| Objective (1) Try to replace the SSS segment by autologous dural graft in order to eliminate the shortcoming and complication of using the artificial vessel and the autologous saphenous vein. (2) To study the feasibility of reconstructing the superior sagittal sinus (SSS) with EC adhesive (ECA) in stead of traditional method of suture. (3) To find a safe and convenient path by planting drug-pot catheter into the SSS for postoperative administration, following-up, etc. (4) To observe the effect of heparin and warfarin as anti-coagulation drug. In short, by this animal experimental study, for the clinical to find a safe , effective and convenient way to reconstruct the SSS.Methods 10 healthy hybrid dogs with average weight of 15kg, irrespective their sex, were used for the experiment. All cases received craniectomy to expose the SSS thoroughly and carefully trace its way, examine its size, abnormality, branches and so on. Then the digital subtraction angiography (DSA) was performed through the catheter inserted into the SSS at its distant end. Then heparin sodium was administrated through the catheter which was also used as the supporting catheter (SC) when anastomosed. 1cm long segment of posterior 1/3 SSS was emputated and its every wall was measured precisely. Accordingly, the approximately same size dural located at 1.5cm far from the SSS was cut off. It was trimmed and plastied with ECA to be a dural graft, which was anastomosed, also by ECA, with the two end of SSS. Replace the SC with drug-pot catheter and close the incision step by step. In the first 2 days postoperatively, heparin was administrated and from the 2nd day 2.5mg of warfarin was taken daily and last forno less than 2 weeks, but one dog for lw. Then, lw(l dog), 2w(2 dogs), 4w(2 dogs) and 8w(4 dogs) later, the sinus reconstructions were respectively evaluated by DSA and histology.Results All cases were successfully reconstructed, followed-up and uneventful but one died of severe blood loss during the craniectomy in postoperative 6 hours, one complicated with epilepsy and another one with infection. The dog normal SSS strictly walked along the midline, the anterior is narrow and, with the transection of triangle, it became wider and wider posteriorly. The average width of posterior 1/3 SSS was 1.5mm and the lateral wall was 3mm. Its branches were almost all located at the middle 1/3 SSS and the posterior end of SSS was very deep and difficult to expose due to the irregular bone. DSA showed that 6/10 SSS emptied into one side of the transverse sinus (TS), 4/10 into bilateral TS and all showed irregularly. When injected with high pressure, the abundant anastomosis branches joined the basilar veins and other sinuses were very clear to see. The histological feature of SSS was similar with that of the dural except for endothelial cells neatly aligned inside the wall of SSS and the sparse "dural border cells" on the inner surface of dural. Postoperatively, patency was found in 6/9 SSS evaluated by DSA. Histology showed the appearance and proliferation of endothelial cell in the inner surface of the graft at the proximal site of anastomosis in postoperative 1-2 weeks and 4-8 weeks later they covered and aligned neatly and ideally. The drug-pot device used within 9 cases was proved to be convenient and practical. It may be used not only to examine the patency but also to administrate for anti-coagulation, thrombosis when necessary. Thanks to the combination usage of heparin and warfarin there were no thrombosis cases but 3/9 SSS obstructed due to the block of EC A and infection respectively.Conclusions (1) Autologous dural graft used as the replacement of SSS segment is...
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