Artikel
Excimer laser assisted non-occlusive anastomosis (ELANA) as an emergency option for acute ruptured complex ICA aneurysms
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Veröffentlicht: | 13. Mai 2014 |
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Objective: Complex ICA aneurysms including giant aneurysms are difficult to treat, especially in an acute setting as presented with subarachnoid hemorrhage (SAH).
Method: Analysis of patients operated with an excimer laser assisted non-occlusive anastomosis (ELANA) as an emergency treatment for acute ruptured complex ICA aneurysms between 6/2013 and 11/2013.
Results: Out of 4 patients operated in this consecutive six-month period, 2 patients received emergency ELANA bypass for ICA aneurysms, both presented with subarachnoid hemorrhage and newly diagnosed giant aneurysms. Both patients received a high-flow EC-IC Bypass with interposition of a saphenous vein graft between the external carotid and the terminal carotid artery. The intracranial anastomosis was performed by the use of the ELANA technique: no occlusion of the recipient artery was needed, because of the non-occlusive nature of this technique. The aneurysms have been successfully treated by trapping of the ICA. There was no mortality, postoperative hemorrhage or major persistent morbidity in both patients.
Conclusions: Emergency ELANA bypass surgery is a surgical option in acute ruptured complex aneurysms if other treatment options (endovascular or surgical clipping) are not possible.