clinically significant benefits of arterial clip closure over suture closure after carotid endarterectomy, and there is potentially some risk.

Abstract:A twenty-eight year old woman presenting with subarachnoid hemorrhage was found at angiography to have a left anterior cerebral-anterior communicating artery aneurysm. Also identified was a fenestration of the right supraclinoid internal carotid artery with an associated accessory middle cerebral artery. This appears to be the second reported case of fenestration of the intracranial internal carotid artery. Fenestrations of cerebral vessels and their possible embryologic origins are briefly reviewed.